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Pear Therapeutics Stock – A Digital Therapeutics Platform

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It seems that mental health has been on everyone’s lips lately. Our MBAs worked like crazy to keep up with what was suddenly a very technology-dominated industry, especially telemedicine. It wasn’t long ago (almost 18 months to be precise) that we first published a list of some of the leading companies offering various riffs on computational cognitive behavioral therapy. Apparently that was just the beginning. In 2020, when the world suffered a collective nervous breakdown, investors invested more than $ 1.5 billion in mental health startups, according to data research firm CB Insights. This year is already well on the way to beating those numbers, with funding reaching $ 852 million in the first quarter alone, up 54% year over year. There are at least seven mental health startups valued at more than $ 7 billion.

Source: CB Insights

In general, many of these companies offer app-based platforms that help people deal with their first world problems, anxiety, and depression using some sort of clinically validated click-thru program. Others claim to have developed AI-powered algorithms to help diagnose or otherwise aid mental health management. Some specialize in meditation and offer content (imagine Matthew McConaughey’s silky voice reading bedtime stories) to help you relax. Another subset of mental health companies is addressing one of the world’s greatest challenges – addiction – through what are known as digital therapeutics.

Digital therapeutics (DTx) are products that “deliver patient evidence-based therapeutic interventions powered by high quality software programs to prevent, treat, or treat a medical disorder or disease.” 1 DTx are different from digital drugs or “smart pills”. “That combine a prescription drug with an ingestible sensor that communicates with a software application to track compliance.

Photo credit: Evidera

About the Pear Therapeutics stock

Boston-based Pear Therapeutics, a leader in developing software-based therapies to help people break their bad habits, plans to merge with a. to go public sospecial pintention aAcquisition cCompanies (SPAC). The startup, founded in 2013, has a $ 248 million over seven rounds of funding, the last being a $ 100 million Series D that closed in March. The round was led by SoftBank (9984.T) and its $ 100 billion Vision Fund. Swiss pharmaceutical giant Novartis (NVS) has been one of the company’s most consistent investors, helping fund Series A through D, despite withdrawing an agreement to commercialize Pear’s digital therapeutics in 2019. Novartis even continued to invest in Pear, despite disappointing results from a 2021 clinical study conducted by Novartis that showed the Pears app was no better than a placebo app for treating schizophrenia.

The proposed merger of SPAC Pear Therapeutics with Thimble Point Acquisition Corp (THMA) is expected to value Pear at $ 1.6 billion. It will also raise approximately $ 450 million for the newly formed company to continue commercializing its three FDA-cleared digital therapeutics and developing more than a dozen other products. The company’s first product, reSET, is a 90-day prescription digital therapeutic for the treatment of substance use disorders that affect approximately 20 million people in the United States alone. Pear’s second product, reSET-O, is specifically designed for opioid addiction, which kills more than 100 Americans every day.

Evidence for pear therapeuticsCredit: Pear Therapeutics

Its third product is Somryst, used to treat chronic insomnia, with very different estimates of how many people cannot sleep well, but the number is likely in the tens of millions.

Products beyond addiction and mental health

In other words, there is no shortage of customers for Pear’s digital therapeutic products that claim to be one total awearable IMarket (TAM) of about $ 11 billion. This does not include a pipeline that extends far beyond addiction and mental health into pain management and other conditions such as irritable bowel syndrome.

Pear Therapeutics pipelineCredit: Pear Therapeutics

In addition, Pear is expanding its digital therapeutic development platform to include digital biomarkers and remote patient monitoring, primarily through agreements with other technology companies.

For example, in 2020, Pear licensed technology from a Canadian startup called Winterlight Labs, which is about $ 5.2 million Development of machine learning based digital language biomarkers that analyze and evaluate cognitive health. Pear licensed the technology to develop and clinically validate digital biomarkers for a variety of diseases, including Alzheimer’s, depression, insomnia, schizophrenia, and opioid and substance use disorders. Earlier this year, the company added several more partnerships:

  • Another Boston-based startup, Empatica, has moved in $ 7.8 million to develop AI-powered wearables for various diseases, such as the early detection of seizures related to epilepsy. Pear is studying technology to assess withdrawal symptoms in patients with addiction to drugs, opioids, and alcohol. The FDA-approved smartwatches track heart rate, fine movement behavior, skin temperature and skin conductivity in order to quantify the reaction of the autonomic nervous system.
  • Florida-based etectRx has developed a smart pill technology called ID-Cap, which sends a very low-power digital message from the patient’s stomach to confirm that a medication has been taken. The patient’s own gastric fluid supplies the wireless sensor with electricity.
  • Chicago-based KeyWise is another company that purportedly uses AI for digital biomarkers, with algorithms designed to provide insights into smartphone keyboard interactions.

Competitive landscape

Pear is far from the only digital therapeutics company in the marketplace that treats addiction and other mental disorders. Here are some of the other players out there, courtesy of Evidera.

The advancement of digital therapeutic companies – Source: Evidera

A review of Crunchbase last month found that companies working on therapies and other services related to addiction have raised more than $ 1 billion in the past few years, a number that is likely much higher since the article apparently leaving out a very direct competitor.

Click Therapeutics is a New Yawk-based startup that is a stunning $ 860 million in funding, including a $ 500 million round in September 2020 led by French pharmaceutical giant Sanofi (SNY). The Click Neurobehavioral Intervention Platform is powered by Clickometrics, a machine learning and data science engine. That’s a lot of buzzwords, but the bottom line is that Click Software is also used as adjunct therapy for addiction and a number of other health conditions, including insomnia and schizophrenia:

Click Therapeutics PipelineCredit: Click Therapeutics

Its first and only commercial product, Clickotine, is a smoking cessation program. The company is currently in a clinical trial evaluating the effectiveness of digital therapeutics in treating major depressive disorder in adults. (Interesting side note: Alphabet subsidiary Verily is leading the completely removed clinical trial as another competitor to Science 37, a SPAC hopefuls that we recently deconstructed and is trying to break into the market with decentralized clinical trials. This is another example for how competitive and the digital healthcare market is wide-ranging, with companies developing multiple software solutions in multiple industries.)

Buy or not buy

There are more reasons to avoid pear therapeutics than just a flurry of mental health competition. We have long argued that SPACS, at least initially, offer little value to retail investors. We recently reinforced this argument by examining why popular SPACs are depreciating. All of these metrics apply to Pear, which will only have $ 4 million in sales this year. While we don’t consider companies before sales or those that haven’t had $ 10 million or more of revenue in a fiscal year, there is some appeal to the company:

Commercial traction from Pear Therapeutics.Credit: Pear Therapeutics

However, we are skeptical of the company’s value proposition. To date, there have only been a handful of clinical studies on Pear’s products and digital therapeutics in general. While the results of these studies have been encouraging, the research is often done in-house, such as a 2020 paper on opioid use and the benefits of digital therapeutics. The company’s published analyzes of the cost-benefit ratio are less convincing. One study predicted cost savings of $ 765,321 per million lives over five years thanks to reSET-O over standard treatments. That seems pretty tiny given the $ 248 million the company has raised so far. A second cost-benefit analysis offered more attractive optics, with the company estimating that a decrease in doctor visits by patients using reSET-O reduced costs by as much as $ 2,654 per person over six months.

Pear’s investment in additional digital biomarker technology is a fascinating but risky bet, as the effectiveness, applicability, and cost-effectiveness of these tools, as well as the company’s ability to incorporate them into its platform, are unknown.

Conclusion

One addiction that Pear Therapeutics and others don’t address is screen addiction, a condition that affects many of us today, especially younger people. That makes us wonder if we need another reason to hold on to our devices. Who needs computer software when you can hack human software with drugs! Countless companies are studying the mental healing powers of psychedelics, including publicly traded companies like MindMed (MMED.NE) and Atai Life Sciences (ATAI). These companies use mind-expanding drugs to treat addiction and other mental disorders. We are on the sidelines for now as the sector is still too volatile and risky given the regulatory environment and the long-term outlook. Similarly, we will also swipe left on Pear Therapeutics, which will trade under the ticker symbol “PEAR,” when the deal goes through.

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Serious gaps in mental health care in Washington prisons, report warns

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Inadequate psychiatric care in Washington prisons puts some prisoners at increased risk of self-harm and suicide and contributes to long stays in solitary confinement, according to a new report from the Ombudsman.

The report, which has been in the works for months, raises the alarm over numerous shortcomings, including high-case psychiatric staff and desperate prisoners waiting to see a psychologist.

Other issues identified by the Office of the Corrections Ombuds (OCO) include problems with prescribing psychiatric drugs and a disciplinary process that often fails to take into account the mental health of the detainee.

“The big realization is that we need more mental health services for incarcerated people,” said Joanna Carns, director of the OCO.

In response to the report, the Department of Corrections (DOC) recognized the continuing challenges in the delivery of mental health care to prisoners and pointed out the way it addresses many of the issues, including by working with outside prison reform groups.

The Ombuds Report is the latest in a series of OCO investigations that focus on the state of mental health care in Washington prisons – a strategic priority for the independent bureau, established in 2018.

Previous reports have focused on prisoners who have died from suicide, the effects of solitary confinement, and concerns related to the quarantine and isolation of prisoners due to COVID-19. Future OCO reports will examine the use of violence and restraints among prisoners with mental illness and the well-being of transgender prisoners.

The latest research paints a picture of a prison system that is ill-equipped to meet the mental health needs of a complex population of approximately 15,000 prisoners, spread across 12 prisons and 12 layoffs. Of particular concern to investigators is anecdotal evidence that inmates of color with mental disorders are treated differently. The report also highlights the particular challenges LQBTQ prisoners face.

A new report from the Office of Corrections Ombudsman finds evidence of numerous shortcomings in the availability of mental health care in Washington prisons. According to the report, prisoners in distress often have to wait to see a psychologist, and a lack of robust treatment options means that some prisoners end up in solitary confinement.

Washington State Department of Corrections /

The report is based on an analysis of more than 300 mental health complaints at the OCO between November 2018 and November 2020. In addition, investigators interviewed detainees, checked mental health data and spoke to DOC employees and administrations.

Countless problems

A key finding is that mental health professionals who are responsible for initial examinations of new prisoners are overwhelmed. According to the report, employees have to do an “extremely high” number of screenings each day and sometimes the location where the screenings are held is not private. This is an issue that the OCO previously reported.

Another persistent problem the report identifies is the lack of access to mental health professionals. This can manifest itself in a variety of ways, from delays after a prisoner sends a letter asking for a counselor to a lack of group therapy options.

Prisoners have also complained that DOC doctors reduced or stopped their existing psychiatric medication, or prescribed medication that was ineffective.

In terms of discipline, the report notes that when prisoners break the rules and get into trouble, “the process does not provide an adequate opportunity to take full account of a person’s mental health,” the report said.

In particular, the report describes a cycle in which an incarcerated person acts based on their mental health and then receives a sanction that does not address the root of the behavior. In some cases, individual prisoners suffer numerous violations due to untreated mental illness.

An example of this was included in the OCO’s 2020 annual report. It was a prisoner who injured himself. When the prison staff tried to hold the person, he hit one of the staff and attacked him. As a punishment, the prisoner was placed in solitary confinement and lost part of his “good time” credit for an earlier release.

Another major concern of the OCO is suicide in prison. Since last year, the OCO has published a number of reports of suicide in prisons, along with several recommendations on how to address the problem. This latest report urges the DOC to adopt these earlier recommendations and warns that in some cases the agency has not properly tracked and tracked prisoners who have harmed themselves or on suicide watch.

Another ongoing concern of the OCO is the use of solitary confinement, also known as intensive management or segregation. The report notes that people with serious mental illnesses are often kept in solitary cells for long periods of time.

“This practice contradicts years of research that have shown that time in solitary confinement exacerbates mental symptoms,” the report said.

DOC has worked with the Vera Institute of Justice, a national prison reform group, for the past few years to reduce the use of solitary confinement.

To address mental health deficiencies, the OCO report makes a number of recommendations, including that the DOC reduce the number of cases for staff examining incoming prisoners for mental health issues.

The report also calls on the DOC to increase its mental health staff to ensure timely treatment and expand opportunities for group therapy. As part of this effort, the report says, it is important that clinical staff reflect the racial and ethnic diversity of prison inmates.

Regarding the disciplining of inmates with severe mental illness, the report suggests that the DOC suggest alternatives to the standard sanctions and, if necessary, seek input from mental health workers.

The report also urges the DOC to reduce the time detainees with severe mental illnesses spend in solitary confinement and to investigate best practices for accommodation and treatment options that do not include segregation.

In addition to hiring more mental health staff, the OCO would also like the DOC to train its frontline detainees to better support the mental health needs of detainees. This includes training on mental health awareness and de-escalation tactics. In response, DOC said it is already prioritizing de-escalation, but there are recognized opportunities for more specific training for people in specialized occupational classes.

One final recommendation urges the DOC to work with the Department of Social and Health Services (DHSH) to facilitate the “temporary transfer” of prisoners in need of inpatient psychiatric care to western or eastern state hospitals.

DOC answers

In a lengthy, formal response to the report, DOC said it plans to ask lawmakers to fund two additional psychology positions as well as funds to improve the prisoner reception process next year.

In the meantime, the agency hopes to have a new assessment of the physical space available in prisons for group therapy sessions by September 30. However, DOC warned that finding suitable rooms and then staffing groups with a correctional officer to ensure security is an ongoing challenge. COVID-19 was another barrier to convening groups.

Next year, DOC plans to broadly roll out a new disciplinary program for people with severe mental illness that it has tested in two prisons. The program is modeled after a similar program by the Oregon Department of Corrections and requires the involvement of the inmate’s primary therapist in the disciplinary process.

The ministry also noted that since 2012 it has reduced the use of administrative segregation by a third and reduced the median stay in isolation by 33 percent. DOC said it has also stopped the use of segregation as a form of sanction and is trying alternatives to solitary confinement such as “transitional pods.”

In a statement on Wednesday, DOC said it was working with the OCO, acknowledging “known challenges related to the delivery of mental health services.”

“The department continues to work to equip and train its staff with the knowledge and skills necessary to support people with mental illness, and continues to review and revise its workforce to achieve adequate caseloads to maintain mental health services and to provide where the greatest patient needs are, ”the press release said.

The agency also said it is working with the University of California San Francisco’s AMEND program to bring a public health culture into the prison system. The DOC is also developing intensive outpatient treatment options that allow people with severe mental illness to receive treatment in the general prison population while in residence.

The current DOC secretary is Cheryl Strange, who previously ran DSHS and was previously CEO of Western State Hospital. Strange was appointed to the position in April. Carns, the ombudswoman, said she hoped Strange would prioritize the recommendations in the report given her mental health background.

“The goal is that people who are incarcerated are better off than when they entered Germany and receive psychiatric care [are] a critical component of that, ”said Carns.

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Oregon health care workers will be required to get vaccinated or face frequent testing

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Oregon Governor Kate Brown speaks during the June 30, 2021 press conference announcing the end of the state mask mandate.

Kristyna Wentz-Graff

Oregon health workers will need to get vaccinated against COVID-19 or undergo weekly tests, which Governor Kate Brown usually plans to introduce in late September.

As an alarming surge in case numbers and hospital admissions threatens to overwhelm public health authorities and local hospitals, Brown announced Wednesday that it has directed the Oregon Health Authority to enact new rules designed to put pressure on health workers. You can either get vaccinated by September 30th or have frequent tests for the virus.

“The more contagious Delta variant changed everything,” Brown said in a press release. “This new security measure is necessary to prevent Delta from causing serious illness on our first line of defense: our doctors, nurses, medical students and health workers on the front lines.”

The new rule falls short of what the state’s largest hospital association had called for: a new rule or regulation that gives individual health systems the power to require Covid-19 vaccination if they so choose. That would have brought Oregon in line with most other states.

Brown feared that vaccination with no alternative could lead to staff shortages, her spokesman said.

The upcoming rules are similar to the testing requirements President Joe Biden and California Governor Gavin Newsom put in place for federal and state employees during the COVID-19 resurgence. But rather than addressing all state or federal employees, Brown limits her focus to health care workers “who have direct or indirect contact with patients or infectious materials.”

Brown’s office is still considering vaccination and testing requirements for government employees, the statement said. The governor, who in recent weeks has emphasized more localized decision-making over state mandates, urged private and public employers across the state to introduce masking requirements and “facilitate employee access to vaccines” with guidelines such as paid time off for vaccinations and others Incentives.

While vaccination assignments are acceptable as a condition of employment in most sectors, Oregon law prohibits health care providers from making them mandatory unless vaccinations are required by state or federal regulations. The governor’s office said Brown plans to “address” this ban when lawmakers meet early next year.

In the meantime, not all providers are waiting. Kaiser Permanente announced Monday that it will make vaccines mandatory for all employees. PeaceHealth’s medical system announced Tuesday that all of its caregivers must be vaccinated against COVID-19 or submit a qualified medical exemption. Those who do not can be removed from patient care.

Health systems across the state have said they support a change in the law, while the Oregon Nurses Association has warned that if nurses are not part of the contract negotiations, they could result in resignation when morale is low and hospitals and long-term care facilities last are already scarce.

The increased demands come as COVID-19 patients are being hospitalized at a worrying rate. As of Wednesday, 393 people with the virus had been hospitalized in the state, 95 more than last Friday and 14 more than the day before.

State health officials released modeling results last week that suggested that nearly 100 people a day could be hospitalized by mid-August if steps are not taken to contain the spread of the Delta variant. The same modeling suggested that the daily case numbers could rise to nearly 1,200 over the same period. The state reported 1,575 new cases on Tuesday.

The state had 393 available beds in a non-intensive care unit and 110 free beds in the intensive care unit as of Wednesday morning.

Despite worrying trends and calls from their own health advisors to get vaccinated as soon as possible, the new requirements for health workers won’t go into effect until September 30th. Brown’s office said an eight week delay will “give employers time” to prepare for implementation and will give currently unvaccinated health care workers time to fully vaccinate.

Vaccination rates for health care workers are higher than rates for the general population, but they vary widely by region, ranging from a low of 43% in Harney County to a high of 81% in Washington County.

Vaccinations for long-term care facilities are particularly critical, the residents of which were responsible for around half of the deaths in the first year of the pandemic.

Approximately 68% of Oregon long-term care workers have been vaccinated – about 10% more than the national average, according to the Oregon Health Care Association, which represents the industry.

In Oregon, by July 3, 70% of all health workers were vaccinated. The rates vary depending on the profession: 87% of vaccinated doctors, 74% of registered nurses and 57% of certified nursing assistants.

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It’s time to expand the definition of ‘women’s health’

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Common diseases such as cardiovascular disease are under-researched in women, making diagnosis, prognosis and treatment difficult in women.Photo credit: BSIP / UIG / Getty

More than one eighth of the world’s population has a condition that can cause pain, profuse bleeding, and decreased fertility, all possible consequences of benign tumors known as uterine leiomyomas or fibroids. Fibroids can be debilitating and are a common reason for surgical removal of the uterus.

Still, fibroids have received relatively little attention from scientists, either in academia or in pharmaceutical companies. The cause of the disease – and how to reduce its impact on fertility – has been debated for decades, leaving doctors unsure how best to treat people.

Unfortunately, fibroids are just one of many underrated aspects of health in people who were female at birth. (This includes cis women, transgender men, and some non-binary and intersex people; the term “women” in the remainder of this editorial refers to cis women.) Clinical and preclinical studies tend to focus equally on men: a third of the Individuals participating in cardiovascular disease clinical trials are women, and an analysis of neuroscientific studies published in six journals in 2014 found that 40% of them used male animals only. Two studies and an article published in Nature on Aug. 5 shed light on the advances in women’s health research – and the need for more.

A study examines the molecular origins of fibroids and reveals a possible mechanism by which tumors form. Drugs targeting key molecular actors in this process could open up new treatment options with further studies.

The other study takes a multidisciplinary approach, examining both the genetic mechanisms and epidemiological factors involved in ovarian aging, which leads to menopause and fertility loss. The age at which women experience menopause varies widely – with a range of around 20 years for healthy women – and fertility can drop dramatically for up to a decade before it begins.

This work expanded the list of genes that contribute to early ovarian aging and highlights the importance of DNA repair mechanisms in determining the age at which women experience menopause.

Both studies illustrate the advances that can be made if the health challenges of women are brought to the fore. However, advocates of women’s health warn that the field is often too narrowly considered. The study of health and disease in women should not be limited to conditions that affect women only. Conditions like type 2 diabetes, Alzheimer’s disease, and heart disease affect men and women differently. Such diseases need to be investigated in both men and women, and the diagnosis, prognosis, and treatment may need to differ between the sexes.

Heart attacks, for example, are one of the leading causes of death in both women and men, but women do not always have the “typical” symptoms that men normally experience. Women are also more prone to blood clots after a heart attack, but are less likely to be prescribed anticoagulant drugs by their doctors. Women are 50% more likely to get an initial misdiagnosis after a heart attack than men and are less likely to be prescribed medication to reduce the risk of a second attack, according to the British Heart Foundation.

When it comes to exercise, women are at risk of serious long-term injury if we continue to model head injury training and management on data from men. As our News Feature reports, it is becoming increasingly clear that women experience head injuries and recover from them very differently than men. Understanding why women are nearly twice as likely to experience concussions as men in sports like soccer and rugby requires multi-disciplinary research – and to understand why women take longer to recover from such injuries.

So far, the evidence is sparse, but preliminary data suggest structural differences in the brain. Axons in the brain of women are wired to thinner microtubules that tear more easily; Hormonal fluctuations should also contribute to this. Biomechanics could also play a role – in rugby, for example, it seems that women fall differently when attacked, which could increase the risk of a concussion. Exercise programs designed specifically for women can help alleviate these injuries.

But the clear message from sports researchers is that it is no longer acceptable to exclusively use data from men in these studies. And when women are included, the data needs to be broken down by gender and include a sufficient number of women. A recent study examining MRI images of elite rugby players included women (KA Zimmerman Brain Commun. 3, fcab133; 2021) but of the 44 elite players, only 3 were women.

But the relative lack of women on committees and scientific advisory boards has meant that few of these decision-makers have direct personal experiences with women’s health needs or research gaps. It is all the more important that funders consult the public when determining research priorities.

Since 2016, the US National Institutes of Health has required researchers to conduct preclinical studies in both male and female animals, tissues and cells, or to provide an explanation as to why it is not appropriate to study both sexes. Now it is up to other funders, researchers, and journals to amplify the impact of this change by making sure to include gender-specific data in publications. Funders should also strengthen the resources allocated to support studies of health and disease in women and keep track of how much money is being used to support such research in all areas, not just gynecological diseases. What is measured is done.

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