F077 DTx series 4/5: Want to get rid of back pain? (Mark Liber, Kaia Health)
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MSK are very expensive to treat, as patients need to go through a lot of medical imaging, are in need of pain medications, sometimes surgery is required and physical therapy should be a regular part of treatment, explains Mark Liber, VP of Business Development at Kaia Health. Kaia Health is a digital therapeutics company offering a solution for mitigating musculoskeletal diseases such as chronic back pain. Kaia Health works by offering the user an AI-supported motion sensor guided exercises, which means that an individual not only tries to follow the video instructions but can get feedback if he is executing the positions correctly or not. The app is additionally supported by an actual coach the user can connect with.
Mark Liber.
As explained by Liber, Kaia is very accessible and has shown positive results in clinical studies. In one of the studies, after six weeks, patients using Kaia Health had similar results compared to patients in the control group who used conventional methods. After 12 weeks, however, differences started to appear, with Kaia Health users having better outcomes. They used the app and exercises three times a week. These kind of results are very encouraging since, especially in the current situation with the COVID-19 pandemic, people oftentimes do not have access to physical rehabilitation facilities.
How to aid COPD with DTx
A different frontier Kaia Health decided to tackle next, is pulmonary rehabilitation (PR) for patients with COPD. PR has been taken out of the insurance scheme in the past, but it does work, and by bringing it to patients’ homes could have enormous impact on patients’ health, says Liber. Many patients with COPD are on oxygen therapy, COPD is prevalent in older populations, and though PR, which is a form of biopsychosocial pain management therapy, is effective, only 2% of patients have access to it, elaborates Liber.
German vs. American healthcare consumer
Kaia Health was founded in Germany, and operates there and in the US. Comparing both healthcare system, Liber sees some similarities but also some striking differences. For example, COPD solution will only be available if the doctor prescribes it. In the US, doctors are aware of PR, but capacities for making it widely available are limited. In Germany, capacities are a much smaller problem, but doctors are less aware of PR and need to be convinced about the method’s effectiveness. While in the US, patients are prepared to pay for solutions if they see an increased convenience with the use, German consumers are more sceptical, and trust needs to be earned rather than assumed.
In the current situation, Kaia Health is to many an essential companion for pain management while self-isolating and moving around less in general. Given the spike in telemedicine use during the outbreak, analysts predicted that new consumer habits will have a positive effect on the uptake of digital health even after the crisis end. Liber has mixed feelings about this prediction, explaining that yes, consumer habits are changing, but if everything goes digital, people will need to prioritize, which digital medium they will use in their time - whether it is for home schooling, Netflix or exercise. While times seems promising for digital health, companies will need to be mindful of these kinds of new daily routine habits.
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Some questions addressed:
Kaia health solutions are defined as digital therapeutics, which means the solutions were tested in clinical trials. The results were of the last one were published in May 2019 in nature partner journal about digital health. The title of the paper is App-based multidisciplinary back pain treatment versus combined physiotherapy plus online education. Let’s talk about the findings. Can you compare your trials to drug development trials in terms of length, phases, access to participants? How did you find them?
Almost 500 people applied to participate in the research, but only 101 were chosen to participate because you included only those with lower back pain problems lasting for less than a year. What does this mean for those with longterm problems?
Apart from musculoskeletal disorders MSD you’re developing a solution for Chronic obstructive pulmonary disease (COPD), which is a chronic inflammatory lung disease, the patients are often smokers, and one of its characteristics is that the lung function decreases over time. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Management of the disease with medications is urgent, while at the same time, WHO recommends: practical counselling, social support as part of treatment, and social support arranged outside of treatment, as part of the efforts to mitigate the disease. How is Kaia Health going to address COPD, and what are you again noticing the differences between the care people get in Germany compared to the US?
Are patients in the US more fragmented because of the differences in health insurances and deductibles they might face? How are you coping with the COVID-19 situation?
Kaia Health was founded in Germany with the company quickly entering the US market as well. How are the different approaches to the way those two countries are tackling the pandemic visible for Kaia Health users?
The COPD module could be of great significance in the current COVID-19 pandemic, when it’s crucial for risk groups to be even more attentive to preventative measurements not to catch the virus, and giving them a telemedical solution is the way to go. One of the components of the app is also practising mindfulness. While mindfulness and meditation have proven positive effects on wellbeing, it seems that mindfulness is becoming a buzzword - if almost every app two years ago claimed to have used AI, today, many apps claim to have the mindfulness component. What are observations you’re noticing in the digital health market?
Kaia Health was founded in Germany with the company quickly entering the US market as well. Can you compare the markets in terms of accessibility, healthcare system and consumer habits?
Where do you see Kaia Health and DTx in the whole opioid addiction issue in the US? Opioids are among the pain mitigation medical tools. Have things changed because Germany accelerated its efforts to enable the adoption of digital health solutions and paved the way to make it easier for digital health solutions to be reimbursed by insurance? Are these the only two market for the moment?
You work with some of the world’s largest employers (Coca-Cola), health systems (NCH) and insurance companies. Can you explain how these collaborations look like?
In 2024, the main focus of the Digital Therapeutics Alliance is on reimbursement and education. Efforts are being made to standardize reimbursement processes and increase awareness among providers and patients.