Once bullish on digital health, Orexo hits a wall on reimbursement

Excerpt – Orexo, which made almost all of its $60 million in 2022 revenues from U.S. sales of Zubsolv, a drug used to treat opioid use disorder, earned negligible income from its three software-based treatments in the first quarter of the year. On the company’s earnings call, CEO Nikolaj Sørensen attributed this to the company’s ongoing difficulty securing reimbursement for digital therapeutics. [..]

Orexo’s new, careful approach is a stark contrast to the bullish tone the company took when it first dove into digital therapeutics in 2019 and 2020. At the time, Orexo was sitting on millions in Zubsolv profits and looking to the future. It signed a deal with German company GAIA to develop a prescription app to help with medication-assisted treatment of OUD, later named Modia, and to license Vorvida and Deprexis, GAIA’s apps for problematic drinking and depression. [..]

In January, Sørensen reported that “close to 1,000 patients” had been prescribed Modia in the fourth quarter of 2022 and that the company was conducting what it called a billing test to see if it could secure reimbursement and bill the prescribing clinics. He suggested those tests could yield revenues in the first quarter.

Those revenues never showed up, because the process was paused by new leadership. “We took a decision from the senior management that they were not comfortable with the process and they felt that this was going to be very complex,” Sørensen told investors.

A prominently announced deal with North Dakota-based Trinity Health is also stunted. The company figured out a way to secure payment for patient use of Vorvida and Deprexis as part of the health system’s collaborative care programs. But the billing model proved too labor-intensive. Moreover, Sørensen said in January that the software wasn’t seeing much uptake and that the clinicians on the ground felt they needed more support to use the products.

[..] comes amid broader turmoil in the digital health industry as Pear Therapeutics, a direct competitor to Orexo, recently filed for bankruptcy after failing to commercialize its prescription digital therapeutics.

“This is a testimony to some of the issues that Orexo has been facing and all other players in digital therapy in the U.S.,” said Sørensen on the earnings call. “And that’s really around how can we build an efficient reimbursement and distribution model, how do we ensure that we get coverage from the insurance companies.”

Full article, M Aguilar, STAT News, 2023.4.28