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 … Read More

Facing headwinds, Teladoc tests its bet on whole-person care

“In recent months, executives have touted Teladoc as a source for “whole-person care” — a bid to distinguish it from smaller virtual companies addressing only one condition, or those who largely make money by facilitating prescriptions. The company offers primary care, urgent care, and virtual appointments, coaching, and disease management for chronic diseases such as diabetes and for mental health conditions. About a third of patients in Teladoc’s chronic care programs are using more than one — and that number has grown year-over-year and sequentially, executives said during a Wednesday earning call. Earlier this year, Teladoc unrolled its integrated care … Read More

Should we trust Apple with mental health data?

“the new coaching service — codenamed Quartz — sounds like an expansion of the Apple Watch play from physical health to mental health, Bloomberg reported. It is “designed to keep users motivated to exercise, improve eating habits and help them sleep better” using “AI and data from an Apple Watch to make suggestions and create coaching programs tailored to specific users.” [..] About five years ago, I wrote about the various ways that the Apple Watch failed as a behavioral intervention. There’s some behavioral science, but also — because I was using it — I discovered that the constant nudging for achievement made me miserable. … Read More

A research team airs the messy truth about AI in medicine — and gives hospitals a guide to fix it

Excerpt – The challenges uncovered by the project [reviews of AI compiled by researchers at Duke] point to a dawning realization about AI’s use in health care: building the algorithm is the easiest part of the work. The real difficulty lies in figuring out how to incorporate the technology into the daily routines of doctors and nurses, and the complicated care-delivery and technical systems that surround them. AI must be finely tuned to those environments and evaluated within them, so that its benefits and costs can be clearly understood and compared. As it stands, health systems are not set up … Read More

We’ve Had a Cheaper, More Potent Ozempic Alternative for Decades: New weight-loss drugs are getting all the hype, but bariatric surgery is still the “gold standard” for treating obesity.

“Ozempic itself is technically a diabetes drug, but its active ingredient, semaglutide, has been approved by the FDA for weight loss under the brand name Wegovy, and can reduce a person’s body weight by up to 20 percent through a weekly injection. An even more powerful drug, known as tirzepatide, or Mounjaro, may soon be approved for weight loss, and a host of new medications are coming down the pipeline. All signs suggest that America is on the verge of a weight-loss revolution. But for people with obesity, semaglutide isn’t even the most effective weight-loss treatment around—not even close. Bariatric … Read More

Dying patients protest looming telehealth crackdown

“Online prescribing rules for controlled drugs were relaxed three years ago under emergency waivers to ensure critical medications remained available during the COVID-19 pandemic. Now, the U.S. Drug Enforcement Agency has proposed a rule that would reinstate most previously longstanding requirements that doctors see patients in person before prescribing narcotic drugs such as Oxycontin, amphetamines such as Adderall, and a host of other potentially dangerous drugs. The aim is to reduce improper prescribing of these drugs by telehealth companies that boomed during the pandemic. Given the ongoing opioid epidemic, allowing continued broad use of telemedicine prescribing “would pose too great … Read More

Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

“Insomnia is one of the most common sleep disorders, posing a significant public health concern, with an estimated prevalence of 10–30% among adults in the general population. These numbers are greater among patients, with reports estimating 69% prevalence among primary care patients. Insomnia disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders – IV (DSM-IV) as the complaint for difficulty in initiating or maintaining sleep, or restorative sleep for at least 1 month. [..] Depression and anxiety are the most common comorbid mental disorders associated with insomnia which can also exacerbate the sleep disorder. Recently, epidemiologic studies … Read More

Valuable

The New England Journal of Medicine’s Lisa Rosenbaum speaks with University of Pennsylvania’s internal medicine physicians Paula Chatterjee (also a health services researcher) and Atheen Venkataramani (also a health economist and founder of Penn’s Opportunity for Health lab) about the role of values in health care, social determinants of health and what physicians can do to improve U.S. health care. An excerpt of the audio interview: [Rosenbaum] Atheen, I know that you also had a formative experience, I think when you were a resident at MGH. Can you talk a little bit about that and how that experience informed your … Read More

Can A.I. Treat Mental Illness?: New computer systems aim to peer inside our heads—and to help us fix what they find there.

“Roughly one in five American adults has a mental illness. An estimated one in twenty has what’s considered a serious mental illness—major depression, bipolar disorder, schizophrenia—that profoundly impairs the ability to live, work, or relate to others. Decades-old drugs such as Prozac and Xanax, once billed as revolutionary antidotes to depression and anxiety, have proved less effective than many had hoped; care remains fragmented, belated, and inadequate; and the over-all burden of mental illness in the U.S., as measured by years lost to disability, seems to have increased. Suicide rates have fallen around the world since the nineteen-nineties, but in … Read More

Health Care Affordability: Iron Triangle Or Iron Curtain?

“The high cost of health insurance and health care services now affects not only the uninsured but also middle-class Americans with employment-based health insurance (ESI), enrollees in the Affordable Care Act exchanges, and Medicare beneficiaries. A popular concept in health policy discussions is the “iron triangle”: here, here, here, here, and here. These authors posit that it is impossible to increase access and quality of care while simultaneously reducing spending. That idea warrants further scrutiny. [..] evidence suggests that failure to improve affordability is primarily due not to a mathematical “iron triangle” constraint, but an “iron curtain” of stakeholders who are aware of promising alternatives but oppose their … Read More