My dad had his first heart attack when he was in his 40’s. His father died of a heart attack in his 70’s. With that troubling family medical history, as I passed 40, I began to focus more on how to avoid the same fate.
As I read more and more of the books and scientific literature on the topic, a clear consensus emerged. Healthy eating and regular exercise are the two most important habits that we can develop to prevent and reverse heart disease, diabetes and other so-called “metabolic diseases.” Of those two, eating healthfully is by far the most important.
All of this reading had a second effect. In addition to helping inform my own choices, it made me realize the enormity of the problem. In the U.S., we spend approximately $4 trillion a year on healthcare. Of that, approximately 90% is spent on diseases caused by people’s decisions and behaviors; including metabolic diseases like type 2 diabetes, heart disease and high blood pressure, and the incidence of these diseases is steadily increasing.
To make matters worse, almost all of those trillions of dollars go to treating the symptoms or the effects of disease. We prescribe blood sugar-lowering medicines to treat diabetes, or blood pressure-lowering medicines to treat hypertension, but we invest very little in treating the underlying causes of these diseases. Given that, it’s no wonder that more and more patients are diagnosed with these diseases each year, and that the cost to treat them continues to rise. If we want to change this trajectory, we must change the way we think about these diseases and how we treat them.
Food: how we grow it, how we eat it – and how these things impact not only our own health, but also the planet’s health. I decided to focus my career on addressing these questions and in 2015 I became the founding CEO of Indigo Agriculture (a company focused on improving the healthfulness and environmental impact of how our food is grown). Simultaneously, my wife and I co-founded Better Therapeutics with Kevin Appelbaum, and I became its Chairman. At Better Therapeutics our mission to fundamentally shift how our country treats metabolic diseases.
Thankfully, we know there’s a solution. Dedicated healthcare professionals have published peer-reviewed articles detailing their one-on-one and small-group work with patients to help change their behavior. Ultimately, the scientific literature shows that changing behavior around diet and exercise leads to improvement – and even reversal – of the disease. These changes can be maintained for years and even decades.
This will surprise almost no one in the medical community. Treatment guidelines for most metabolic diseases start with something like, “counsel the patient on improved diet and exercise.” Most physicians try to do that, but with only a few minutes spent with the patient during the average appointment, and perhaps only a few seconds of that time spent on lifestyle counseling, it’s not surprising that this approach rarely works. And we don’t have enough therapists, or enough money, for every patient to receive one-on-one or small group cognitive behavioral therapy.
We founded Better Therapeutics in 2015 on the hypothesis that we could develop software that would help patients address the root causes of metabolic diseases in a cost-effective, scalable way. And what started out as a big vision five-and-a-half years ago is now coming to fruition. We have demonstrated that the software we developed is effective in multiple clinical trials. The FDA has established a clear path to authorization for software products. And now, partially as a result of the Covid-19 pandemic, patients and physicians are more receptive to the concept of digitally delivered healthcare than they have ever been. The culmination these events creates a unique moment in time and an opportunity to fully advance Better Therapeutics to have the impact on society and our healthcare system that we believe it can.
Today we announced the combination of Better Therapeutics with a SPAC and a concurrent PIPE financing that will bring up to $107M into the company when the deal is completed and enable Better Therapeutics to be publicly traded, while expanding our investor base to include prominent healthcare investors like Farallon, Sectoral, Alyeska and Pura Vida. The funds will be used to advance BT-001, our product in development for the treatment of type 2 diabetes, and to develop our broad pipeline of prescription digital therapeutics.
All early-stage companies have risks and unknowns, and that is even more true with disruptive concepts. But the advantage of attacking big problems with innovative solutions is that it has the potential to make a significant positive impact on the world and build a valuable company in the process. It has been an honor to work with Kevin Appelbaum and the Better Therapeutics management team over the last five years as we faced some of those challenges, and I look forward to doing great things with them in the future.
