Biofourmis is part of a small but growing group of venture-backed start-ups looking to augment traditional medicines with digital technology, including wearables and software.
The hope for these kinds of digital-drug combinations is to add personalization to medicine to help ensure the right patient gets access to the right drug at the right time. By tracking how patients are faring outside of the hospital, doctors might suggest a change in dosage or a different combination of drugs. In theory, such technology is attractive to pharmaceutical companies looking to boost the efficacy of expensive specialty medicines.
The field is known as “digital therapeutics,” and research firms estimate it could be worth more than $9.6 billion by 2026. It’s part of a larger trend of digital technology making its way into the health care sector, which is worth more than $3.5 trillion in the U.S. alone.
Now Biofourmis going to get help in its quest with a new $100 million infusion led by Softbank’s Vision Fund 2, with participation from previous investors, including Sequoia.
Wearables, but not for consumers
To get a sense of what Biofourmis does, it’s instructive to look at one of its customers, Novartis, maker of a heart failure drug called Entresto.
In this case, a doctor prescribing Entresto would ask the patient if they wanted to enroll in a support program. If the patient agrees, Biofourmis ships them a wearable device that tracks their heart rate, oxygen saturation, blood pressure, and other relevant metrics. That gives Biofourmis’ team a better sense of whether the patient is improving at the rate they should be. There’s also an app for patients to check their own progress and relay their symptoms, as well as a dashboard for their doctors and nurses.
Biofourmis worked closely with doctors to develop the technology. One of the company’s longtime medical advisors and boardmembers is the cardiologist Maulik Majmudar, who has worked at Amazon for several years on the team behind the “Halo” health-tracking device.
While Halo is meant for consumers, Biofourmis’ wearables are intended for clinical uses. Typically, the pharmaceutical company will pay for the wearable device up-front so the patient doesn’t bear any additional financial burden.
Biofourmis CEO Kuldeep Singh Rajput said the company ran multiple clinical studies to show that wearables can help clinicians predict heart failure events several weeks in advance, and intervene before that happens.
Heart failure is the main area of focus for now, although the company has been increasingly been branching out into other disease areas. In the U.S., more than 6.5 million people have heart failure, which costs the health care system more than $30 billion to manage. It’s also one of the leading causes of death.
The company says it is also moving into other areas like chronic pain, oncology and Covid-19. It is also looking to expand by selling its services into health systems to help monitor patients once they get discharged. In the U.S., hospital systems are penalized if they have a higher-than-expected 30 day readmission rate after a patient is discharged for conditions like pneumonia and heart failure.
Finally the right time?
Digital therapeutics companies have struggled, particularly as deals with drug-makers have failed to get off the ground. Proteus Digital Health, a so-called “digital pill” maker, filed for bankruptcy earlier in the summer after once being valued at $1.5 billion. Meanwhile, Novartis recently cut off a partnership with Pear Therapeutics, another company in the space, and Sanofi walked back its relationship with Alphabet-backed Onduo.
Still, Biofourmis’ Rajput is convinced that now is the right time for these kind of technologies to accelerate.
“The pandemic has really fast forwarded the market,” he said.
Softbank’s Greg Moon, a managing partner for its team in Asia, agrees that the pandemic could help demand.
“Kuldeep spent three years building the technology,” he said. “And then he made really fast progress with clinical studies, global pharma companies as well as governments.”
SoftBank’s other recent health care bets include Alto, which is in the pharmacy space, and Karius, a company that is working on faster diagnosis of infectious disease. Vision Fund 2 has done nine deals so far, and four of them are in health-tech.
Still, outside investors say there might be some challenges ahead for these companies before they hit the mainstream.
“We will need a better understanding around the cohorts of patients who will really respond well to these types of digital-drug combinations,” noted Steve Tolle, a veteran health investor with HLM Venture Partners. “Just like with traditional drugs, start-ups will need to show health systems and pharma who will benefit.”