Abhishek Shah’s parents were diagnosed with diabetes just when he was mulling over what kind of healthcare startup he wanted to build. This was three years ago, back when Shah was an entrepreneur-in-residence at Mumbai-based venture capital firm Lightbox Ventures. The predicament of his parents prompted him to start Wellthy Therapeutics, an online disease management tool to help patients manage chronic diseases such as diabetes.
“In an ideal world, great medication coupled with great diagnostics and great user behaviour should result in great patient outcomes. But it just doesn’t happen, for multiple reasons,” Shah, who also dabbled in venture capital for about three years at Ronnie Screwvala’s Unilazer Ventures, told TechCircle in an interview. “There’s a gap in what the theory says and what happens in reality. Our aim is to get into the basics, find what’s missing and boost the real-world outcomes of existing therapies.”
Digital therapeutics, the core of Mumbai-based Wellthy’s business model, is still somewhat unchartered territory in the overall healthcare sector. The premise of the concept is to use digital technologies that leverage the power of data to manage diseases and it primarily propagates healthy behavioural and lifestyle changes. However, unlike wellness, digital therapeutics focuses on delivering clinical outcomes.
Globally, while the concept has made some headway in the US and European markets, it’s still early days in India. Shah’s plan is to bring significant changes in patient outcomes of chronic disease management, one condition at a time. Given his personal experience, Wellthy has picked diabetes to start that journey. The disease affects around 70 million people in India, second only to China which has about 110 million patients.
Patients can access Wellthy’s services through a mobile app that uses artificial intelligence (AI) and machine learning (ML) capabilities to gather as much data as possible to effectively push chronic disease patients into making behavioural and lifestyle changes.
The app acts as a drug companion to help patients establish healthy habits around diet, exercise regime and prescribed medicines. Dedicated health coaches explain the prescribed drugs and diets to patients in a language they understand and offer live feedback. The app also tracks calories, based on the patient’s food intake, and monitors vitals. The data goes to paramedics and doctors for analytics and reports, who can access them on their dashboard for prompt interventions.
“In simple terms, digital therapeutics attempts to make existing healthcare solutions better. We take proven medical interventions which have offered great results in their ideal settings, culturally reimagined it for India, restructured it for this market’s affordability and made sure that the delivery can happen through a smartphone into the daily lives of patients,” Shah said.
As a digital therapeutic solution, Wellthy aims to improve the patient’s self-management skills even before they start managing a chronic condition, enable them to take smart decisions and augment pharmacological therapy with behavioural therapy to boost real-world efficacy.
“We measure the efficacy based on patients’ health improvement. We have two check-points, first at 120 days and then at 365 days. The first month is when we lose a lot of our patients because it isn’t meant for everyone. Our real challenge is to understand the right patients,” Shah added.
The Research Society for the Study of Diabetes in India (RSSDI) endorsed Wellthy as a clinical intervention that can be prescribed by a doctor for Type 2 diabetes in 2016. The company also presented its results at the American Diabetes Association and at the International Conference on Advanced Technologies & Treatments for Diabetes (ATTD 2018).
“The science is already there. We are just improving the delivery system of that science. The delivery is done through a combination of logic, content and communication based on clinical intelligence and behavioural intelligence,” he said.
While most consumer wellness apps take a direct route to their users, Wellthy has adopted a business-to-business-to-consumer (B2B2C). It works with hospitals and clinics, insurers, pharmaceutical companies and medical device makers to reach its potential users.
The startup reaches its users in three ways. It can be prescribed directly by doctors as part of an insurance policy or bundled into a medical device or drug. Doctors in its partner hospitals and clinics decide if a patient should be given companion therapy. They direct patients either to visit Wellthy’s online platform or a pharmacy to get an activation code. It partners with health insurance, life insurance and re-insurance providers to manage the risk of the existing client base and to help them build new and affordable products.
In the pharmaceuticals and device manufacturing segment, the startup has partnered with firms such as Cipla and Roche. While the solution is bundled with Roche’s blood glucose monitoring system Accu-Chek Active in India, Cipla will soon start offering Wellthy with its drugs.
Wellthy has a much deeper relationship with Cipla, India’s third-largest drugmaker. Cipla recently acquired an 11.71 % stake in the startup for Rs 10.5 crore.
Last year, Wellthy raised Rs 13.5 crore in a seed round led by GrowX Ventures and the family office of Ranjan Pai, chairman of Manipal Education and Medical Group. Apoorva Patni-led Currae Healthtech Fund and Singapore-based Beenext Ventures also participated in that round.
Next stop -- managing cardiac diseases
After nearly three years of experimentation, research and development, the company began working with commercial partners this year. It also has extended its offerings to cardiology.
“We will go deeper into these two chronic disease areas -- cardiology and diabetes -- and work with multiple partners for these. We will stick on with these two for now. The plan is to do one new therapy area a year. It takes 12-18 months to develop, test and clinically validate a therapy,” Shah said.
The app is currently available in English and Hindi, and it plans to cover all the major native languages this year.
“We now know that our therapy is improving not just the blood sugar levels, but a lot of elements around it including patient’s happiness, health management skills, and overall quality of life. Positive health outcome is not just metrics, but the feel-good factor that patient gains. Our mission is to reduce, prevent and control the chronic illnesses of 10 million patients by 2025,” Shah added.
Wellthy currently works with over 100 partners, a good majority of them being clinics and hospitals, and a couple of early pharmaceutical partners. The startup plans to expand to a second market in Asia in the next quarter through an insurer.
Digital therapeutics, like many other internet-led business segments, is an unregulated one. While the US Food and Drug Administration (FDA) has taken some progressive steps which make it easier for digital health products to be cleared and approved, India is yet to open up to the concept. While it could be a few years before the regulations come into force in this segment, more companies including big pharma firms are expected to attempt marketing digital therapeutics as a prescription medical treatment for chronic conditions.