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Ep10: Brent Vaughan CEO, Cognito Therapeutics

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DOCSF 2021

Transcript

0:03 Eugene Borukhovich   

Welcome to the Digital Therapeutics (DTx) Edition of Digital Health Today, and I’m your host Eugene Borukhovich. In the last episode, I thoroughly enjoyed speaking with Ed Cox, who was CEO of Dthera, a DTx company that focused on Alzheimer’s, and is currently serving as EVP and Global Head of Digital Medicines at EVERSANA.¬†

Today, I’m speaking with none other than Brent Vaughan, another early pioneer in the DTx space, who also straddled both sides of the equation as an entrepreneur at Cognoa and now Cognito, and a venture capitalist at Morningside Ventures. But before we dive in, Brent and I crossed paths for sure while I was still in New York City and he was CEO and co-founder of WellnessFX. But my declining cognitive function does not remember the actual moment. Nevertheless, I thoroughly enjoyed getting to know Brent, and I can tell his neurons are constantly firing as a deep thinker but, more importantly, as a do-er in this industry. And now we‚Äôll jump to my conversation with Brent Vaughan.¬†

I am here today with Brent Vaughan, the CEO of Cognito, but I will let him explain who he is and his background. So welcome.

 

1:19 Brent Vaughan  

Thanks a lot. Thanks for having me. Yeah, so I’m Brent Vaughan, I’m the CEO of Cognito. My background is coming up with leading product and business development in biotech, pharma, and device.¬†

My foray into the digital therapeutic side of it started when I was working in a translational medicine company a number of years ago. A friend of mine had built the consumer side of WebMD, and decided that we could build WebMD for healthy people. Those brainstorming and whiteboard sessions turned into me joining as co-founder of WellnessFX, where we built a direct consumer diagnostic and telemedicine platform and stood that up in 46 states before selling it to one of the players in the nutrition space. 

And from that, I was able to be at the right place and meet the scientific founder and be the co-founder of Cognoa, which we built into one of the leaders in the digital therapeutic space with two breakthrough designations for DTx products. The lead product, which will be the first diagnostic device hopefully approved, allows primary care physicians to diagnose autism. That seems to be at the FDA now. 

So my background is really on the product side, looking at where novel technologies can meet unmet medical needs. Filling that gap in ways that people haven’t done before– that’s the thing that I find fun.



2:35 Eugene Borukhovich  

Amazing. And now I know before the recording we were talking about where we actually met, because to me, this podcast is about digital therapeutics, but it’s also very much about the individual. I think we mentioned WellnessFX, and it just connected the neurons that I was still in New York back then; I think we might have interacted with that, because I was looking at WellnessFX for Health 2.0. That took us down memory lane. So let’s go back to the early days, especially when you joined as a co-founder of Cognoa. What was that experience like? I don’t even think ‚Äúdigital therapeutics‚ÄĚ as a term really existed– at least not to the extent that we know now. What was that road like?¬†

 

3:20 Brent Vaughan  

Yeah, it didn’t really exist. I know a lot of people claim ownership over things, but as far as I can tell, I think Sean Duffy– who was just starting Omada down the street from us in San Francisco– I think he’s the one that maybe pioneered it. And I think Eddie [Martucci] and the folks at Akili, as well as Corey [McCann] and his team at Pear [Therapeutics] kind of made it famous. But yeah, nobody knew what we were. I still remember after we sold the company, I had a couple of venture capitalists who had passed on a round come back to me about a year later and say, ‚ÄúGeez, if you brought WellnessFX to us now, we would invest!‚ÄĚ What we figured out was how to build was a concierge MD squared, or MDVIP service at an Amazon storefront price. And had we been perceptive enough to explain it with that one sentence, we might have grown into a bigger company instead of selling it.

 

4:09 Eugene Borukhovich   

Yeah, listen, sometimes it’s just timing. Sometimes it’s the wording. And I’m a big believer that while grit has a lot to do with it– and hard work– sometimes it’s luck as well that is a part of the equation.¬†

 

4:22 Brent Vaughan  

All of the teams that I’ve built have heard me say many times, ‚Äúit’s usually better to be lucky than good. And you should try to aim to figure out how to be both.‚ÄĚ But I think some of the things that we learned there– first in digital health and digital medicine, digital therapeutics hadn’t really been coined– you’ve seen how the industry’s evolved a little bit.¬†

We started with business-to-consumer (B2C). We built a B2C marketplace for people to have in-depth diagnostic panels and be more engaged in managing your health. We saw a few things; healthcare investors were wary of B2C, because when you tell the consumer that it is not covered by insurance, it makes your product an inferior good in a lot of people’s minds. So you end up having to spend more on acquisition, because it’s B2C, and at the same time, you have to take a discount on price because you’re not covered by insurance, irrespective of the quality of your product or service. I think that that was kind of key.¬†

One of the other things that we really learned around engagement was when the chief medical officer that I that I brought in– when we were talking about how to get people to be more engaged and science- and fact-driven engagement around managing their health–he said, ‚ÄúListen, it’s not that patients aren’t smart enough to understand this. It‚Äôs that we have spent decades in the healthcare industry coming up with language that is purposely inaccessible to patients.‚ÄĚ Yes, we have an education deficit, but it’s not an intelligence problem– it’s a communication problem. And it starts on the healthcare side. Now, I thought that was really powerful. And even though I focused on the prescription digital therapeutics side since then, I’ve tried to remember that. There are some people that have done well in B2C, like [inaudible], the big health group– they‚Äôve done a great job over there. But the future of how we think of our learnings from digital health and how it applies in a place like digital therapeutics is that we need to think more like ‚ÄúB2B2C‚ÄĚ; in our case that middle B is the doctor. So it’s B2D2C.

 

6:25 Eugene Borukhovich  

Those are amazing lessons. I think for DTx– and the fact that we talk about consumerism in health care and health– it’s still not quite there. And to your point, there are companies that are succeeding in it, and some of those lessons you took to Cognoa. I know you handed off the keys a little while ago, so I don’t want to dwell on Cognoa. But I want to still dive into that journey inside Cognoa, as you guys were trailblazing this as a prescription digital therapeutic. Some of the discussions that you were having and lessons learned you brought to Cognito, which we’ll get to later.

 

7:08 Brent Vaughan  

¬†Yeah, when we started that it was eight years ago. So a few things. We did spend some time trying to understand whether or not it was going to be a D2C versus a prescription. There are right answers on both sides, so we really started to understand who our decision makers were– parents concerned about their child’s developmental trajectory. This is a pretty serious subject, right? This is something that you want to have a pediatrician engaged in the conversation. Ultimately, that drove us to much more of a prescription- and physician-mediated kind of solution, and I think that made the most sense there. I think that that was one of the real key learnings.¬†

And I think true improvements in healthcare improve outcomes, lower total system costs, and increase patient engagement. When we learned that mantra, back when I was at Lilly, that last point about engagement wasn’t part of it. It was just ‚Äúimprove outcomes, lower costs.‚ÄĚ So I think that if you look at people in the DTx and therapeutic device space that are doing well, the ones that have that involvement have a strong UX voice early on. That’s how you preserve that voice of the patient while still developing a prescription regulated product.



8:33 Eugene Borukhovich  

¬†Agreed. And so what led you to Cognito? I know you spent some time in Morningside as well, as a VC, and I know that they’re an investor in Cognito. So maybe touch on your VC experience and what made you join Cognito now?

 

8:49 Brent Vaughan   

Sure. So Morningside had been our lead investor at Cognoa and I developed a relationship with them over six years. When we handed the company off to the new CEO, to start to drive the commercial phase of the company, I got to move to the Morningside side and really take point on doing diligence and looking at companies in the digital therapeutics space, as well as the AI and machine learning platforms in healthcare (because Cognoa was built on an AI machine learning platform). So that was fun, I got to see a lot of different things. And having been on the other side so many times, I tried to always be responsive and have empathy for folks that were presenting to us. But as I was doing that, I started to see what I thought were some macro trends; sometimes you need to take a step or two away from things, you need a little distance, to gain perspective. 

Being able to step out of the day-to-day of Cognoa and all the things that we had going on, I started to look at the landscape. It became clear to me, I had this moment– alcoholics call it a ‚Äúmoment of clarity‚ÄĚ– I had this moment where I could see what the next generation of digital therapeutics was going to be.¬†

Briefly, if you look at the first wave of digital therapeutics and digital health, a lot of those were adherence and compliance companies. It wasn’t a great business model– I have to put digital in front of it. And the next wave that came along were people that were trying to improve outcomes. But we’re trying to take efficacy risk off the table a priori, so that became ‚Äúappified‚ÄĚ cognitive behavioral therapy (CBT) companies, which take behavioral therapy that has been shown to work and make it more standardised and more easy to distribute. That’s not really a technology/innovation play so much. I think that Pear has made great grounds there, and they‚Äôve really helped shape a marketplace, but I think those products are becoming commoditized quickly. It’s going to be really hard to start another Pear. I would not invest in that.¬†

But looking forward, I started to seeРespecially in CNS, but I could see it in some other areasРthere was an opportunity for digital therapeutics or therapeutics and devices to have drug-like mechanism effects that could actually create protein level changes and drive disease modification. You could do it in a way that, when you finish your human proof of concept, you have what looks like a Phase 2 dossier with a drugРyou could have a mechanism of action that is de-risked and validated through translational medicine studies, just like a drug. Your goal is not to be an adjunct or in a compliance crutch to some other therapeutic, but to be a therapeutic intervention that would go head-to-head with approved drugs in the space. 

So that’s what I saw, and I started actively looking. One of the companies in Morningside‚Äôs portfolio was Cognito, and I saw there was the chance to have what I was referring to as ‚Äútranslational digital therapeutics companies,‚ÄĚ which is a horrible name, and no one will ever use it. But that‚Äôs what I was thinking and that was the thing that I was most excited about. I spent a lot of my time looking specifically for that; in Cognito, I found a company that had all the pieces there and was on the cusp of being able to tell that story. So I stepped in and I was lucky enough to come in and have a great team in place and technology that I thought we could start with to get over that threshold.

 

12:31 Eugene Borukhovich  

Part of this podcast is also trying to demystify for consumers and health consumers what digital therapeutics is. Maybe you can walk us through that experience of a patient on Cognito. As you guys get rolling and commercialising, what does that experience look like from a human behaviour perspective?

 

12:52 Brent Vaughan  

Yeah. To back up just a bit, I think part of what’s mystifying or confusing about digital therapeutics is that it’s a protean term that can mean most anything, so it’s really contextual. I think for us, it’s very specific. We have hardware and software that allows us to replicate the technology that was first developed by our scientific founders, Ed Boyden, and Li-Huei Tsai at MIT.¬†

They showed that you can start to activate the immune system of cortical neurons, as well as provide direct neuronal stimulation. There are different ways you can think about trying to activate neurons, but what they figured out was if you do an EEG and you look at a patient– they started this in animals– if you look at brains that have more advanced Alzheimer’s pathology, the neurons don’t fire at some of the frequencies that you normally would see. They found that when they added signals or stimulation at gamma frequency, the neurons start to fire in concert with it, and you start to get what’s called entrainment; different parts of the brain start to fire together in concert. It turns out that this is one of the things that stops happening as you advance the pathology of Alzheimer’s. They looked at different modalities. In my past, I worked in companies developing novel drugs with Alzheimer’s, and one of the first hurdles you have to overcome is the blood-brain barrier. How can you get the right amount of drugs into the right place? What they discovered was you can get direct access to the prefrontal cortex by using the auditory cortex and the visual cortex, instead of trying to put a drug in through the bloodstream and ultimately get across the blood brain barrier.¬†

So we provide modulated frequency and intensity of light pulses and auditory pulses, and we use software to control how we deliver them. They start to stimulate those brain cells and the brain cells do two things as they start to fire at these gamma frequencies and start to entrain. It changes chemokine and cytokine expression and upregulation and downregulation across these cells, which turn on the immune response. Microglia activationРwe start to clear a-beta and tau without having to shove an antibody in there to do it. 

If you’ve been around neurologists (and CNS), neurologists always like to talk about cells that fire together, network together, and having this entrainment– getting these neurons to fire together– they start to network together. We will be able to show both in animals, and recently in man, fMRI that show we’re improving an increase in the functional connectivity between areas of the brain. We modulate the biology of these cells and have an on-mechanism effect that creates protein level changes; we just do it through the visual and auditory cortex instead of through a drug.

 

16:01 Eugene Borukhovich   

Got it. Is it an app? So from a pure user experience–

 

16:09 Brent Vaughan  

From a user experience, it’s a device that the patient can use at home. Our most recent clinical study was 12 months on therapy. Patients did this on a daily basis at home with their home care provider, which is oftentimes a family member. They’re able to sit at home, able just to have a device that they can wear at home that provides the light stimulation and the auditory stimulation.

 

16:31 Eugene Borukhovich   

Gotcha. It’s interesting that Cognito was already in the portfolio; we had Ed Cox on one of the previous episodes, and the Alzheimer’s space is tough. It sounds like you’ve been through the paces on the molecular side. It’s a big problem to solve. But you’ve seen the passion– it‚Äôs just exuding. So, why still Alzheimer’s? I know it’s one of the toughest problems to solve out there, both in molecular and non-molecular, but what makes you think you can do it again?

 

17:00 Brent Vaughan   

Yeah. You know, in the world of drug development, all of the therapeutic development and low-hanging fruits have been grabbed; it’s all been solved. We’re really good at emergency medicine, we’re pretty darn good at infectious disease. But there are some things that we’re getting better at bad build indications for (people that have genetic constructs); we treat those, and the rare disease folks are good at focusing on those. But the chronic diseases of ageing and the diseases of ‚Äúwearing out‚ÄĚ are the big challenges: cardiovascular disease, Alzheimer’s, multiple sclerosis (MS), and autoimmune conditions fall into that. I think there are two types of people; there are people that would rather make an incremental change with a lower likelihood of failure, and there are people who want to try to fix the things that stymied others. And that’s what attracts me.

 

17:55 Eugene Borukhovich   

I get a sense of which bucket you fall in. That’s good. 

 

18:01 Brent Vaughan  

So Alzheimer’s– I think when you see major pharma companies dial back and exit basic CNS research, this is a huge problem. Nobody can replace what a pharma company that was spending a billion dollars in the space was doing. So I think continuing to work against these is how we ultimately solve these problems. And our understanding of the etiology of these diseases continues to increase. Biogen is doing great things. And if you look at what [inaudible] is doing, if you look at what Lily is doing, even though the outcomes are sometimes one step forward, one step back, our general understanding of etiology and how to address it is progressing. I fervently believe that these things are solvable, and a technology that we’re applying towards it was technology that no one had thought to try before.

 

18:46 Eugene Borukhovich   

So since you mentioned pharma, I think you may or may not know, I spent a couple of years in a big pharma company–¬†

 

18:46 Brent Vaughan  

So did I, I’m recovering.¬†

 

18:55  Eugene Borukhovich  

I lost all my hair, I keep joking about that. But I think, to me, it’s an interesting relationship (as I was trying to push quite a lot in the DTx space)– the DTx companies getting to know the end consumer and the tremendous amount of data points and all of that. The dilemma is, is it DTx companies with the knowledge of the consumer that will swallow the pill? Meaning, there might be an additional molecular treatment for your ultimate DTx? Or is it pharma companies that will swallow DTx companies as an add on? Or is it on the spectrum? I’m just curious where you, Brent– because you’ve been leading and trailblazing this– where you think that falls in?

 

19:44 Brent Vaughan   

Yeah, I think it depends on what the indication is that you’re trying to address. In the same way that I spoke about whether you end up being prescription or a B2C, it depends on if you’re trying to deal with insomnia versus trying to diagnose autism or slow the progression of Alzheimer’s. I think they have different places.¬†

For us, I’m jaded against adherence compliance. I‚Äôm jaded against applifying CBT. I think that with Cognito and the companies that I see being able to plot similar journeys, there is the ability to have drug-like effects and drug-like outcomes. When you think about working with pharma, I think it‚Äôs important not to go in because they’ve got a distribution network you want to leverage or because they can pay for clinical studies that you haven’t figured out how to raise money for. Go into a true co-development relationship, where you say, ‚ÄúListen, we have a mechanism of action that can affect disease modification. And we have no drug-drug interaction.‚ÄĚ We can look at true combination therapies in the way that a Gilead would have thought about it.¬†

So I think there are different slices. Will there be a slice for people to do adherence compliance? For sure. And there will be a slice for people that are ‚Äúapplifying‚ÄĚ CBT, but those are just not the ones that I’m excited about right now. I think the only problem is if you misunderstand what segment you’re in, because then you can waste time and money and maybe not be successful, because you’re tilting at the wrong windmill.

 

21:20 Eugene Borukhovich   

Well it’s time for a question from my journalistic partner on this podcast, Brian Dolan, who is the founder of Exits & Outcomes, and– as I like to call him– the digital health detective. Let’s see what question Brian has for our guest today.

 

21:35 Brian Dolan  

The last time we spoke, Brent, you outlined an evolution of digital therapeutics that I hadn’t heard before. And it resonated. If I remember, right, you talked about the early digital therapeutics, really being medication focused trying to help people take their meds. And then it evolved into appified coaching, which might be one way to think about the current crop of CBT-focused digital therapeutics companies. And then the third category, which is emerging today, is a category that Akili and your old company Cognoa– as well as your current company, Cognito– are in. Can you explain this third category? How is it different from CBT? And can you explain it in a way that those of us who majored in philosophy can understand it?

 

22:20 Brent Vaughan   

Great, thanks, Brian. That’s a great question, and I’m happy to expand on it a little bit. I was actually a minor in philosophy. I was one class short of being a double major in biochemistry and philosophy. So there you go. And I might argue that some of the philosophy classes have served me better in many companies than being a biochemist.¬†

To expand a little bit on how I think about the different categories of this next generation of digital therapeutics– when I talk about drug-like mechanisms, it’s not that I’m married to the idea of a drug or therapeutic. But we’ve all come to accept this idea that drug therapeutics, whether it be biotech or pharma, have a target that they modulate, and that target modulation yields an on-mechanism effect. And for anybody who’s worked in biotech and pharma, when you say target modulation, and on-mechanism effect, they know exactly what you’re talking about. So we see our target modulation when we have an EEG patient, and we flip the switch and add our stimulation, and you can see the gamma entrainment and the coherence start to build across parts of the brain– literally like turning a light switch. We know we are modulating that target, and we know that our therapeutic is getting in. It would be the same as if you gave someone a tyrosine antagonist, a receptor antagonist, and you were able to see the change in the modulational receptor. And then we think about on-mechanism effect. This is where I think this generation of digital therapeutics is going to be able to distinguish themselves.¬†

I think it’s important to use translational biomarkers. We use PET, we use fMRI, we use QEEG and use the same tools that a pharma company would use to elucidate a Phase 2 dossier for their therapeutic. If you can tell the story the same way with the same type of tools, then ultimately you should be able to look at the same type of label claim and be able to be valued in a similar way. That’s the exciting future for what I think of as next generation digital therapeutics.

 

24:23 Eugene Borukhovich  

Let me jump in here. This actually brings me to the next futuristic discussion of PDT as a prescription digital therapeutic, and what I think people have been talking about– disease management 2.0. So if you think about the WellDocs, Livongos, and Omadas of the world, where’s your head on it, especially as it relates to this new third translational portion?

 

24:47 Brent Vaughan   

So I think that the Omadas and the WellDocs and the Livongos is a whole conversation. When we started WellnessFX, we were just– we could just about see Omada’s building from our building, we were both down in San Francisco. We started in the early days. I think what¬† Livongo did so well– Glen Tullman and his crew– they figured out execution and scale on the commercialization side. I think that’s quite interesting, in that people have talked for so long about expanding the role of and moving things from specialty care, which is what it was when we all grew up. More and more, you got to the point where all GPs did was refer to specialists, and medical care got more and more siloed, and– if you think about it– less and less patient-friendly. We’ve seen a drive back towards that primary care side, and a bigger push to give more power to influence patient trajectory to nurses and the other non-MD practitioners, which makes a lot of sense; it lowers our cost of delivery, it improves turnaround and immediacy of care, which ultimately should improve outcomes. So it checks all the boxes.

The way I look at it– and I don’t pretend to understand Livongo and Omada’s businesses like they would– that’s really an extension. They’re extending that continuum of care further out of the doctor’s office and more where the patient is every day. I think that that side is quite interesting.¬†

I think that the applifying of CBT, and those types of areas for which there’s not much efficacy risk, they’re just getting too commoditized. When I was on the venture side, I saw multiple companies that were getting stood up in that space. And it was clear to me that some of the big payers and providers were being faced with that build-or-buy decision; instead of investing in an established player, they realised the barriers to entry are not that big, so they’re just gonna build their own. All right, they’ve got the data, they’ve got the patience, and the efficacy risk is low because the data is published. As a business model, it‚Äôs difficult– not that it’s not a valuable intervention. But this digital therapeutic piece on the prescription side– if you start to look more like a drug or a therapeutic device, you fit into the way our healthcare service works. So I think that has more longevity. If you’re starting a company with a completely novel technology or product, that’s exciting. Now if you’re starting a company with a known technology or product, like say movie rentals, but you have a completely different business model and distribution, that’s pretty exciting. Now you start a company with a completely novel product or service and a completely novel business model– I think you just start with a ton of money.

 

27:30 Eugene Borukhovich  

Fascinating advice to the entrepreneurs, hopefully many of them are listening. This brings me back to the experience with your Cognito product also fitting into the existing healthcare system. Obviously, you’re going after it as a prescription digital therapeutic, so it’s clear that doctors are part of that equation– and nurses. I know we talked about the translational piece to the masses of consumers, and I keep saying on this podcast, I hate the word ‚Äúadherence‚ÄĚ because no human being wants to be told they‚Äôre not adherent. When it comes to Cognito specifically, do you look at health coaches, caregivers, and the human to help that patient truly reach their goals? Where do you see the humans in the prescription digital therapeutic?

 

28:23 Brent Vaughan   

Well, I want to go on record by saying that humans are important. But no one likes to be called consumers either, and in the product world, we spent so much time talking about users–

 

28:40 Eugene Borukhovich  

Honestly, my wife– and not this is not about her– but when she was going through breast cancer, she hated to be called a patient. She said ‚Äúit’s only a slice of my life.‚ÄĚ That’s a side note.

 

28:53  Brent Vaughan  

Yes. So when we look at the areas where our mechanism of action can take us, we see great ability to move the underlying pathology of tauopathies– Alzheimer’s obviously being the biggest one to start with. But we’ve already started to show proof of concept in some other tauopathies, and because of this high-level mechanism that can drive neuroimmune responses and networking, we start to look at things like stroke and demyelinating conditions. All of these conditions are things where your ultimate rehabilitation involves some network of caregivers and family. This is what I said earlier, that one of the learnings from digital therapeutics is that companies have learned you need a UX person in the product side early, as opposed to pharma, wherein what you think of as UX is fill-finished packaging and patient instructions. That’s like at the end of Phase 3. We’ve purposely developed our product for a home-based, minimally-invasive intervention that can be supported by the at-home caregiver and family. We think engaging that network, especially when you’re working in behavioural health, or in CNS is really important, because that is ultimately the world around us and how we interact with it. That is part of how we drive our rehabilitation. That‚Äôs quite key, trying to expand those roles.¬†

One of the one of the things that got me at the very beginning, when we we started WellnessFX, is that I believe the idea of infrequent batch delivery of healthcare information– i.e., going to your primary care physician and having them lecture you once a year that you should eat better and lose weight and exercise more– turns out to be a pretty failed communication model. What we see everywhere else is when everyone takes infrequent batch communication and moves it over to higher frequency, smaller-packet information, it’s more interactive; you just get better engagement outcomes. To do that in things like Alzheimer’s, you either need to have a huge care network, which is going to be burdensomely expensive, or you need to figure out how to better engage the people that are part of that environment. To your comment about your wife, don‚Äôt just think about how you would treat the patient, but think about how you’re treating the person. Then that opens up that whole social network and family network around them.

 

31:24 Eugene Borukhovich  

Absolutely. And you know part of this podcast is not just about the technology or the business of it, but it’s actually about the person that I’m speaking to. So we started off with what brought you here, but I also want to finish this off with what’s your ‚Äúwhy‚ÄĚ and what gets you up in the morning.

 

31:46 Brent Vaughan  

Yeah, you know, a little bit of where I started. I get excited when I see novel technologies that can be used to address– I’m kind of a healthcare person. Yeah, it would be fun to think I’m gonna start a company to design a rocket to go to Mars, but somebody’s already doing that. Since I understand a lot of the problems in healthcare, having been around it for a long time, when I see a chance to use novel technologies to solve some of these problems, it gets me interested.¬†

One of the things I saw that helped me solidify this idea of drug-like digital therapeutics that have translational validation was when I first shared this paper with a couple friends of mine; they thought a digital therapeutic that could make protein-level changes sounded a little crazy. I remember reading this really cool paper, and I was on DTx Europe or something, and somebody asked a question. I just went off; only one person in the audience probably cared about my answer. But I saw this paper where some researchers had been using brain stimulation, and they’d looked at electricity. I think this was light-based, and it still required some labelling in the cells. So it was a preclinical model. But you can see the promise there; they used brain stimulation through light, and they were able to recreate the same biochemical dissociative effect in a neuronal cell that you see with ketamine administration. The light bulb went off. Just think if we could have an electronic version of ketamine that we could flick on and off! Think of what that would do for breakthrough pain for cancer patients, for example, for emergency medicine. 

I think there’s this exciting world where we stop using software and hardware technology to prop up or support or make sure people take a drug or measure a drug. Instead, we start using it to say ‚Äúforget about the drug.‚ÄĚ What’s the effect we’re going for? Is there a lower side effect profile way of accomplishing that? This is what people have been asking themselves at Novartis and Lilly and Pfizer for years, and now I think we can start to see ways to do that. I think that’s pretty cool.¬†

 

33:53  Eugene Borukhovich  

Amazing. So I bet you don’t even need an alarm every morning to get up.Thank you for making the time and informing our listeners. It was really a pleasure to get to know you.¬†

 

34:04 Brent Vaughan   

Great, thanks. It’s been an absolute pleasure. I wish I could pop over and have coffee with you in person.

 

34:10 Eugene Borukhovich  

We will come to that day, one day. 

 

34:12  Brent Vaughan  

Okay. Excellent. Great. Well, thank you so much Eugene.

 

34:16 Eugene Borukhovich  

Thanks so much for tuning into Digital Therapeutics Edition of Digital Health Today, a production of Mission Based Media. Be sure to hit that subscribe button to this podcast on your favorite podcast player, so you’re then automatically notified when we post our upcoming episodes, where I speak with dozens of leaders and trailblazers who are forging the path for digital therapeutics. If you’d like to learn more about YourCoach Health, or Brian Dolan’s Exits & Outcomes, you can always find the links to this and more in the show notes for this episode. You can connect with me personally on Twitter @HealthEugene, or follow my journey of writing my first book, Hard Pill to Swallow at hardpilltoswallow.substack.com. I’m Eugene Burokhovich, and catch you next time.



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