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For the first time, Surfing NASH takes a deep dive into the prospect of digital therapeutics, their ability to drive outcomes and the critical success factors for proper use and deployment. This is an increasingly apt topic which intermittently surfaces on the podcast but has never featured at the center of conversation. The Surfers are joined by Naim Alkhouri and two new guests with prominent focus in this space: Joe Rubinsztain, CEO and Co-Founder of ChronWell, and Mark Berman, CMO of Better Therapeutics.

Among a plethora of discussion points unpacked, the panelists explore the following major themes:

09:24

Mark is first to elaborate on his work and underscores the big idea at the foundation of Better Therapeutics: much of cardiometabolic diseases - including NAFLD - is rooted in behavior. While both primary care and specialty clinics absorb the consequences, neither is adequately equipped to facilitate society-wide behavioral change. Better Therapeutics exists to answer this dilemma by developing forms of what's called Prescription Digital Therapies. Representing a new treatment modality, the use of digital therapeutics under physician supervision can enable digitally-delivered behavioral therapy that is prescribed, reimbursed and accessible to patients in need through the use of a smartphone.

15:25

Better Therapeutics has recently focused on applying Prescription Digital Therapeutics to combat the swelling burden of NAFLD and NASH. In doing so, their team partnered with two of Naim's clinics to conduct a feasibility study. Naim elaborates on quantifying the analysis of that study. While a 90-day window is restrictive in terms of identifying fibrosis improvement, changes in AST and ALT were examined in addition to analysis of metrics provided by FibroScan. Naim shares ideas around implementing combination therapies which harness digital apps and agents like resmetirom or semaglutide. From here, conversation opens up to impressions and questions from the panelists. Jörn Schattenberg highlights quality of life as a valuable endpoint and Roger Green asks Mark to expand on the premise and deployment of cognitive behavioral therapy.

26:02

Joe details the inception of ChronWell and the company’s mission of assisting providers and insurers to deliver optimal care beyond the medical practice with teams empowered by scalable technology. He envisions a future where “computers are treating simple, delimited diseases in a well designed pathway which is augmenting the ability of a doctor to deliver.” He goes on to discuss the role of insurers in this future and explains the nuances that align ChronWell’s identity as a digital platform.

37:24

The group discusses the benefits behind having an app where patients are in command of their wellness journey. Louise spurs comments around the idea that transparency is enhanced when levels of patient comfort and trust with a process are high. She goes on to describe facets of an app she is developing called MyLife365.me. This is a free lifestyle app that tracks how your daily life choices of food, drink and exercise impacts your liver health.

46:00

Finally, Roger prompts the panelists to share final thoughts around the future of this space. Each offers a unique perspective accounting for different pieces of a collective puzzle: combating Fatty Liver through digital health. If you enjoy the episode or have questions on this subject, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write us directly at qu