Eleanor has raised $50 million in new funding, and there is a new solution to the addiction problem that plagues tens of millions of Americans?

At the end of 2020, 42 percent of adults in the U.S. reported symptoms of anxiety or depression, while the CDC reported that about 90,000 people nationwide would die of drug overdose in 2020, a five-fold increase from 1999.

The problem of drug abuse has always been a serious public problem in the international community, and drugs are originally a good remedy for curing diseases and saving people, but once they are abused, they become "drugs". The Criminal Law of the People's Republic of China defines drugs as "narcotic drugs and psychotropic substances that can cause people to become addicted to the control prescribed by the state", so from the definition we can regard drugs as narcotic drugs and psychotropic substance abuse, that is, substance use disorder (SUD).

In the 1960s, SUD was accepted by the American Medical Association as a disease concept, and since it is a disease, it can be treated.

Eleanor Health, a company that provides mental health and addiction treatment to patients, was founded in 2019 and is headquartered in Massachusetts, USA, and is led by two female founders, Corbin Petro and Nzinga Harrison.

Co-founder and CEO Corbin Petro said: "About 40 million people in the United States fight addiction and mental illness every year, but less than 1 in 10 SUD patients and 1/2 of people with mental illness are treated, not that patients refuse treatment, but that the cost of treatment is too high and the effect is not very good." ”

So Eleanor Health needs to address two problems: treatment outcomes without progress and high treatment costs.

Drug-assisted physiological detoxification,

Group therapy assists in psychological detoxification

How to improve the treatment effect? The problem of untying the bell must also be tied to the bell person, starting from the nature of addiction and its biological mechanism.

Over millions of years of human evolution, the desire for pleasant substances has been "written into dna." There is a reward system in the human brain: when there is a pleasure stimulus acting on the brain, the brain secretes neurotransmitters such as dopamine while remembering this feeling and stimulation, and makes the act of finding stimulation. This system is the physiological basis of drug addiction and the physiological premise that addiction can be treated with drugs.

Addiction treatment is usually divided into two parts, the first part is physical withdrawal and the second part is psychological withdrawal.

In fact, many people who walk into The Eleanor Health Clinic say, "Initially it was just to help with sleep or relieve anxiety, but after tasting the sweetness, 'try again and again' deepened the desire for stimulation, and the threshold of pleasure became higher and higher." "About 50% of people with addiction are accompanied by mental illnesses such as depression and anxiety.

Addiction and mental illness seem to be a chicken-and-egg question, but Corbin Petro, CEO of Eleanor Health, said: "Since the two go hand in hand, only simultaneous treatment is the cure." ”

Eleanor Health proposes a model of holistic care that ranges from drug-assisted to group therapy.

Drug-assisted is an effective method of physiological detoxification, Eleanor Health provides patients with a comprehensive treatment of addiction and mental illness, and patients are free to choose whether to consult offline or online. During the online consultation, the doctor sends the prescription sheet to the local pharmacy, and the patient picks up the medicine offline. Eleanor prescribes drugs such as buprenorphine, naltrexone, methadone, etc. During the pandemic, Eleanor prescribed doses of up to four weeks for stable patients using methadone, given the difficulty of getting their medications from urban lockdowns.

Drugs help patients get rid of addiction and smoothly survive various physiological withdrawal reactions, but what makes patients more painful is the relapse again and again after addiction.

The drug addiction relapse rate is very high, about 60%, this is because there is a class of drug addiction memory in the human brain, even if the patient is physically addicted, but when exposed to medication-related clues again, the memory is activated, causing relapse. For example, a drug carton can also cause patients to relapse, but it is difficult for patients to stay in the ideal environment all the time, and the purpose of treatment is to return to normal life.

At this stage of psychological withdrawal, the effect of the drug is very limited, and group therapy is more effective.

Eleanor decided to let patients go to the crowd from the beginning of treatment, reduce shame, and reduce relapse rates. Corbin Petro said: "People who fail to quit are often seen as losers without perseverance and self-control, but we know that addiction is a chronic disease that can recur and has little to do with perseverance and self-control, and patients should not be ashamed of it." ”

Eleanor organized a mutual aid meeting for patients to bring together patients with similar symptoms. Everyone in the mutual aid club has the same label, and no one is ashamed of being addicted to alcohol or drugs.

In addition to mutual aid clubs, Eleanor also provides counselor counseling and life help. "A subset of SUD patients are plagued by economic and housing issues that have become a source of their substance abuse or alcohol abuse, and we provide a Community Recovery Partner (CRP) for patients who want to solve their living problems." Corbin Petro said.

All of these services can be directly accessed to the Eleanor Clinic to communicate with doctors in person, or online remote consultation, Eleanor has established physical clinics in Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Texas and Washington.

When Eleanor was founded in 2019, CEO Corbin Petro did not trust telemedicine, especially in the areas of mental health and drug withdrawal, and patient compliance is the key to determining whether treatment can be effective, and teletherapy does not seem to be conducive to patient compliance.

Before the pandemic, 90% of Eleanor's business was conducted offline, and telemedicine was only an adjunct. After the outbreak of the epidemic in 2020, Eleanor shifted 90% of its business online in just two weeks. To improve patient compliance, Eleanor regularly mails test tubes for urine testing to users, corbin Petro said: "Telemedicine has proven to work well, but it will require Eleanor to put in more effort." ”

Earlier this year, Eleanor published a series of research data on its website, saying that 84 percent of users had improved in substance abuse, 70 percent had reduced depression and anxiety, and membership had an 84 percent drop in emergency and hospitalization rates.

Although Eleanor is able to provide all services online, they ensure the operation of physical clinics, solving problems such as "devices without remote connections" for patients.

Adopt VBS payment model,

Billed by performance, not by quantity

Solving the problem of treatment effect, another "big mountain" is to reduce the cost of treatment.

In 2010, the United States passed an Affordable Care Act, known as Obamacare, which emphasized that health care should focus on quality, not quantity.

In 2019, Eleanor decided to adopt a "Valued-Based Service" (VBS) payment model, that is, to charge according to the effect of the service, in layman's terms, to see the effect and then give money. This decision seemed radical at the time because, despite years of reform, the "Fee For Service" (FFS) model remained the mainstream of mental health in the United States.

For the first few months, Eleanor had been losing money because it was unable to submit enough data for a short period of time to prove that the treatment was effective. But after the outbreak of the epidemic, VBS showed the advantages that FFS did not have, "many projects need to be tested in physical clinics, and after the epidemic, the number of people entering physical clinics has dropped sharply, and this part of the income has been cut, but if charged according to the VBS model, as long as the effect can be guaranteed, revenue can be guaranteed." Corbin Petro said.

For now, Eleanor's adoption of the VBS model is a win-win situation, reducing unnecessary expenses for patients, such as an 84% drop in user emergency and hospitalization rates in eleanor's submitted data; and ensuring revenue for Eleanor.

Eleanor's user sources are mainly threefold: individual users, users referred from the primary care system, and users of cooperative health insurance companies. To date, Eleanor has established partnerships with health insurance companies such as Amerigroup and Optum.

Eleanor believes there is room for growth for users from health care companies and primary care networks.

The first is that the current mainstream practice of US health insurance companies is to outsource mental health, resulting in low reimbursement rates, low user visit rates, and if health insurance companies integrate their businesses, there will be more addictive patients receiving treatment.

Secondly, addicts often avoid medical treatment because of stigma, and if they can improve the social atmosphere, then they will also increase the number of patients who seek medical treatment.

Eleanor expects to exceed 60,000 registered users by the end of 2022 and reach 22 million users from partner health insurance companies.

Recently, Eleanor announced the completion of a $50 million Series C round of financing, which was led by General Catalyst and followed by Town Hall Ventures and Warburg Pincus. Eleanor intends to use the funds to develop new partners and expand into new markets.

Global investment in digital mental health soars,

The first IPO companies appeared

In 2021, venture capital in the digital mental health sector soared due to the COVID-19 pandemic and the consequent impact of group psychology, with a total of 113 financing incidents and a total of $3.54 billion in financing throughout the year.

The entire mental health field is broadly divided into several categories: mental illness such as depression and anxiety disorder, fan mental health, alcohol drug abuse, sleep health, chronic pain, etc. Among them, pan-mental health has the lowest entry threshold, but its popularity is also the highest.

In 2021, three companies in the field of digital mental health will be listed first: Talkspace, LifeStance, and Pear Therapeutics, whose main businesses are to provide online remote mental health services, online and offline integrated nursing delivery platforms, and SUD digital therapy software development.

In the field of substance use disorders, such as drug abuse and alcohol abuse, the world's leading companies include 2Morrow, Click therapeutics, monument, OREXO and Pear therapeutics, most of which are companies developing digital therapies. Among them, OREO is a listed pharmaceutical company, Pear Therapeutics has been listed, and its reSET software is a behavioral therapy-based software product for the treatment of drug abuse, and it is also the first FDA-authorized prescription digital therapy to improve psychiatric disorders.

Some companies in the field of cognitive and behavioral digital health

In 2021, the total amount of digital mental health financing in China will reach 1.86 billion US dollars, which is the same as the upward trend in the global digital mental health field. Foreign mental health enterprises for the B-end market has been relatively mature, and the domestic is still developing.

In the treatment of drug addiction, the market demand in the United States is greater, and the domestic research in the field of addiction is expected to be a technology such as digital therapy.