1 in 8 people globally live with a mental disorder. Among these, 300 million are affected by anxiety. In high-income countries, this number climbs to 15% of the population. Behind these statistics are friends, family, or colleagues struggling to find relief.

The dominant treatment for anxiety today is medication. While drugs like SSRIs and benzodiazepines can be effective, they often come with side effects that many find hard to accept. Therapy, though transformative, requires significant time and resources, often stretching for months or even years (commonly 3–18 months).

Meanwhile, healthcare systems worldwide are under immense pressure. Europe, for instance, faces a projected shortfall of 4 million healthcare workers by 2030—600,000 doctors, 2.3 million nurses, and 1.1 million social care staff and assistants.

This raises an urgent question: How do we support people with anxiety while lightening the load on healthcare professionals?

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A New Era of Anxiety Management: Technology

Digital mental health apps like Liven, BetterHelp, and Moovd are already making waves, helping users identify triggers and manage stress. Similarly, wearable devices like Muse and handheld tools like Moonbird are leveraging biofeedback to promote relaxation.

But one category is especially intriguing—‘touch medicine.’

Research shows that tactile stimulation can significantly reduce anxiety, stress, and even physical pain. Skin-to-skin contact—or the next best thing, technology that mimics it—opens the door to a new kind of therapy: one that’s effective, safe, and side-effect-free.

Touchwaves & MYSA: A Game-Changer

I recently spoke with Pauline van Dongen, co-founder of Touchwaves, about their innovative solution, MYSA.

Pauline described MYSA as more than just a device: “It’s a companion.” The shirt combines tactile stimulation with biofeedback to support anxiety management.

Martin: Anxiety is a growing concern globally. How do you see MYSA fitting into the broader context of mental health solutions?

Pauline: MYSA responds to two critical gaps: the increasing demand for mental health support and the growing interest in actionable tools for self-care. Products like Somnox and Moonbird show that the market is ready for hardware-based solutions that empower individuals to take charge of their well-being.

We’re also exploring MYSA’s role within therapy settings. Together with Levvel, a youth care organization, we’re studying how MYSA can help therapists support their clients more efficiently, potentially reducing treatment time. It’s not about replacing professional care but amplifying its effectiveness and providing additional support between sessions.

What’s Next for MYSA?

The potential for MYSA goes far beyond anxiety management. Pauline envisions MYSA extending beyond anxiety support into areas like:

• Stress Management in High-Pressure Professions: Healthcare, education, law enforcement, and other demanding fields.

• High Performance and Sports: Recovery, focus, and relaxation for athletes.

• Broader Mental Wellness: Tools like MYSA offer moments of balance in a chaotic world, encouraging users to pause, breathe, and reconnect.

“At its heart, MYSA is about creating moments of balance in an unbalanced world,” Pauline told me.

And that’s something we can all relate to—a need to pause, breathe, and reconnect.

👉 If you’d like to experience MYSA or learn more, feel free to get in touch here.

+ Health-tech is good

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P.S. I used some of the following sources to obtain the data for this article:
(1)European Parliament (2)WHO (3) Photo by Solving Healthcare on Unsplash

Patient21 is a five-year-old German startup that combines a digital healthcare platform with real-world brick-and-mortar clinics.

The company has raised a total of $187 million in funding, with Pitango, Israel's largest venture capital fund, leading the Series C round of €100 million. This round saw participation from Bertelsmann Investments, Artian, and existing investors such as Target Global, Piton Capital, and PICO Venture Partners.

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Patient21 is shaking up primary healthcare by blending advanced digital solutions with physical clinic operations, aiming for a seamless, patient-centered healthcare experience.

Its strategy lies in six pillars:

1. Digi-Physical Platform: They blend digital health services with physical clinics to create an integrated patient experience. This ensures patient records are always up-to-date and accessible, helping healthcare professionals make better decisions and provide higher quality care at lower costs​

2. Focus: Their primary focus is on dentistry for now, with over 80% of its clinics targeting oral health. The rest are split between gynecology and general practice. Patient21 is committed to value-based healthcare, which emphasizes the quality of care provided to patients rather than the quantity of services rendered.

3. Technology: Patient21 has developed specialized software to manage patients and direct them to its 50-plus outpatient clinics across Germany. Additionally, they've created clinic-facing software that reduces administrative burdens for healthcare professionals, allowing them to prioritize patient care. This innovative approach effectively addresses staff shortages in the healthcare sector.

4. Data: The company leverages data to optimize healthcare delivery, ensuring patients get the best possible advice and treatment​.

5. Expansion: Patient21 has seen significant growth, with more than 300,000 patient visits each year, now operating 50 clinics across 19 cities in Germany. The company employs 650 professionals in the dental field, enhancing its capacity to deliver high-quality healthcare services.

6. Strong Leadership: Christopher Muhr, former COO at Auto1 Group and co-founder of Citydeal (acquired by Groupon in 2010), along with Nicolas Hantzsch, who has led successful ventures like Veganz (IPO), MetaTravel/HometoGo (IPO), and Groupon (IPO), draw from their entrepreneurial journeys and personal battles with cancer. Their experiences drive their mission to innovate primary care through digital solutions at Patient21.

+ Health-tech is good

👉 5 Takeaways from HLTH Europe 2024

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Now, I'm excited to share five key takeaways from HLTH Europe with you.

1. Accessing the Netherlands: A clogged market or too gouda to be true?

Douwe from Healthy Capital moderated this great panel, featuring Piet Hein Van Dam, founder and CEO of Clear.bio, Niels van Gorp from Digizo.nu, and Corien Staels from Staels.com.

The Netherlands presents unique challenges as a market. With citizens expecting health services to be covered by their health plans, initiatives relying on out-of-pocket payments often struggle to succeed.

Other challenges in the market include:

• Worker Shortage: An expected shortfall of 600,000 workers by 2030.

• High Healthcare Expenses: €103 billion spent in 2023.

• Aging Population: 50% of the population is over 50 years old.

• Rise in Chronic Diseases: 80% attributed to lifestyle and environment.

• Large Inefficiencies: Long waiting lists for health care services.

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2. Welcome aboard, Amsterdam!

Speaking of out-of-pocket initiatives, Aware.app just launched in Amsterdam last week, strategically coinciding with HLTH Europe week. They offer super convenient health checks covering over 70 key biomarkers for a yearly membership of €179. They're also in Berlin, Frankfurt, Hamburg, Munich, and Vienna. I love this idea and can't wait to see how it takes off in the Netherlands!

3. AI in the NHS - changing the game

It was an impressive panel where members of the NHS showcased various initiatives they're taking to adopt AI. The discussion highlighted an AI Copilot that helps doctors take notes more efficiently and quickly, and even helps reduce coding errors for health insurance companies. They also introduced a Clinical AI Fellowships program designed to train medical professionals in AI.

Hats off to the NHS for these forward-thinking initiatives!

4. Transforming Perspectives on Psychedelics: A Journey Beyond the Trip

The panel, moderated by Genevieve from The Jurvetson Foundation, featured Florian Brand, CEO of Atai Life Science, and Kabir Nath, CEO of Compass Pathways. They dived into how psychedelic research could revolutionize mental health treatment.

They talked about the massive global mental health crisis, with a billion people affected and traditional meds like SSRIs often falling short. The focus was on the promise of psychedelics, especially for patients who haven’t found relief with other treatments, and the need for top-notch data and solid clinical trials to tackle stigma and misconceptions.

Florian mentioned Spravato's success and Atai's plans to use similar in-clinic treatment models for their psychedelic drug candidates to make them more accessible and affordable.

The panel was a fantastic chance to highlight cutting-edge research in psychiatry and the importance of a team effort to advance mental health care. I'm passionate about this topic and truly believe that psychedelics have the potential to significantly enhance mental health treatment.

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5. Calm/Storm HealthTech Breakfast - Event Recap

On Tuesday, I attended a HealthTech Breakfast hosted by Calm/Storm in collaboration with naturalX Health Ventures at The Hoxton in Amsterdam!

The event gathered over 100 HealthTech enthusiasts, including VCs, founders, and industry veterans, fostering lively discussions and valuable networking opportunities.

Lucanus Polagnoli, founder of Calm/Storm, presented their latest Digital Health Compass, offering fresh insights into the dynamic HealthTech market. During the event, Marvin Amberg introduced naturalX Health Ventures, emphasizing three key points:

1. It's a new venture capital fund dedicated to consumer health.

2. The fund is backed by Schwabe Group, a renowned German pharmaceutical company specializing in plant-based medicine.

3. They have launched a €100 million Series A/B fund aimed at becoming a leading European investor in the consumer health sector.

+ Health-tech is good

👉 VCs Pour Over $220 Million into This Business Model

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📍 7 Emerging Trends in Functional Food
👉 Click here to read the full article.

📍Inside Hims.com New Growth Strategy
👉 Click here to read the full article.

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• In Europe, 61 million people have Type 2 Diabetes, while in the US, the figure is 38.4 million.

• Over 49 million Europeans have cardiovascular disease, compared to 16.3 million in the US.

The World Health Organization lists an unhealthy diet as a top risk factor for global mortality and disability.

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The Solution

Several companies are addressing this issue by providing personalized nutritional care services, leveraging technology and expert guidance from registered dietitians.

1. Foodsmart: The company offers a telehealth nutrition solution that connects individuals with personal dietitians. Members can access meal planning, grocery delivery, and a food marketplace tailored to their dietary needs and budget. Recently, Foodsmart raised $10 million to expand its food prescription program, Foodscripts. This initiative partners with health systems like Advocate Health, Memorial Hermann Health System, and Intermountain Health to refer patients to dietitians and provide subsidized meals tailored to specific conditions. Foodsmart aims to make Foodscripts ubiquitous by 2030, transforming how nutrition is integrated into healthcare. Total Funding: $72 million.

2. Season Health: The company matches individuals with board-certified dietitians based on their health goals and conditions. Members receive personalized nutrition consultations, meal plans, and access to a food marketplace. The company recently secured $34 million in funding from investors such as Andreessen Horowitz and CityBlock, underscoring its growing influence in the market.

3. Fay Nutrition: The startup connects individuals with licensed nutritionists covered by their insurance plans. Nutritionists design customized meal plans and provide one-on-one guidance. Fay recently emerged from stealth with $25 million in funding from General Catalyst and Forerunner Ventures. Fay offers a franchise model that empowers registered dietitians to run their practices independently while being covered by insurance. This model has proven especially beneficial for patients on GLP-1 medications like Ozempic, who are required to see dietitians to develop healthy habits.

4. Nourish: The company offers a virtual platform for personalized nutrition coaching from registered dietitians. Members receive meal plans, grocery lists, and ongoing support. Nourish recently raised $35 million in a Series A round led by Index Ventures to expand access to their services and develop AI tools for better personalization and efficiency. This funding will help Nourish grow its network of dietitians to over 1,000 by the end of 2024 and integrate "food as medicine" into their programs.

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Business Models and Revenue Streams

These companies make money through subscription-based models, where members pay a monthly or annual fee for dietitian services, meal plans, and food marketplaces. Some also partner with insurance providers, allowing members to access services at a reduced cost or even for free.

Let's take a closer look at Nourish's numbers:

Key Financial Metrics

• Consultation Fee: $165 per session

• Typical Number of Sessions per Customer: 4 to 5 sessions

  • Revenue per Customer: $660 to $825

Registered Dietitian (RD) Compensation & Benefits

Base Compensation

• Per-Session Rate: $45-$55

  • Annual Earnings for Full-Time RDs (25 sessions per week): $70K-$90K

This is the Nourish Dietitian Pay Calculator

Market Size and Number of Dietitians

In Europe, the nutritional care market is worth €10.2 billion and has over 30,000 registered dietitians. In the U.S., the market is valued at $16.5 billion, with around 93,000 dietitians and nutritionists.

Potential M&A Buzz in Nutritional Care

The nutritional care scene is gearing up for some major shake-ups, driven by the soaring demand for personalized nutrition and the need for scale and tech smarts. Several factors could fuel M&A activity in this space:

• Big Tech Eyeing Deals: Amazon, Google, and Apple are eyeing nutritional startups to weave personalized nutrition into their massive ecosystems. They’ve got the data and reach to revolutionize how nutrition fits into healthcare.

• Telehealth and Digital Health: Companies like Teladoc and Livongo are hungry for nutritional care platforms to beef up their virtual health offerings. Think one-stop virtual care shops that include personalized nutrition.

• Pharma’s New Frontier: Pfizer, Merck, and Novartis are diversifying beyond pills. Buying into nutritional care means offering preventive health solutions alongside meds.

• Retail Giants in the Mix: Walmart, Kroger, and Amazon (via Whole Foods) want to add nutritional services to their online stores and loyalty programs. Imagine personalized nutrition plans right next to your weekly grocery list.

In a nutshell, expect the nutritional care industry to see some serious merging and acquiring. It’s all about blending health, tech, and customer needs in new and exciting ways.

+ Health-tech is good

👉 The Emerging AI Agent Landscape in Healthcare

Other topics you might find interesting 💡

📍 7 Emerging Trends in Functional Food
👉 Click here to read the full article.

📍7 Longevity Clinics leading the way in Europe
👉 Click here to read the full article.

Suggestion? Critiques? Send your feedback in this link or reply to this e-mail.

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P.S. Photo by engin akyurt on Unsplash

What is an AI agent?

Broadly speaking, AI agents are systems designed to make autonomous decisions and take actions based on general instructions from a user. They typically consist of four main components:

1. Powerful Large Language Model (LLM): This component interprets the user’s intent and formulates an action plan based on the objective and available tools.

2. Tools: These extend the core LLM's capabilities, including functions like web search, document retrieval, code execution, and database integration, as well as incorporating other AI models. These tools enable the agent to perform actions such as generating documents, executing database queries, and creating charts.

3. Memory: This includes access to relevant databases (long-term memory) and the ability to retain task-specific information over multiple steps (short-term memory), which is crucial for completing complex action plans.

4. Reflection and Self-Critiquing: Advanced agents possess the ability to identify and correct their own mistakes during execution and adjust their priorities as needed.

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The Evolution from LLMs to Agents

Opportunities with Task-Specific AI Agents

AI Agents tend to perform better when designed for specific domains or narrower tasks. As the landscape evolves, I'm increasingly excited about task- and industry-specific agents. These agents offer tailored solutions that address unique challenges and requirements, helping to overcome common development issues.

For example, obtaining the right information for fact-based decision-making often involves complex workflows. Data usually resides in internal databases and requires analysts to write queries for extraction. Task-specific agents, particularly in data analysis, simplify this process.

They can efficiently search, access, evaluate, and synthesize information, making it easier to answer user questions and make informed decisions.

Healthcare Market Landscape

1. Medical Imaging AI Agents:
   These AI systems assist in analyzing medical images like X-rays, CT scans, and MRI scans for detecting and diagnosing diseases. Some examples are:

   
   -Kheiron Medical Technologies helps doctors find mammogram malignancies, HQ: London, UK. Funding: $22 million

   -Oxipit, a computer vision software startup specializing in medical imaging HQ: Ljubljana, Slovenia. Funding: $6.6 million

   ---

2. AI Agents for Clinical Decision Support:
   These AI tools aid clinicians in making diagnostic and treatment decisions by analyzing patient data. For instance:

• AI agents that predict disease risk and recommend preventive measures

• AI agents that suggest treatment plans based on patient's medical history and test results

e.g. Ada Health, HQ: Berlin, Germany. Funding: $169.8 million

3. AI Agents for Automating Administrative Tasks:
   Companies like HealthForce (HQ: Vienna, Austria. Funding: $1.4 million ) offer AI agents specifically designed to automate administrative workflows in hospitals across Europe, such as:

• Scheduling appointments and managing calendars

• Processing insurance claims and medical billing

• Procurement and inventory management

  
  TORTUS AI also falls into this category. HQ: London, UK. Funding: $4.2 million

  ---

4. AI Agents for Drug Discovery and Development:
   AI agents in this category leverage data and computing power to accelerate drug R&D processes. Some examples are:

   
   -BenevolentAI, HQ: London, UK. Funding: $292 million

   -InSilicoTrials, HQ: Leuven, Belgium. Funding: $37.3 million

   ---

5. AI Agents for Mental Health and Wellness:
   Startups like Unmind (HQ: London, UK, Funding: $63.5 million) and Mindstep (HQ: Copenhagen, Denmark. Funding: $5.7 million) provide AI-powered digital therapeutics platforms for mental health conditions like anxiety, depression, and brain fog. Their AI agents offer personalized interventions such as:

• Cognitive behavioral therapy via chatbots and apps

• Brain training games and exercises tailored to individual needs

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The Evolution

The journey to create effective and widespread autonomous AI Agents is one of ongoing exploration and innovation. By understanding the current landscape, categorizing agents by their focus areas, and closely monitoring their evolution, we can anticipate exciting advancements in autonomous AI technology.

+ Health-tech is good

👉 11 Key Digital Health Trends Shaping Europe in 2024

Other topics you might find interesting 💡

📍 7 Companies Pioneering Health-Tech AI in Spain
👉 Click here to read the full article.

📍7 Longevity Clinics leading the way in Europe
👉 Click here to read the full article.

Suggestion? Critiques? Send your feedback in this link or reply to this e-mail.

This newsletter can impact those around you. Feel free to share it.

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P.S. I used some of the following sources to obtain the data for this article:
(1)European Parliament (2)Prosus (3) EIT (4) Photo by Igor Omilaev on Unsplash

Impressive Market Growth

The digital health market in Europe is expected to reach USD 267.2 billion by 2030. This rapid growth is driven by several factors:

• Rising adoption of digital health services like telemedicine, remote monitoring, and electronic health records by healthcare providers.

• Increasing demand for remote patient monitoring, especially due to shortage of medical professionals.

• Increasing internet and smartphone use, along with government initiatives promoting digital healthcare transformation. In 2019, France launched the 'My Health 2022' plan, which focuses on enhancing eHealth services through improved interoperability, nationwide EHR implementation, AI in healthcare, a healthcare data hub, and telemedicine investment.

  

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Segment Highlights

• Tele-healthcare was the big winner, snagging 43.2% of the revenue in 2023, thanks to the aging population and the push for remote monitoring.

• Diabetes apps took the top spot with a 24.3% revenue share in 2023, as diabetes cases keep climbing.

• In terms of end-use, the patients segment led the market with a revenue share of 34.1% in 2023, driven by the increasing preference for telehealth services among the population.

• The software component segment is expected to grow fastest due to need for efficient workflow management.

Investment Focus Areas

• Artificial intelligence (AI) products and services are likely to attract investor interest and meetings.

• The increasing prevalence of chronic diseases such as diabetes, cardiovascular, and respiratory diseases, among others are accelerating market investment. Cardiovascular disease causes 3.9 million deaths in Europe every year.

• However, investors are cautious about digital therapeutics companies due to regulatory and reimbursement challenges.

• Companies with proven clinical outcomes and return on investment metrics have an advantage in securing funding

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  + Health-tech is good

  

  ---

  

  👉 5 German Health-Tech Startups with Fresh Seed Funding

  Other topics you might find interesting 💡

  📍 The Longevity Supplements Market - Opportunities and Key Players
  👉 Click here to read the full article.
  
  📍"D2C" Health Giant: A Look Inside VIOME Growth Strategy
  👉 Click here to read the full article.

  ---

  Suggestion? Critiques? Send your feedback in this link or reply to this e-mail.

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  This newsletter can impact those around you. Feel free to share it.

  Share

  ---

  P.S. I used some of the following sources to obtain the data for this article:
  (1) Yahoo Finance (2) Mordor Intelligence (3) Research and Markets (4) Photo by Quang Tri NGUYEN on Unsplash

  

  
  
  

Germany is a thriving hub for startups, and Berlin shines as its star player. In 2023 alone, 468 startups were founded. With people from 186 nationalities and 49% of startup employees being non-German, Berlin has one of the world's most diverse workforces.

In late 2023, Germany introduced significant financial reforms to support the tech industry. Employees can now defer taxes on stock options until they sell them, and more companies (up to 1,000 employees and $108.7 million in revenue) can now offer these plans. Additionally, new funds such as the $1.76 billion Growth Fund Germany and the DeepTech & Climate Funds are set to take growth-stage companies to new heights.

Berlin is Germany’s startup hotspot:

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Let's Dive into 5 German Startups: From Femtech to Preventive Health, All Recently Funded!

1. Ovom Care

-HQ: Berlin, Germany
-Product: Ovom Care pioneers AI-driven fertility care, using advanced algorithms to personalize treatment decisions for patients. By analyzing historical and real-time patient data, their innovative approach enhances outcomes and affordability. With dynamic pricing and potential reimbursements for unsuccessful pregnancies, Ovom Care removes financial barriers, providing a more supportive journey to parenthood.
-Investment: In April 2024, the company secured a €4.8 million seed funding round, led by Alpha Intelligence Capital and backed by Ananda Impact Ventures and Merantix.

2. AERA Health

-HQ: Munich, Germany
-Product: The startup integrates digital and brick-and-mortar services to pioneer preventive medicine. AERA runs physical treatment centers across Germany, beginning with Munich. These spaces offer a range of services including health checks, ortho-biologics, and longevity medicine.
-Investment: The company secured €4 million in pre-seed funding in 2023. Notable investors in this round include former Amazon Consumer CEO Jeff Wilke, Logitech’s President & CEO Bracken Darrell, Neworld.Global, Korify Capital, and Evoleen.

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3. Likeminded

-HQ: Berlin, Germany
-Product: Likeminded's B2B digital platform aims to offer personalized support for corporate employees, with the goal of preventing overwork and burnout.
-Investment: Back in October, the company shared some exciting news: their seed funding round got a €1.5 million boost. Initially closed at €5.9 million in August 2023, the investors onboard include Heartcore Capital, Holtzbrinck Digital, IBB Ventures, and N&V Capital. Likeminded has now raised a total of €10.9 million across three rounds.

4. theblood

-HQ: Berlin, Germany
-Product: theblood offers a subscription-based service for regular menstrual blood testing, providing insights into cycles, health, and blood. Their main product includes menstrual blood analysis and biomarkers, alongside the development of a non-invasive at-home blood test for monitoring health.
-Investment: theblood has raised a total of €1.2 million in funding over 2 rounds.

5. MindAhead

-HQ: Berlin , Germany
-Product: MindAhead is crafting a cognitive tracking app tailored for the elderly, prioritizing early detection and treatment of cognitive impairment.
-Investment: The company has wrapped up a €500k pre-seed round, spearheaded by RoX Health and joined by OHA Osnabrück Healthcare, Beteiligungs GmbH, CDP Venture Capital, AC75 Startup Accelerator, Moonstone, Ikigai, and several serial business angels.

+ Health-tech is good

👉 The Longevity Supplements Market - Opportunities and Key Players

Other topics you might find interesting 💡

📍 8 Food-As-Medicine Startups That Raised $400 Million in Funding
👉 Click here to read the full article.

📍The $8.8 Billion DTC Genetic Testing Market
👉 Click here to read the full article.

Suggestion? Critiques? Send your feedback in this link or reply to this e-mail. 🙁 😐 😍

This newsletter can impact those around you. Feel free to share it.

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P.S. I used some of the following sources to obtain the data for this article:
(1) Startup Genome (2) Crunchbase (3) WellFound (4) Photo by S. Widua on Unsplash

Poor nutrition is one of the main causes of chronic diseases, and the food we eat is harming our health:

• Obesity rates have tripled in the last 40 years in the EU.

• Dietary risk factors were linked to 11 million deaths globally in 2017.

• Type 2 diabetes cases are projected to double by 2045
  

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Maintaining a healthy diet might sound simple, but it's actually quite challenging, especially for low-income communities, who are hit hardest by illnesses linked to poor diets. Accessing fresh food continues to be a struggle, especially for them.

New companies using food as medicine are helping people get healthier from the inside. They understand that food plays a significant role in staying well. Some even customize meals for your health needs, like a prescription from a doctor. It's all about preventing, managing, and treating illness.

7 Food-As-Medicine companies have collectively raised $400 million in funding:

In Europe

1.Oviva (Zürich, Switzerland): Oviva is a digital platform serving as a diet and lifestyle coach, bringing together certified dietitians, health systems, and insurers. Oviva has raised a total of $113 million in funding.

2.ZOE (London, UK): ZOE leverages scientific research and advanced AI for personalized nutrition, aiming to improve the health of millions. ZOE has raised a total of $88.7 million in funding over 6 rounds.

3.Lifesum (Stockholm, Sweden): Lifesum is a Swedish digital health startup that helps clients become healthier by using applied psychology and technology. Lifesum has raised a total of $21.7 million in funding.

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In the U.S.

4.Season Health (Texas, US): Season Health is the leading food-as-medicine platform that enables people with chronic conditions such as diabetes and kidney disease to eat well and live well. Combining clinical nutrition care, meal recommendations, education, and food delivery into one comprehensive solution, Season aims to help more people see food as a healthy pleasure and create a world well-fed. Season Health has raised a total of $43.6 million in funding over 4 rounds, with Andreessen Horowitz among its main investors.

5.Foodsmart (California, US): Foodsmart is the largest telehealth network of registered dietitians in the US with a mission to make eating well simple. The company’s telenutrition program, backed by a healthy food marketplace, makes healthy eating personalized, convenient, and affordable. Foodsmart has raised a total of $114.8 million in funding.

6.Bitewell (Colorado, US): Bitewell makes food-as-medicine accessible and actionable for disease prevention and condition management. Bitewell has raised a total of $6 million in funding over 3 rounds. Bitewell secured pre-seed funding from Antler in 2020.

7.Chiyo (NY, US): Chiyo is a femtech firm specializing in maternal nutrition. They provide meal delivery services tailored for fertility, pregnancy, and postpartum stages. Chiyo has secured $3 million in funding.

8.ModifyHealth (Georgia, US): ModifyHealth makes food as medicine simple, effective, and enjoyable for providers and patients. Along with home-delivered, medically tailored meals, ModifyHealth provides dietitian support, remote patient monitoring, and education to ensure sustained benefits. The company partners with providers, payors, employers, and patients to make adopting healthier diets and lifestyles a reality. ModifyHealth has raised a total of $14 million in funding.

Food-As-Medicine in Europe: An Overview

While big food companies promote unhealthy products and big pharmaceutical companies rush to get miracle weight loss drugs approved quickly, turning to food as medicine can help prevent, control, and sometimes even reverse long-lasting illnesses.

However, linking diet to real health results can be challenging. Convincing healthcare plans and skeptical consumers will require companies to conduct clinical trials.

+ Health-tech is good

Suggestion? Critiques? Send your feedback in this link or reply to this e-mail. 🙁 😐 😍

Other topics you might find interesting 💡

📍 7 Companies Pioneering Health-Tech AI in Spain
Health-Tech in Spain is booming. 👉 Click here to read the full article.

📍61% of Digital Health Companies Pivot from B2C to B2B
B2B business models predominate digital health. 👉 Click here to read the full article.

Needing help with Growth Strategies, Fundraising & M&A? Get in touch!

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P.S. I used some of the following sources to obtain the data for this article:
(1)NIH (2) cbs.nl (3) Fitt Insider (4) Techcrunch (5) Dealroom (6) Photo by Brett Jordan on Unsplash

These three words really speak to me; they sound like exactly the kind of brand I'd want to give a shot. In fact, it's these very pillars that make people really trust and love Hims. The company went public in 2021 through a merger with a SPAC (special purpose acquisition company), with a deal valued at $1.6 billion.

Hims' appeal lies in its strong brand identity, particularly resonating with millennials. Hims has also been entirely “cash pay,” meaning it doesn’t accept insurance. Members pay a subscription of around $20-60 per month to have 24/7 access to online physician consultation and steady supplies of generic medications.

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Expanding a Direct-to-Consumer (D2C) health brand presents unique challenges and risks. Some companies set themselves apart by introducing new features, expanding their product categories, and forming partnerships to improve consumer value.

Let's delve deeper into Hims' growth strategy.

Success comes from executing effectively across four key pillars:

In 2023, 30% of Him’s subscribers used a personalised product, doubling the number from the previous year.

The strategy to attract and retain customers relies on four principles:

1. Consumer-Centric: Focused on meeting consumer needs and desires.

2. Partnerships & Ambassadors: Utilizing celebrity ambassadors and forming partnerships with retailers such as Target and Walgreens.

3. Multi-Channel Development: Engaging in TV advertising and leveraging social media platforms like Instagram and TikTok.

4. Data Security & Privacy: Implementing robust privacy practices to ensure the safety and confidentiality of patient and provider information.

A recurring revenue model lays the groundwork for robust revenue growth and margin expansion, with noteworthy figures to consider:

• 90% recurring revenue from subscription agreements

• A gross margin profile of 75%

• Payback period of less than 1 year

Even more important, the growth in subscribers is propelling revenue expansion.

Over the past 2 years, the average monthly revenue per customer has remained stagnant. It appears that the introduction of new products and services is strategically aimed at retaining customers on the platform and encouraging cross-selling, thereby mitigating churn.

Despite the static average monthly revenue per customer, adoption and retention remain strong, driven by innovative products and services. Now, the company is shifting its focus towards an uncharted territory by expanding into preventive care, with a specific emphasis on preventive cardiovascular health.

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Cardiovascular disease (CVD) is the leading cause of death globally, presenting both a highly complex issue and a substantial market opportunity.

- In the U.S., over $300 billion, or 15% of total health expenditures, is spent on managing and treating CVD.
- In the European Union, CVD costs €282 billion annually, with health and long-term care accounting for €155 billion (55%), approximately 11% of EU healthcare spending.

Clinical studies have shown that erectile dysfunction (ED) can serve as an early indicator of cardiovascular disease (CVD), alongside other risk factors. Leveraging its expertise in sexual health, Hims adopts a "dual-action approach" to address both sexual and heart health concerns. By personalizing treatments based on patient data, platform providers offer tailored solutions for individuals with ED and additional CVD risks, enhancing their awareness and treatment options.

Following consultation, if deemed clinically appropriate, patients receive a customized treatment formulation. This includes various dosages of ingredients from common ED medications and statins, all conveniently combined into a single tablet.

Building on its commitment to innovative health solutions, as a trusted pioneer in health and wellness with over a million platform users, Hims can uniquely facilitate sexual health treatment while identifying and connecting individuals with elevated cardiovascular disease (CVD) risk factors to preventive care. About 30% of Hims customers have factors elevating their CVD risk.

How did you like today’s Newsletter?

🙁 😐 😍

+ Health-tech is good

P.S. I used some of the following sources to obtain the data for this article:
(1) Hims Inc (2) WHO (3) CDC (4) NIH (5) Fortune

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The $1.8 trillion worldwide consumer wellness industry is familiar with trends that come and go; but today, consumers aren't just trying wellness trends blindly; they're asking, "What does science say?

Influencers flooding the consumer scene have brought a mix of wellness info, some reliable, some not. As consumers look to avoid deceptive marketing, healthcare provider advice is back in the spotlight.

In the United States, doctor suggestions rank third in influencing what consumers buy for their health.

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Healthy aging

The demand for products and services promoting healthy aging and longevity is booming, fueled by the rise of preventive medicine, health tech, and anti-aging research. This trend has led to the emergence of Longevity Clinics as a promising business opportunity.

What is a Longevity Clinic?

A longevity clinic aims to boost health and lower the chances of age-related illnesses through various treatments. These clinics, run by licensed medical experts, offer a range of services and products. Some concentrate on spotting age-related diseases early, providing hormone and stem cell therapies, while others introduce cutting-edge treatments like 'anti-aging' supplement plans.

The recent shutdown of the NY longevity clinic Modern Age, after raising $33 million, made clear the challenges these clinics are facing: include standardizing practices, addressing cost disparities, and navigating the variety of clinics offering longevity services.

Clinics typically offer comprehensive tests and personalized recommendations, but concerns arise regarding the reliability of certain assessments like aging clocks and whole-body MRI scans. Furthermore, the proliferation of stem cell treatments raises safety and efficacy issues.

Petr Šrámek, Managing Partner at Longevitytech.fund, outlines what customers can anticipate from a reputable longevity clinic:

• The clinic team includes experts from diverse longevity fields, prioritizing translational science.

• The clinic should actively participate in longevity clinical studies.

• MDs must have long-term experience managing patients with functional and integrative medicine approaches, dealing with modulation of biological pathways related to the roots of different conditions and being educated on the theory and applications of other areas like OMICS, cell biology, nutrition, and physical activity prescription.

• The main focus should be medical interventions to increase healthspan.

• The clinic shouldn't rely solely on "magic" equipment solutions but remain flexible to adopt safer and more effective tools as they emerge in the market.

• The clinic should not offer quick fixes but rather long-term programs.
  

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Several longevity clinics are gaining popularity, let's explore the most relevant ones in Europe:

HOOKE
Locations: (1) London, UK
Management Team: Kate Woolhouse (CEO), Lev Mikheev (Founder)
Team size: 20
Price Range: €8.550 - €63.000

Longevity Center
Locations: (2) Zurich, Switzerland & Warsaw, Poland
Management Team: Joanna Bensz (co-founder,CEO), Prince Michael of Liechtenstein ( co-founder)
Team size: 36

Healthy Longevity Clinic
Locations: (2) Prague, Czech Republic and Florida, USA
CEO: Petr Sramek
Team size: 16

Clinique La Praire
Locations: Lake Geneva, Switzerland
Management Team: Simone Gibertoni (CEO), Adrian Heini (Medical Director)
Team size: 381
Price Range: The starting price for the 1-week program is €50,000.

AYUN
Locations: Zurich, Switzerland
CEO: Francois Casanova
Team size: 7
Price Range: #ND, the clinic is launching in Zurich, Q2 2024.

Lanserhof Lans
Locations: (6) Austria, Denmark, Germany (3), UK
CEO: Christian Harisch
Team size: 131
Price Range: starting at €2,890 (Lanserhof Kur Classic, 7 nights)

Six Senses
Locations: Ibiza, Spain
Management Team: Neil Jacobs (CEO), Dr Tamsin Lewis (Medical Advisor)
Price Range: €500 (1 day) - €4,300 (7 days)


As we wrap up, it's fascinating to think about what's ahead in Longevity. Treatments like gene therapies, cell therapy, and 3D bioprinting hold a lot of promise for the future.

Suggestion? Critiques? Send your feedback in this link or reply to this e-mail. 🙁 😐 😍

+ Health-tech is good

P.S. I used some of the following sources to obtain the data for this article:
(1) MIT Technology Review (2) Longevity.Technology (3) McKinsey (4) Linkedin
(5) Header photo by Johny Georgiadis on Unsplash

Other topics you might find interesting 💡

📍 7 Companies Pioneering Health-Tech AI in Spain
Health-Tech in Spain is booming. 👉 Click here to read the full article.

📍25 Top VC Funds Investing In Health-Tech in Europe (Seed to Series A)
Europe has become a vibrant hub for health technology 👉 Click here to read the full article.

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Spain, particularly Barcelona, has always held a special place in my heart. From 2008 to 2012, I called Barcelona home, forging strong friendships with fellow entrepreneurs and investors along the way. Intrigued by the health-tech scene, I decided to dig deeper.

The health-tech startup ecosystem in Spain 🇪🇸 is renowned for its excellence, with a diverse range of companies utilizing AI in areas spanning from drug discovery to virtual reality treatments.

Recent funding initiatives are bolstering the ecosystem, as evidenced by Nina Capital's announcement last February of their third financing vehicle worth €50 million. This fund is dedicated to investments ranging from €200,000 to €2 million in early-stage and Series A ventures. Nina Capital has raised more than 300 million euros in five years.

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1. MethinksAI

-HQ: Barcelona, Spain
-Product: MethinksAI primarily concentrates on stroke, which ranks as the second most prevalent cause of death and a significant contributor to disability worldwide. Their primary offering is an artificial intelligence medical imaging software designed to conduct stroke diagnosis, unlocking the potential for stroke treatments from non-contrast CT scans.
-Investment: Methinks has raised a total of €5 million in funding over 3 rounds.

2. Legit.Health

-HQ: Bilbao, Spain
-Product: Legit.Health utilizes computer vision and artificial intelligence technology to facilitate life-saving diagnoses and therapies for skin conditions. Through image recognition and AI-driven recommendations, the company introduces cutting-edge technology to empower both patients and healthcare providers, facilitating improved and expedited clinical decisions.

3. Mediktor

-HQ: Barcelona, Spain
-Product: Mediktor is an advanced AI-based medical assistant that helps patients get the right care they need when they need it. It's backed by solid clinical validation and guides people to the appropriate level of care, making healthcare more accessible and navigation smoother. With its smart AI technology, users can chat naturally in multiple languages. Mediktor's software is versatile and can be seamlessly integrated into various platforms like websites, mobile apps, and desktops. Its clients include health plans, hospitals, telehealth services, and pharmaceutical companies.
-Investment: Mediktor has raised a total of $15.8 million in funding over 3 rounds, investors include Alta Life Sciences, Castel Capital and NAOS.

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4. humanITcare

-HQ: Barcelona, Spain
-Product: The system developed by humanITcare strives to offer enhanced patient monitoring, improved data quality, and streamlined protocols for healthcare providers, all without increasing their workload. This AI-driven, evidence-based solution guarantees accessible, efficient, and effective healthcare for everyone, facilitated by a user-friendly API-based solutions.
-Investment: humanITcare has raised a total of €3.3 million in funding.

5. Quibim

-HQ: Valencia, Spain
-Product: Quibim develops innovative tools aimed at unlocking imaging data to enhance patient outcomes. Their primary focus lies in applying AI techniques to medical images obtained from MRI, CT, PET scans, aiming to reveal new insights that can be translated into actionable predictions for life sciences and healthcare providers.
-Investment: Quibim has raised a total of €17 million in funding, investors include Amadeus Capital Partners, Adara Ventures, Apex Ventures, Partech Partners, Crista Galli Ventures, Tech Transfer UPV and Juan Roig.

6. IOMED

HQ: Barcelona, Spain
Product: IOMED creates software for managing medical records with a focus on efficiently organizing clinical data. Their technology harnesses the capabilities of Artificial Intelligence to extract healthcare data from various sources within hospitals. This includes activating data from both structured and unstructured sources, such as handwritten records.
Investment: IOMED has raised a total of €13.6 million. Key investors include Philips Ventures, XTX Ventures, Adara Ventures, EASO Ventures, and Inveready.

7. Idoven

- HQ: Madrid, Spain
- Product: Idoven is a health technology company pioneering early detection and precision medicine solutions for cardiovascular diseases. Through its AI-powered platform, Idoven significantly enhances the speed, consistency, and accuracy of electrocardiogram (ECG) interpretation. Utilizing robust proprietary AI algorithms compatible with existing ECG devices, the company also endeavors to develop biomarkers for patient identification, risk assessment, prognosis, and monitoring drug cardiac safety.
- Investment: IDOVEN has raised a total of €22.5 million in funding. Key investors include Insight Partners and Northzone.

+ Health-Tech innovation is good

P.S. I used some of the following sources to obtain the data for this article:
(1) Crunchbase (2) Adara Ventures (3) Sifted (4) Nina Capital

Other topics you might find interesting 💡

📍 5 Startups focusing on Preventive Health
7 out of 10 deaths are caused by Chronic Diseases: heart disease, cancer, diabetes, AIDS or other conditions. 👉 Click here to read the full article.

📍16 Venture Capitalist Backing Microbiome Tech Startups
The Microbiome Tech Investment Landscape. 👉 Click here to read the full article.

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Doctor: When was the last time you had a health check-up?
Me: Hmm, I think it was about 5 or 6 years ago; was my response.

Unaware, it was too late. On July 15th, 2018, I ended up in the hospital, battling a chronic diverticulitis (missing out the FIFA World Cup final, France vs Croatia).

Every year, around 41 million people worldwide die from chronic diseases, which make up seven out of every ten deaths globally.

Of these deaths, approximately 17 million are classed as premature, meaning people are passing away much earlier than expected on average.

Figures like these highlight the necessity for increased focus on proven preventive healthcare strategies:

- Routine cardiovascular exams alone save tens of thousands of adult lives each year,
- 4 million deaths worldwide are prevented by childhood vaccination every year,
- Preventive health screenings and primary care consultations have also been found to significantly increase life expectancy, particularly among the 30- to 49-year age group.

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Which countries have most improved their life expectancy at birth?

Estonians have experienced the most significant increase in life expectancy, gaining 6.1 years between 2000 and 2021. Following closely are Ireland (+5.8 years), Luxembourg (+4.7 years), Denmark (+4.6 years), and Slovenia (+4.5 years).

Monitoring life expectancy estimates is crucial for assessing societal well-being, and policymakers heavily rely on these trends to shape government policies.

The Dutch government wants everyone to have five more healthy years by 2040, which could lower healthcare costs.

France is also dealing with aging population, putting pressure on its social security system. To tackle this, the French government has passed reforms, facing resistance, to raise the retirement age and encourage people to work longer.

5 Startups focusing on Preventive Health

1. ZOI (France): co-founded by Ismaël Emelien, former special advisor to Emmanuel Macron during the early days of his presidency; the company aims to integrate routine medical checkups with preventive care through a mobile app.
   Investment: Zoi has raised an impressive seed round of €20 million, from business angels exclusively, in 2022.

2. Ancora Health (Netherlands): Founded by Sridhar Kumaraswamy, Rahul Gannamani and Jose Castela Forte in 2019, Ancora Health’s aim is to add more healthy years to society and has developed an approach that differs from regular health programs. It doesn’t only focus on clinical parameters, but also on behaviour and lifestyle support.
   Investment: Dutch banking giant Rabobank, invested €3 million in the digital health startup in 2022.

3. Forward (USA): a startup redesigning the way healthcare is delivered, using all the technologies healthcare has neglected: sensors, mobile, and AI. Forward introduced CarePods, an autonomous, AI-enhanced medical facility (image below). The company was founded in2016 by former executives and engineering leaders from Google and Uber and led by serial-entrepreneur, Adrian Aoun.
   Investment: The company has raised a total amount of €600 million by some of the world's best investors including First Round Capital, Eric Schmidt and Marc Benioff.

4. Neko Health (Sweden): Founded in 2018 by Hjalmar Nilsonne and Daniel Ek (founder/CEO of Spotify), Neko Health believes that with the help of the latest sensor technology and AI, it is possible to create more affordable and thorough examinations that can raise the quality of healthcare and focus on prevention. Investment: Neko Health has raised a total of €60 million in funding.

5. Pernuvo (USA): A Cindy Crawford-backed startup offering whole-body MRIs for €2,292. Prenuvo has created an artificial intelligence-powered alternative to traditional magnetic resonance imaging that can be used to screen and diagnose more than 500 medical conditions, including most solid tumors at Stage 1.
   Investment: The company has raised €64 million in Series A in 2022 led by Felicis and well-known angel investors, including Nest founder Tony Fadell, 23andMe Inc. Chief Executive Anne Wojcicki, and Cindy Crawford.

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I'm really happy to see more startups focusing on preventive health. At the same time, it's concerning to see some of them charging €2500 to €3500 for a full checkup. It seems like only people with deep pockets can afford it.

(But) I'm optimistic that as more people start using these services, prices will come down over time, making them affordable for everyone in the long run.

In conclusion, regular check-ups and routine tests play a vital role in maintaining overall health and well-being. While immediate medical attention is essential for addressing illnesses and injuries, these preventive measures enable physicians to monitor diagnostic readings and detect any underlying health issues early on.

For middle-aged and elderly individuals, in particular, routine tests and exams are indispensable for screening chronic diseases and infections, including cancer, diabetes, and heart disease.

Emphasizing the importance of preventive healthcare is essential for promoting longevity and improving health outcomes across all age groups.

When was the last time you had a health check-up?

+ Health-Tech innovation is good

P.S. I used some of the following sources to obtain the data for this article:
(1) PublicHealth.org (2) Imperial College London (3) Health Holland (4) Techcrunch (5) Eurostat

Other topics you might find interesting 💡

📍 The FemTech Revolution
Unlocking Opportunities in Women's Healthcare. 👉 Click here to read the full article.

📍16 Venture Capitalist Backing Microbiome Tech Startups
The Microbiome Tech Investment Landscape. 👉 Click here to read the full article.

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Right now, I'm exploring which events to attend in 2024, and I've compiled a list of the top 5 events in Health-Tech that I'm considering.

If you have any recommendations, please feel free to share them with me :)

HLTH Europe 2024
Date: 17 - 20 June 2024
City: Amsterdam
Website: www.europe.hlth.com

Audience breakdown: 70% of the audience is made up of:
- Investors,
- Startups,
- Health technology, solutions & services,
- Health systems & health providers,
- Life sciences, biotech & pharma

Over 300 speakers will take the stage at HLTH Europe, and it appears that there will be a lineup of very interesting speakers, some of them are:

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Entrepreneurs
- Andrea Berchowitz, Co-Founder of Vira Health - UK
- Asima Ahmad, Co-Founder & Chief Medical Officer of Carrot Fertility - USA
- Caroline Mitterdorfer, Co-Founder & CEO of LEVY - Germany

Investors
- Edward Kilphuis, Partner of Sofinnova Partners - France
- Bert-Arjan Millenaar, Founder & CEO of NLC Ventures - Netherlands
- Lucanus Polagnoli, Founding Partner & CEO of Calm/Storm Ventures - Austria

Corporates
- Malin Johansson, VP Global Digital Health Partnerships and Commercialisation at Novo Nordisk - Denmark
- David Evendon-Challis, Head of R&D and Chief Scientific Officer at Bayer Consumer Health - Switzerland
- Ida Luka-Lognone, CEO Health, Board Member at Allianz Partners - France

health.tech Conference 2024
Date: 05 - 06 June 2024
City: Munich
Website: www.health.tech

Audience: hospitals, payers, tech-companies, startups, data companies, and regulators.

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Speakers: a very interesting group of leading people in Health-Tech, some of them are:

Entrepreneurs
Saeju Jeong, Co-Founder and Executive Chairman of Noom - USA
George Hadjigeorgiou, Co-Founder of ZOE - UK

Investors
Julien Hobeika, Partner of EQT Ventures - France
Rob Kniaz, Founding Partner of H Tree Capital - UK

Corporates
Hema Purohit, CTO & Director Healthcare, EMEA at Microsoft - UK

EIT Health Summit
Date: 18 - 19 April 2024
City: Rotterdam
Website: www.summit.eithealth.eu

Digital Healthcare Show
Date: 24 - 25 April 2024
City: London
Website: www.digitalhealthcareshow.com

DMEA 2024
Date: 09 - 11 April 2024
City: Berlin
Website: www.dmea.de

Well, it seems like April and June will be busy months with a lot of networking, innovation and of course some drinks 🍻. If you are planning to attend any of these events, feel free to ping me—I would love to grab a beer with you!

+ Health-Tech innovation is good

Other topics you might find interesting 💡

📍 50 Companies Pioneering the Future of Menopause Health
Menopause is having its moment. 👉 Click here to read the full article.

📍10 Acquisitions In 9 Years, Inside Unilever Prestige's M&A Strategy.
Deep dive into Unilever’s growth engine 👉 Click here to read the full article.

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Growing a Direct-to-Consumer (D2C) health brand comes with its own set of challenges and risks. While the D2C model offers many benefits, including direct access to consumers and the ability to build a strong brand, it also has its drawbacks.

Some of these risks to consider are:

1. Competition: Establishing a long term moat to compete against new entrants, such as leveraging network effects.
2. Value Proposition: Crafting a compelling value proposition in the healthcare sector that fosters consumer trust and credibility, particularly challenging for D2C brands without physical presence or professional endorsements.
3. Unit Economics: Developing a business model with clear avenues for monetization.
3.1 Average Order Value (AOV): Focusing on strategies to boost AOV and/or increase purchase frequency.
3.2 Customer Acquisition Cost (CAC): Devising a pragmatic approach to ensure a positive LTV/CAC > 3 ratio
4. Acquisition: building a repeatable and scalable acquisition engine.

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The challenging macroeconomic conditions of last years proved to be a significant obstacle for emerging D2C digital health startups, particularly those in the early stages of their journey, which had to make substantial initial investments in building brand awareness and acquiring customers.

This led me to ponder the strategies that successful D2C Digital Health brands are adopting to sustain their growth. Due to the lack of affordable funding for acquiring customers or a captive audience of pandemic-era buyers, D2C companies had to focus on operational efficiency and the long-term value of their customers. Some companies set themselves apart by introducing new features, expanding their product categories, and forming partnerships to improve consumer value. Others explored opportunities to diversify their revenue streams by engaging in B2B ventures.

In this edition of the newsletter, I'll delve into the growth strategy of Viome. In an upcoming newsletter, I'll delve into the strategies of other companies such as ZOE, Ro.co, and Hims.

Let's explore the growth strategy further:

1. Viome (a Viome Life Sciences Company) - (Washington / US)
Provides a direct-to-consumer healthcare test that analyzes microbial and human gene expressions (mRNA), in order to provide individuals with health insights and the nutrition they need.

The numbers:
Employees: 86
Revenue 2023: €26 million ($29 million in Dealroom)
Total Funding: €161 million and was last valued in 2022 at €312 million (multiple of 12x the revenue, not bad )
Total Test performed: 350,000 from consumers in 106 countries (primarily the U.S., U.K., Canada and Australia)
Pricing: Gut Health Solutions from €73/mo ( Test + Probiotics & Prebiotics)

Growth Strategy: Viome employs diverse channels, both digital and physical, to enhance its expansion.

1. Online:
   -Influencers & Affiliate Marketing: Viome has implemented a User-Generated Content strategy, partnering with celebrities and influencers at the micro and medium-tier levels. The company has capitalized on these endorsements by featuring a dedicated link on its website, offering special discounts to individuals who are introduced to the brand through these influencers. Notable examples include Paris Hilton and actor Tom Hopper. Affiliate Program: Viome offers a 15% commission to its affiliates, with an average order value (AOV) of €165.
   -E-mail Marketing: Taking advantage of the great interest of consumers in VIOME products, the company nurtures them, via email marketing, with relevant content, webinars and events.
   -Performance Marketing: A large amount of the capital raised is allocated to advertising on Facebook, Instagram and other social networks.
   

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   Viome’s Biggest Advocates

2. Offline:
   -Partnerships (Retail): The pharmacy chain CVS plans to introduce Viome tests in approximately 200 stores across the United States. The collaboration works as follows: CVS is purchasing kits in a wider revenue share agreement.

3. Product & Inorganic Growth:
   -Product category expansion: Viome will use its last funding of €80 million to develop new product lines around mouth and dental health (Oral Health Test + Supplements from €63,5/mo).
   -Acquisitions / Inorganic growth: In line with the expansion of new product categories, Viome acquired Naring Health in 2023, enhancing its personalized medicine offerings. Additionally, in 2019, Viome acquired Habit, a prominent personalized nutrition company owned by Campbell Soup Company (NYSE:CPB)
   

   

The truth is that in D2C, the acquisition cost only tends to get worse over time. Increasing CAC, plus robust personnel structures required to handle growth have contributed to the challenge of achieving profitability.

Despite this, there appears to be a promising opportunity for D2C Digital Health companies to diversify their product offerings and minimize these expenses by leveraging their established customer base. For instance, Viome initially focused on gut health tests and supplements, but is now venturing into oral health and longevity solutions. Similarly, companies like Ro.co and Hims have successfully expanded from sexual health to hair growth and mental health services.

+ Health-Tech innovation is good

P.S. I used some of the following sources to obtain the data for this article:
(1) Viome.com (2) Dealroom (3) Crunchbase (4) Techcrunch

Other topics you might find interesting 💡

📍 Europe in 2040: The Future Of Health
Europe needs a fresh perspective on healthcare. 👉 Click here to read the full article.

📍Don't Die: The Rise of Longevity Technology
As people increasingly seek to delay the aging process and extend their healthspan, a notable business opportunity is emerging for companies to introduce innovative products and services in this field. 👉 Click here to read the full article.

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10 years ago, a wave of companies emerged, promising to revolutionize health by empowering individuals to monitor their diet, sleep, exercise, and other habits through digital means. However, funding for digital health considerably dwindled between 2022 and 2023, leading many companies to shift their focus from direct-to-consumer (DTC) models to business-to-business (B2B) approaches.

This transition has been notably adopted by industry titans like Calm, CostPlusDrugs, and GoodRx, even before 2022, who now prioritize employer and payer partnerships while continuing their direct-to-consumer efforts.

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A common pitfall among digital health ventures is the application of a strategy cultivated in the tech sector to the healthcare domain, which operates under an entirely different set of dynamics. Unlike consumer tech startups that rapidly introduce a minimum viable product (MVP) and refine it based on consumer feedback, the lean startup approach is unsuitable for the intricate and highly regulated healthcare sector.

Many tech founders initially focus on consumer-oriented products but later realize that healthcare providers and insurers are the primary decision-makers and target customers for their products.

Rock Health conducted research involving 85 digital health startup founders, affirming the prevailing rumors: B2B business models dominate the digital health sector.

Among the startups surveyed:
- 34% began life with a B2C business model.
- Of those who started as B2C companies, 61% changed their business model to either B2B2C (45%) or B2B (16%).
- Only 14% of companies surveyed currently operate under a B2C business model.

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A Better Approach

In healthcare, the old way was to invent something, like a fitness tracker, and then figure out how to use it. But, a new, more effective approach is emerging: one that puts the emphasis on understanding healthcare challenges before creating solutions.

Here's how it works:

1. Spotting the Gaps: Instead of making gadgets and then trying to find a use for them, we start by spotting where healthcare is falling short. Maybe it's something like making sure people take their meds or improving how doctors and patients talk to each other.

2. Getting to Know the Problem: Once we know what's missing, we dive deep into understanding the issue. We look at what's already out there, talk to doctors, patients, and others involved, and really get why things aren't working as well as they could.

3. Setting the Must-Haves: We make a list of the key things our solution needs to do to effectively address the issue. Things like being accurate, not costing a fortune, and fitting into how things already work.

4. Crafting the Fix: With our list in hand, we create a solution from scratch that ticks all the boxes. We keep tweaking and improving until it's fully optimized.

This approach called “need-driven innovation” , makes sure our solutions actually fit the bill and make a real difference in people's lives.


Another Valuable Approach: B2C2B in Digital Health

B2C2B, commonly referred to as the bottom-up approach, has facilitated the entry of companies such as Slack, Zoom, Dropbox, and other software firms into the B2B market. Now, a similar trend is emerging in digital health, as a wave of startups initially market their products and services directly to consumers. Upon reaching a significant user base, they pivot towards engaging insurance companies, employers, and other organizations.

Why choose B2C2B?: While B2C2B can be more complex to execute, it gives startups the power to acquire and engage users directly without first contracting with the payor.

In a nutshell, the B2C2B motion is trying to control the growth through direct patient acquisition. You can build up your own funnels and channels to acquire patients, but then still get paid by the traditional system of payors and employers.

Applying successful tech strategies to healthcare isn't enough. In the era of rapidly growing digital health, the key to success lies in understanding the true needs, crafting innovative solutions that meet stakeholders' core requirements, and proving that the product delivers superior outcomes.

+ Health-Tech innovation is good

P.S. I used some of the following sources to obtain the data for this article:
(1) Rock Health (2) Fast Company (3) Stanford (4) a16z

Other topics that might pique your interest 💡

📍 Europe in 2040: The Future Of Health
Europe needs a fresh perspective on healthcare. 👉 Click here to read the full article.

📍Don't Die: The Rise of Longevity Technology
As people increasingly seek to delay the aging process and extend their healthspan, a notable business opportunity is emerging for companies to introduce innovative products and services in this field. 👉 Click here to read the full article.

The contents of this newsletter have the potential to influence those around you. Feel free to share it.

Share

As entrepreneurs, we're always envisioning the future and contemplating how we can create impactful solutions to address significant challenges in the next 10 to 20 years.

It's not hard to imagine that by 2040, healthcare will be structured around citizens rather than the institutions that currently dominate the systems. The need for a new, cost-effective, and sustainable approach to healthcare in Europe is driven by factors such as aging populations, shifts in culture, complex financing models, high costs of innovation, a shortage of skilled personnel, and growing health disparities.

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A New Healthcare Vision

The Current Situation: Healthcare in Europe is managed independently by each nation, resulting in a diverse array of systems shaped by unique cultural, economic, and political factors. Funding for healthcare primarily comes from three sources: government schemes, social health insurance (SHI), and private health insurance (PHI). The allocation of health spending is largely influenced by political decisions and tends to align with each country's economic size, as measured by GDP. In 2020, the average healthcare expenditure in Europe accounted for 10.9% of GDP (it was 8.8% in 2019). However, access to new medicines and innovative technologies varies significantly across Europe due to differing pricing and reimbursement models.

Recognizing the urgent need to address healthcare challenges and disparities, especially exacerbated by the recent pandemic, the European Commission introduced a new EU Global Health Strategy in November 2022. This strategy emphasizes the importance of ensuring the health and well-being of European citizens and calls for transformative approaches to enhance healthcare capacity and capability.

The strategy highlights the importance of:

1. Transforming European healthcare systems significantly, with a strong emphasis on digitalization and developing a more sustainable healthcare workforce.

2. Encouraging the adoption of environmentally friendly healthcare systems.

3. Placing greater emphasis on primary care and prioritizing preventive measures to maintain people's health. This includes empowering individuals with a deeper understanding of their health and giving them more control over their well-being.
   

This transition shifts from the current focus on reactive treatment to a focus on proactive health promotion, prevention, and symptom management.

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In 2017, Deloitte launched its Global Future of Health campaign, foreseeing a shift towards proactive health management enabled by emerging technologies like AI and digital platforms. Deloitte envisions a future of healthcare in Europe where prevention takes precedence over treatment, aiming for population-based, efficient, and cost-effective care by 2040. Treatments will follow the ‘5P’ approach, focusing on prediction, prevention, participation, personalization, and precision to enhance longevity and well-being.

How Could This Futuristic Vision Impact Different Stakeholders?

European healthcare is on the verge of a profound transformation as organizations transition from existing isolated systems to a collaborative network of interconnected partners.
In the future of health, stakeholders like MedTech, pharma and technology companies and big data organisations will assume new roles aligning with outcome-based care delivery.

The Impact:

1. Empowered citizen: Everyday people will have easy online access to their private health records and decide who can access their data and how it's used. With digital skills, they'll take charge of their health, using technology like Age-Tech and Fem-Tech, as well as the latest in geriatric science and precision and regenerative medicine to learn more about healthy aging.

Within Age-Tech there are already real players in the market:
- Cera (UK): total funding € 303 Million
- Birdie (UK): total funding €43 Million
- Ouihelp (France): total funding €33.4 Million
Other companies in the market are: Cuideo (Spain):€5 Million, Nobi (Belgium) €14 Million, Marta (Germany): €6.6 Million

My previous newsletters have featured some of the most promising Fem-Tech startups in Europe, focusing on areas like fertility and menopause.

2. Governments, along with private and public insurance organizations and other payers, will introduce Universal Health Coverage (UHC) for core services using new funding models based on outcomes. By 2040, equal access to healthcare and financial protection for all citizens will be widely accepted throughout Europe.

e.g. France is the first country to offer elective egg freezing for nonmedical reasons under public health coverage. However, this decision deserves in-depth scrutiny in the future because the cost-beneficial profile is yet unknown.

3. Healthcare providers will prioritize patients and use digital tools from start to finish to track progress. European citizens who need help will be guided to the right place for care automatically. Primary care networks will focus on the health needs of the community using a personalized approach. They will use AI for remote monitoring and diagnostics and gather real-world data on vital signs.

There are already great innovations in this area:
- Doccla (UK) Europe's leading virtual hospital.
- Tucuvi (Spain) automates medical phone conversations with AI.
- Nabla (France) provides doctors with an AI-powered tool that generates clinical notes from patient consultations. It raised €22 Million in Jan/2024. 
- Ganymed Robotics (France) is developing robotic systems designed to assist surgeons in performing minimally invasive procedures.

4. A steady and sustainable healthcare workforce is crucial. Advances in AI robotics, cognitive automation, data exchange, and digitization will improve healthcare professionals' productivity and work-life balance.

European investors are already watching these companies closely:
- CogStack (UK) helps hospitals measure workforce productivity and automate data tasks (including clinical coding).
- Healthtech-1 (UK) automates admin tasks in primary care like patient registration and triage. The startup began automating patient registrations in primary care.

5. MedTech companies will lead Value-Based Healthcare (VBHC). AI-powered products and services will enhance understanding of their clinical use, offering cost-effective solutions. MedTech will employ advanced data analytics and collaborate closely with users to create new cognitive technologies for improved health results.

3 medical device startups to watch in Europe:
- Volta (France) is developing a software called to help treat atrial fibrillation, a condition that causes an abnormal heart rhythm.
- FundamentalVR (UK) provides a virtual reality (VR) platform for surgical training with the latest medical devices and complex procedures, with optic and haptic VR simulation.
- Robeauté (France) is building microrobots with a built-in motor which can carry therapeutic cargo or diagnostic sensors to get to the disease site in the brain.

6. Pharmaceutical companies will use AI throughout their operations to boost productivity and enable the delivery of 5P medicine. Streamlining research and development and production processes will be essential for pharmaceutical companies to achieve a positive return on investment (ROI) from innovation.

Some notable companies employing AI for drug discovery are:
- Cradle (Netherlands) uses generative AI to help biologists design improved proteins and accelerate research and development. In November 2023, Cradle raised €22 Million.
- Exscientia (UK), is an AI-driven precision medicine company committed to discovering, designing, and developing the best possible drugs in the fastest and most effective manner using its AI technology.
- Iktos (France) is making use of AI technology for drug discovery and design, using it to rapidly identify small molecules that can become clinical candidates.

Collaborative partnerships for Value-Based Healthcare (VBHC) among all stakeholders will drive progress in the future of health in many countries.

Europe's healthcare system is on the verge of a significant transformation that will impact everyone involved. If this vision becomes reality, it will lead to healthier populations and more sustainable healthcare.

P.S. I used some of the following sources to obtain the data for this article:
(1) Think Global Health (2) Eurostat (3) European Commission (4) Deloitte (5) Dealroom (6)Crunchbase

Other topics that might pique your interest 💡

📍 25 Top VC Funds Investing In Health-Tech in Europe (Seed/Series A)
Europe has become a vibrant hub for health technology 👉 Click here to read the full article.

📍Don't Die: The Rise of Longevity Technology
As people increasingly seek to delay the aging process and extend their healthspan, a notable business opportunity is emerging for companies to introduce innovative products and services in this field. 👉 Click here to read the full article.

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As I dive into the world of health-tech business opportunities, I couldn't help but wonder: What's keeping other serial tech entrepreneurs in Europe busy?

Many successful entrepreneurs create one company and spend their lives scaling it, but for others, one just simply isn’t enough.

I have stumbled upon 8 seasoned entrepreneurs who are making waves in tech-driven healthcare and biotech. Wait, but... tackling healthcare is tough.

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This list is in no particular order.

1. Martin Varsavsky
Sector: Fertility
Where: Spain
Martin is an Argentine entrepreneur and philanthropist based in Madrid. With a long trajectory in the telecommunications sector, he has founded companies like Viatel, Jazztel (IPO 1999), Ya.com (acquired by T-Online) , and Fon.

Martin encountered a setback in his life when he and his wife attempted to begin a family. Shortly after their marriage, Nina, who was 31 years old at the time, discovered she was facing infertility challenges. For this reason, in 2015 Martin founded Prelude Fertility/Inception now the largest chain of fertility clinics in the USA. Two years later he also founded Overture Life, focused on automating the embryology lab. Overture is backed by Khosla Ventures, Marc Benioff and Allen & Company.

2. Michael Greve
Sector: Longevity
Where: Germany
Michael is among Germany's most accomplished tech entrepreneurs. He co-founded companies like WEB.DE and lastminute.de and was an early investor in several German unicorns, like Babbel, Staffbase, and Mambu.

He started out Forever Healthy more than a decade ago as a personal quest to shed the extremely unhealthy lifestyle he acquired while building his own startups (this resonates with me). Michael is also the founder of Kizoo Venture Capital. Kizoo’s focus is on the creation, mentoring and financing of rejuvenation biotech startups that turn basic research into therapies for human use.

3. Daniel Ek
Sector: Preventive Health
Where: Sweden
I don’t need to introduce Daniel; I'm certain you've recently tuned into a podcast, enjoyed your favorite music, or perhaps even meditated using Spotify (yes, he’s the founder and CEO).

Daniel’s new venture is Neko Health, a health tech startup, offering a revolutionary approach to preventive healthcare through comprehensive full-body scans supported by AI software. This technology aids doctors in identifying various health issues, such as skin conditions, cancer, cardiovascular diseases, and diabetes, along with other metabolic syndromes. The company secured €60 million in a Series A funding round, spearheaded by Lakestar, with contributions from Atomico and General Catalyst.

Daniel's investment firm, Prima Materia, has recently placed a strategic investment in a longevity-focused company. It’s invested €10m into Epiterna, a Swiss startup working on slowing ageing.

4. Sokratis Papafloratos
Sector: Men’s Health
Where: UK
Sokratis is a serial entrepreneur who has started, built, and exited. In 2006 he founded TrustedPlaces (Yelp-like local reviews site), acquired by Yell Group in 2010.

In 2018 Sokratis founded Numan.com, a digital health platform dedicated to revolutionizing men's health. Numan offers a digital subscription service for men’s health issues, including hair loss, gut and lung health, sexual health, and nutritional deficiencies. Numan has raised a total of €75m from White Star Capital, with participation from Novator, VNV Global, and Anthemis Exponential.

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5. Nils Regge
Sector: Longevity
Where: Germany
Nils is a serial entrepreneur, with six exits since 2009. Some of his most outstanding ventures are: CASAMUNDO acquired by Leisure Group, Finanzcheck exit to Immobilienscout (now Hellman & Friedman) and HomeToGo, Germany's first SPAC IPO.

In 2017 Nils co-founded Apollo Health Ventures, an early stage Venture Capital firm co-founding and investing in healthcare companies targeting age-related diseases and aging itself.

6. Dinko Valerio
Sector: Respiratory Disease
Where: Netherlands
Dinko is a scientist-turned-entrepreneur, in 1993 he founded Crucell (IPO), a biopharmaceutical company specializing in vaccines later acquired by Johnson & Johnson. After working to make Crucell a success, Valerio helped set up the spin-off company Galapagos Genomics, one of the biggest and most successful biotechs in Europe. He also founded the Venture Capital firm Aescap Venture in 2006.

Currently he’s the co-founder and Executive Chairman of Leyden Labs, a company targeting commonalities of respiratory viruses.

7.Greg Bailey
Sector: Longevity
Where: UK
Greg is a physician, financier, and biotech entrepreneur. He was a former managing partner of Palantir Group, Inc., a merchant bank specializing in biotech and intellectual property and he was the initial financier and an independent director of Medivation, Inc. (MDVN:NASDAQ), acquired by Pfizer in 2016. He also led the seed financing of Biohaven Pharmaceuticals Holding Company Ltd. Previously, he founded and financed Ascent Healthcare Solutions, VirnetX Inc. (VHC:AMEX), and SalvaRx Group PLC.

His latest startup is tackling longevity by focusing on how to halt and even reverse the aging process. Juvenescence has already raised $249M and already has 11 products in the works. Ranging from their ketosis product which is already out, to technologies that have proven to regrow limbs in frogs.

8. Steven Bartlett
Sector: Psychedelics, Nutrition, Health Wearables
Where: UK
In 2014 Steven founded the social media marketing agency Social Chain, which went on to become “Social Chain AG” a publicly listed company.

Steven is as a speaker, investor, author, content creator and the host of one of Europe’s biggest podcasts, ‘The Diary of a CEO’. In 2020 he’s also invested in, and taken a role as an advisor in atai life sciences - a biotech company working to cure mental health disorders.

With a special focus on innovative companies in health and nutrition, Steven has recently invested in companies such as Huel, WHOOP, and ZOE.

As we're discussing serial entrepreneurs venturing into health-tech and bio-tech within Europe, let's shift our focus to see what some entrepreneurs across the Atlantic, in the United States, are up to.

Kevin Ryan
Sector: Fertility, Psychedelics, Therapeutics, Healthcare Marketplaces
Where: New York
Often called the “Godfather of NYC tech,” Kevin is one of the leading internet entrepreneurs and investors in America. He has founded several New York–based businesses, including Gilt Groupe, Business Insider, Zola and MongoDB (IPO).

Kevin continues to found and invest in companies through AlleyCorp, a venture capital firm he founded in 2008. Through Alley Corp Kevin has invested in or founded companies such as Nomad Health, Pearl Health, Transcend Therapeutics, Journey Clinical and Maven.

Brian Armstrong
Sector: Longevity
Where: San Francisco, CA
Brian is the co-founder & CEO of Coinbase (IPO). In 2023 he raised $40m for NewLimit, a longevity pharma startup that aims to increase the number of healthy years each person lives by epigenetically reprogramming cells.

Luka Ivicevic
Sector: Longevity
Where: Miami, Florida
Luka is now on his third startup. He started Penta, Germany's largest bank for businesses in 2016 that was later acquired by Qonto in 2022.
Luka’s latest endeavor, Index Health, is a functional medicine startup with a primary focus on promoting wellness and extending longevity. By identifying risky genes, providing personalized care plans, and getting ahead of our DNA, Luka says that he firmly believes it will be possible for this generation to live to be 150 years old.

After listing these serial entrepreneurs, it's pretty obvious they're onto something big. The healthcare setups in the US and Europe are like night and day: America relies a lot on private insurance, while lots of European countries offer universal healthcare, meaning everyone gets treated no matter what. But despite this dichotomy, these entrepreneurs are all working towards helping people live longer and healthier lives.

As I mentioned in one of my earlier newsletters, the idea of living forever has been a longstanding dream for humanity, it seems that we do not want to die. The question is, is this true?

Top 10 longevity sector investments:

P.S. I used some of the following sources to obtain the data for this article:
(1) a16z (2) Linkedin (3) Sifted (4) Business Leader (5) Crunchbase (6) Longevity Technology (7) lifespan.io

Other topics that might pique your interest 💡

📍 The Health Wearables Market
Checking my body battery has become a morning ritual for me. Intrigued by the advancements in this industry of Health Wearables, I decided to delve deeper and was blown away by the sheer amount of innovation and capital being invested. 👉 Click here to read the full article.

📍16 Venture Capitalist Backing Microbiome Tech Startups
The Microbiome Tech Investment Landscape 👉 Click here to read the full article.

The contents of this newsletter have the potential to influence those around you. Feel free to share it.

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+ Health-Tech innovation is good

A research, published in Davos on Wednesday by the World Economic Forum and the McKinsey Health Institute (MHI), found that on average women were in poor health for 25% longer than men and that this could be cut by almost two-thirds if the health gap was closed.

Recognizing the potential for positive change, investments directed towards addressing women's health disparities have the power to not only extend both the quantity and quality of life but also contribute to a projected annual boost of $1 trillion to the global economy by 2040. Furthermore, closing this gap could have a transformative impact equivalent to 137 million women gaining full-time employment by 2040, offering them the means to support themselves and their families, ultimately contributing to lifting more women out of poverty.

A huge opportunity exists to develop additional solutions for women in the working age group, as almost half of the health burden affects women during their working years. This often results in implications for their capacity to earn income and provide support for themselves and their families.

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Private equity and venture capital investors are increasingly channeling investments into women's health.

The surge in these investments is propelled by the emergence of clear opportunities in women's health and the rise of female-led technology (FemTech) start-ups seeking to disrupt the healthcare market. Notably, activity within the FemTech space is concentrated on maternal health patient support, consumer menstrual products, gynecological devices, and fertility solutions.

In the past four years, top deals in the startup landscape predominantly focused on men's sexual and overall health. A McKinsey analysis reveals a significant funding gap, with 11 start-ups addressing men's health concerns, including erectile dysfunction, securing $1.24 billion from 2019 to 2023, compared to eight start-ups addressing endometriosis, which received $44 million. Although funding for erectile dysfunction-related ventures was six times greater, recent trends indicate a shift. Over the same period, newcomers in women's health garnered $2.2 billion in funding, with 60 percent of the top deals exclusively targeting women's health issues such as endometriosis, fertility, and maternal and neonatal health.

Considering the substantial unmet need and the resultant opportunities, those who neglect investments in women's health may risk being outpaced by competitors who tap into this high-potential market.

Conclusion

Acknowledging the significant potential to enhance the well-being and economic opportunities for half of the global population acts as the driving force to bridge the women's health gap. Every aspect of this disparity, encompassing issues like limited education and suboptimal treatments, presents an opportunity for positive transformation with the active engagement of governments, life science innovators, educational institutions, philanthropists, activists, and other stakeholders.

Improving women's health and well-being generates a ripple effect that reaches into families, communities, and nations. By adopting a comprehensive approach through collective action and ongoing investment, not only can we reduce the health disparity, but we can also contribute to enhancing our shared global future.

Other topics that might capture your interest:

📍 The 18 Most Promising Fertility Startups To Watch
As fertility rates decline and people choose to have children later in life, venture capitalists are now recognizing the potential in investing in reproductive tech startups. 👉 Click here to read the full article.

📍Rethinking Employee Healthcare and Benefits in the 21st Century.
Employers are facing increasing pressure to proactively address societal issues, including women's health, health equity, and mental well-being.
👉 Click here to read the full article.

The contents of this newsletter have the potential to influence those around you. Feel free to share it with anyone you believe might find it interesting.✌️

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+ Health-Tech innovation is good

Martin

P.S. I used some of the following sources to obtain the data for this article:
(1) McKinsey & Company full report

Hey there,

I'm thrilled to take a moment and share a slice of my journey with you through this newsletter. Back in June 2023, I kicked off The Endurance Revolution with a simple yet ambitious goal—to delve deep into the health tech and sport tech industry. Why? Because I've made a conscious decision that this is where I want to channel my time and energy for the next two decades.

The first iteration of The Endurance Revolution—the one you're currently reading—saw some decent numbers with 20 articles and almost 100 subscribers in just six months, marking it as the inaugural MVP - minimum viable product. Now, it's time for the next chapter.

In recent months, my focus has honed in mainly on health tech. Why? Because I hold a strong conviction that the future lies in health technology—a future in which we can enjoy extended lifespans and improved quality of life, leveraging a healthcare system that is not just efficient but also integrated and proactive.

So, here's the exciting news—I'm introducing the second phase of this newsletter. The next step? A brand new name and logo. Say goodbye to The Endurance Revolution and welcome "The Future of Health." I hope you find the new look as invigorating as I do! 😊 What can you expect in this revamped version? Well, get ready for M&A analyses of the health-tech industry, insightful charts brimming with relevant data, and exclusive interviews with entrepreneurs, operators, and investors primarily active in Europe.

Thank you for being part of this journey! I hope you continue to find joy in it.

Note: you should expect a full rebranding after this newsletter.

1. M&A on the Rise

In 2023, the digital health sector experienced a significant downturn in funding levels due to multiple factors. This decline was primarily attributed to higher interest rates, constraining venture capital firms' ability to raise funds. As a result, startups faced lower valuations and a frozen IPO market, leading to reduced available cash.

This financial strain pushed many startups towards consolidation efforts, anticipating potential mergers and acquisitions as a means of survival; Babylon Health was big news last year, with a very difficult 2023. Additionally, the industry's focus shifted towards assessing the effectiveness of solutions developed during the peak investment period, seeking insights into their impact on healthcare access and quality of care.

Looking ahead to 2024, the digital health landscape might see a gradual rebound in funding, especially in the latter half of the year. Notably, leading companies backed by venture capital are considering M&A as a strategic tool to incorporate smaller competitors, acquiring customers, expanding geographical presence, and enhancing their product offerings. This consolidation trend may signal a shift towards a more mature and diverse healthcare environment, potentially liberating resources from smaller, less impactful entities to support the growth of the next wave of healthcare entrepreneurs and scalable enterprises.

2. AI in Healthcare

Since ChatGPT's launch in late 2022, Generative AI has significantly impacted the landscape of AI in healthcare. As the technology continues to gain traction, focus now shifts towards developing the essential infrastructure to seamlessly integrate AI tools into healthcare systems. This includes establishing robust safety and compliance standards while ensuring transparency regarding the data used to train these AI products. Amid expectations of reduced hype and investment in 2024, attention remains centered on pivotal aspects. For AI builders, addressing algorithmic biases, ethical concerns, and enhancing transparency stands as crucial steps towards facilitating the integration of AI into practical clinical applications. Simultaneously, healthcare stakeholders, comprising providers, payers, and life sciences companies, are tasked with solidifying AI governance approaches. They must carefully weigh the trade-offs between platform-level integrations, like EMR plugins, versus specialized applications for specific functionalities to craft enduring AI strategies, with transparency notably gaining importance, particularly in tools aiding clinical decision-making and claims appraisals.

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The Maturity Curve

In order to grasp the upcoming wave of innovations, it's essential to examine Rock Health's maturity curve. I particularly appreciate Rock Health's Maturity Curve for monitoring advancements in healthcare innovation. This analysis assesses and ranks developments based on three measurable indicators:

1. research publication volume reflecting early potential and industry interest,
2. venture funding indicating investor excitement and maturity, and
3. partnership activity serving as a proxy for commercial traction.

The maturity curve evaluates health tech innovations across five stages of maturity throughout their evolution:

• Nascent: areas are gaining early awareness in the market

• Emerging: areas are increasing in activity, including from large-scale players

• Developing: areas graner major funding and market buzz, but are not yet scaled

• Calibrating: areas are currently scaling and settling into longer term trajectories.

• Mature: mature innovations may take different pathways (eg: Niche, Fad, etc)

Let's take a look to what we should be following closely in the year ahead.

3. Food as medicine: (maturity score, Nascent). In 2024, retailers such as Instacart and Kroger are expected to intensify investments in medical nutrition innovations, aligning with the expanding legislative and reimbursement landscape. Health plans are anticipated to lead in adopting food-as-medicine programs as wraparound services, with other payers likely to follow suit. Innovative healthcare providers and startups, especially in areas like obesity care, can leverage food-as-medicine initiatives to differentiate their care delivery models through partnerships with emerging startups focused on this approach.

4. Digital obesity care: (maturity score, Nascent). In the realm of GLP-1 medications, challenges related to supply chain, cost, and accessibility will persist, influencing their market journey. Payers are expected to advocate for precise triage and treatment programs, emphasizing the integration of drug therapies within holistic care models, while emerging obesity care models aim to stand out through enhanced personalization and addressing the root causes of disease.

5. Caregiver solutions: (maturity score, Emerging). In 2024, the caregiver-focused market is anticipated to expand amid challenging economic conditions, driven by increasing challenges and negative health impacts faced by caregivers. Employers and consumers may invest in administrative caregiver solutions, with successful B2B2C options demonstrating the ability to reduce absenteeism, boost engagement, and enhance caregiver-employee well-being. Life sciences companies and providers may also explore caregiver-oriented solutions, particularly in clinical areas with high caregiver influence, while startups are expected to offer diverse solutions addressing various caregiving needs.

6. AI in healthcare: (maturity score, Developing). Already explained above.

7. Value-based care enablement: (maturity score, Developing). In 2024, the success of value-based care enablement hinges on outcomes demonstrated by major national payers and managed service organizations. Consolidation within major provider systems may drive the platformization of value-based care enablement solutions, addressing multiple needs in a unified approach. While providers aim to expand value-based contracting in clinical areas with established care pathways, the complexity of developing and executing these contracts remains a central challenge, prompting reliance on startups focused on enablement to navigate this complexity.

8. Retailers as providers: (maturity score, Calibrating). Retailers are forging partnerships with digital health companies, indicating the maturity of the sector in delivering care beyond traditional clinics.

   In 2024, the retail sector is expected to broaden its care models, venturing into higher-cost clinical areas like chronic diseases. Focus will be on minimizing friction during handoffs between retail and traditional providers, meeting home-based demand through omnichannel services, and creating partnership opportunities for startups and providers in the pursuit of convenient care expansion.

9. Data interoperability: (maturity score, Calibrating). In 2024, the significance of access to accurate and reliable healthcare data will rise, with interoperability solutions prioritizing precision, depth, security, and usability gaining distinction. Advanced data infrastructure adoption among incumbents emphasizes the need for disruptive interoperability solutions, expected to include built-in analytics and insights capabilities. Payers and providers are urged to assess and upgrade their internal data management strategies to support advanced analytics in the evolving landscape.

10. Bonus Track: Psychedelics

I am personally very bullish on the Psychedelics market. Psychedelics, historically used in religious and ceremonial settings, are gaining increased interest for their potential in treating various physical and mental conditions. The evolving media narrative and promising research contribute to growing acceptance of psychedelics as medicine. Early results suggest that psychedelic therapy, by creating new neural pathways, could reshape how we approach mental illness and other conditions, with potential FDA approvals in the coming years paving the way for mainstream acceptance.

Psychedelics showed promise in treating mental illness as early as the 1950s, but research was essentially shut down in the 1960s. In 1970, the Controlled Substances Act classified psychedelics as Schedule 1 drugs, which have “no currently accepted medical use and a high potential for abuse.” Now, a second wave of psychedelic research is underway, including a number of promising academic studies related to treating anxiety and depression. As a result, the use of psychedelics for medical purposes has renewed credibility and there is currently significant clinical trial activity for a number of psychedelic compounds that have a credible chance of achieving approval from FDA.

I am closely following two companies in this sector:

- Atai Life Sciences: Atai has raised a total of $522.1M in funding over 11 rounds. Their latest funding was raised on Aug 15, 2022 from a Post-IPO Debt round. Peter Thiel is one of the main investors.
- Compass Pathways: Compass has raised a total of $271.2M in funding over 6 rounds. Their latest funding was raised on Aug 16, 2023 from a Post-IPO Equity round.

In 2024, the psychedelics market is poised for a transformative year marked by specific advancements. Anticipate a surge in FDA approvals for psychedelic therapies, signifying a critical milestone in mainstream acceptance. Ongoing research and clinical trials will likely yield breakthroughs, especially with substances like psilocybin and MDMA, showcasing their potential to revolutionize mental health treatment. The industry will see continued efforts to destigmatize psychedelics, fostering increased regulatory acceptance and accessibility. Innovative treatment modalities integrating psychedelics into mainstream mental health care are expected to emerge, providing clinicians with additional tools to address conditions such as depression, PTSD, and anxiety. Overall, 2024 promises to be a pivotal year, driving the psychedelics market toward wider recognition and application in therapeutic settings.

As we look ahead to 2024, the unfolding landscape promises interesting dynamics, marked by a gradual resurgence in funding and heightened M&A activity within the health tech sector. It's imperative for the market to recalibrate in order to sustain its trajectory towards maturity and continued growth.

Wishing you a successful and a healthy year ahead!

The contents of this newsletter have the potential to influence those around you. Feel free to share it with anyone you believe might find it interesting.

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+ Health-Tech Innovation is good

Martin

P.S. I used some of the following sources to obtain the data for this article:
(1) Philips (2) Crunchbase (3) Global Data (4) Rock Health (5) Sifted

Breast cancer ranks as the most common form of cancer globally, responsible for approximately 1 in every 6 cancer-related deaths in women. While the vast majority of breast cancer cases affect women, a small percentage, ranging from 0.5% to 1%, occurs in men.

How breast cancer screening currently works?
Currently, the primary method for screening breast cancer is a type of X-ray imaging called a mammogram. While mammograms are generally effective, detecting roughly 87% of cancers, they require access to imaging centers. This can pose challenges for many individuals, particularly those with limited financial means, who may consequently postpone their screenings due to the associated high costs and difficulties in arranging transportation.

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The Solution

When breast cancer is identified during its initial stages, the chances of survival approach nearly 100 percent. However, if tumors are discovered at later stages, that survival rate diminishes to approximately 25 percent.

With the aim of enhancing the overall survival rate among breast cancer patients, scientists at MIT have developed a wearable ultrasound device. This device has the potential to enable individuals to detect tumors during their early stages. It could be especially beneficial for individuals at a heightened risk of developing breast cancer between their regular mammogram screenings.

MIT graduate student Wenya Du, Research Scientist Lin Zhang, Emma Suh ’23, and Dabin Lin, a professor at Xi’an Technological University, are the lead authors of the paper, which appears today in Science Advances.

How does the ultrasound bra work?

Interval cancers, which are breast tumors that develop between scheduled mammograms, constitute approximately 20 to 30 percent of all breast cancer cases. These tumors tend to exhibit a more aggressive nature compared to those typically detected during routine scans.

The device in question is a pliable patch that can be affixed to a bra. This setup enables the wearer to glide an ultrasound tracker along the patch's surface and capture images of breast tissue from various perspectives.

Source: science.org

The MIT Team has devised a compact ultrasound scanner designed for on-demand imaging. This scanner utilizes the same ultrasound technology employed in medical imaging centers but incorporates an innovative piezoelectric material that allows for its miniaturization.

To render the device wearable, the researchers have crafted a flexible 3D-printed patch with honeycomb-like openings. Using magnets, this patch can be fastened to a bra featuring suitable openings for the ultrasound scanner to make contact with the skin. The ultrasound scanner is housed within a small tracker that can be maneuvered into six different positions, facilitating complete breast imaging. Furthermore, it can be rotated to capture images from various angles, and it does not necessitate any specialized expertise to operate.

In their new paper, the research team revealed that the device successfully identified breast cysts in a 71-year-old patient with a history of these masses. And the best news: The image resolution—taken of tissue up to eight centimeters deep in the breast—resembled a traditional ultrasound scan.

The Future

After the device clears clinical trials with success, The MIT team envisions transforming breast cancer screening into a more convenient, cost-effective, and notably more comfortable process. This innovation could be particularly revolutionary for individuals at higher risk of breast cancer, effectively reducing the barriers to screening.

The research team aspires to establish a process where, after collecting data from a patient, artificial intelligence can be employed to analyze the evolving changes in the images. This approach has the potential to offer more precise diagnostics compared to the traditional method of relying on a radiologist's assessment of images taken years apart. Furthermore, they have intentions to investigate the adaptation of ultrasound technology for scanning other areas of the body.

+ Brest Cancer Solutions are good

Martin

P.S. I used some of the following sources to obtain the data for this article:
(1) WHO (2) MIT (3) Science.org