CurieMD is using telehealth to close the menopause support gap – Newsdio

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The American female technology startup CurieMD offers menopause diagnosis and prescription of treatment through a telehealth platform, starting in California, where it was launched late last year.

The founder, Dr. Leslie Meserve, says the goal is to expand access to treatment and support services for middle-aged women, spying on a business opportunity by offering an auxiliary digital service aimed at a women's health area which, according to her, is often overlooked in the provision of standard health services and suffers from a lack of trained doctors.

It also suggests that there is a "unique fear" in the US. UU. Regarding the use of hormone therapy for the treatment of menopause that has left an access gap in support services, blaming the concerns caused by deceptive advertising attached to the 2003 Women's Health Initiative study that It involved a link with breast cancer.

"The study authors published a press release prematurely that later became a sensationalist overnight story about the hormonal therapy that causes breast cancer," he explains. "What they didn't say was that in the estrogen-only arm of the trial there was a lower incidence of breast cancer." So that was never said anywhere. The other thing they couldn't say was that the slight increase in risk was not statistically significant … They hurt women greatly by publishing this press release prematurely. ”

More than fifteen years later, Meserve believes that it is the right time for telehealth services to help close the information and support gap that menopause still orbits, partly as a result of the "deep-rooted" but out of place fear of hormone therapy

Investment in products aimed at women's health and well-being has also skyrocketed in recent years as VC cotton takes advantage of a little-invested opportunity in which more founders are also focusing, led by women entrepreneurs who run the attention to women's problems.

Now there are a number of new female technology companies focused specifically on menopause. When asked about competitors, Meserve points to several other new American companies, including Gennev and Elektra Health.

"There is much more interest in telehealth and I think it is the perfect time for more information to be given to the world … to make sure that women know that going through menopause is not the end of anything, it is the beginning of a wonderful second half of life, ”he suggests, arguing that the regular health care services that women often access do not have time to devote to discussing the symptoms of menopause and possible treatments with their patients.

"Telehealth will not be appropriate for all the medical problems we are sure of, but the diagnosis and treatment of menopause symptoms are really based on an argument," he says. “We let patients know that we are a complement to the regular care they need from their gynecologist and primary care doctors. But the treatment of menopause requires a lot of discussion, a lot of talk therapy: it is a very cognitive diagnosis and treatment. And many obstetric gynecologists and primary care doctors don't really have the time to explain the advantages and disadvantages of hormone therapy to their patients.

“They do the physical. They address immediate and urgent needs, but may not have the time to address something that doesn't feel so urgent. The symptoms of menopause, from insomnia to hot flashes, do not feel so urgent for professionals, so I do not think they are always given the necessary time. And we know that doctors and other professionals are in a hurry. The way our insurance models work has to see patients every nine to 15 minutes and, sometimes, a 15-minute office visit is simply not enough to perform a Pap test, a physical exam, and respond to all these questions. Then we are a complement. We are not in place of your regular physical exams, we are an addition to those. "

Meserve practiced in primary care for almost two decades before moving on to specialize in menopause services, a change that led to the idea of ​​establishing a company to address the health problems of middle-aged women through a telehealth-based platform in the web.

"I grew up with my patients and a few years ago I realized that my patients had many symptoms of menopause, so I trained in the treatment of menopause and then I became a certified menopause practitioner," he tells Newsdio . , explaining his own transition from practice in primary care to focus on menopause care.

“I realized, obviously, that I was only going to be able to see a very small number of patients and patients in my community. And I know that women across the country suffer from these symptoms and cannot find doctors who feel comfortable talking about menopause and menopause treatment. And so, through friends of friends, I connected with another doctor in our community, along with his friend who has experience in new companies and we had the idea (for the company). "

"We know that trained doctors are lacking in this area, we know that women want this relief, they want relief from symptoms, they want to live wonderful lives," he adds, and says that the key idea is to use telehealth consultations and algorithmic classification to reach " as many women as they want the treatment. "

CurieMD patients complete an online questionnaire about them and their symptoms to obtain treatment suggestions, which may include a prescription for an oral contraceptive or, in cases where there may be a risk associated with taking estrogen, an antidepressant for the relief of perimenopausal symptoms; and a plant-based hormone therapy for menopausal women, with the beginning using an algorithm to help telehealth professionals offer appropriate treatment suggestions.

"Depending on the way patients answer the questions in our questionnaire, they are led along a certain path to help our professionals choose the right therapy," he explains, noting that they are not using AI to drive recommendations. Instead, patient responses are used to determine what additional questions are asked to extract other relevant information, in a classic decision tree algorithm.

"The first thing we have to determine is whether they are in perimenopause or menopause," he says, discussing the flow of decisions. “Then, in perimenopause, their cycles fluctuate, their ovaries enter and leave retirement. That happens at 40 years old. And women begin to have perimenopausal and menopausal symptoms at that time, many of them do. Then they will have hot flashes, night sweats, irritability, mood symptoms. But the treatment for perimenopause is different from menopause. Perimenopausal patients can be treated very effectively with low-dose oral contraceptive pills, so one of the branches of the algorithm is, first of all, are you in menopause or perimenopause?

“And then, for menopausal patients, they have the option of choosing bioidentical hormone therapy. And if they have undergone a hysterectomy, they only need estrogen, so they would follow the path asking about their estrogen needs. And then, if they still have a uterus, they will need estrogen and progesterone. Then, they have the option of choosing what type of estrogen they want to choose, whether they want oral estrogens or estrogens administered through the skin, which is a patch. ”

In cases where a woman has vasomotor symptoms, such as insomnia and hot flashes, but has had breast cancer or there is another contraindication for estrogen (such as having previously had a blood clot), the CurieMD platform may prescribe an antidepressant to treat Your symptoms.

"They are candidates for an antidepressant called venlafaxine (which is) very effective in treating vasomotor symptoms in all patients, but we use it primarily for women who cannot take estrogen," says Meserve.

For now, the platform has only three doctors who conduct remote consultations for the "dozens" of early registrations that have been seen so far, with an external company that provides trained doctors who perform remote consultations.

"We are working with a large national company that hires doctors who have chosen to provide telehealth," he says. "They are board certified and we provide them with additional training on women's health, especially in the medications … we offer."

Per Meserve CurieMD applies "stricter" prescription guidelines than a doctor could use in person, exactly "because he is a telehealth company."

She gives the example of a patient who has had a blood clot in the past, where a doctor in person could talk to a patient's hematologist and develop a plan for him to receive a very low dose estrogen patch. In this case, the CurieMD remote service could not offer such a comprehensive approach to prescribing a treatment.

"In telehealth we don't know all the doctors in the community of each patient, so we can't do coordinated care with specialists outside the box," she says. "So, if they have any risk factors, such as a history of coagulation, or of course if they have a history of breast cancer, we cannot treat those patients with hormonal therapy." So, if you really want hormone therapy, it will be a visit in person with a doctor. "

Another exception would be patients who have migraines and who may want to take an oral contraceptive pill. "It depends on the type of migraines they have," she says. "So that is beyond the scope of what we are going to prescribe."

As part of the questionnaire process, patients are also asked to rate the severity of their symptoms. Meserve says he is confident that this will allow him not only to demonstrate to the individual patients the effectiveness of the prescribed treatment, but also to present the findings to the medical community in general, with the aim of demonstrating "the safety and efficacy of telehealth" to this particular use case

"One of the things I would like to make sure we are doing is really convincing the general medical community about the safety of telehealth in certain medical conditions," he says. "It is not appropriate for all medical conditions … There are certain things that need a visit in person. But the medical community is beginning to understand, adapt and rely on telehealth, but I think the more data we have, the more we can convince them to that this is a good complement for visits in person. "

“Patients accept more (telehealth) than doctors. Doctors are very conservative and take a long time to change, so I think that one of our missions is to present the data to doctors and help them understand that this is not a substitute for good care in person, it is just an addition, " add.

The business model for the service is direct for the patient, which means that CurieMD is not connecting to the US health insurance market. UU. On the other hand, there is a registration fee (currently not applicable), a consultation fee and a recurring subscription (taken by credit card) for any current prescription sent to patients by a mail order pharmacy hired for that part of the service (In a frequent question on their website, the consultation rates "are lower than those of most co-payments and our drug prices are competitive with those of most pharmacies").

The team has raised about $ 1M in angel and venture capital investments to finance business development so far.

Meserve says the plan is to scale across the country, taking a state-by-state approach to develop coverage in order to obtain the necessary contracts and medical licenses.

"I would like to be in another 20 states by the end of this year," he adds.

In terms of differentiation against the growing number of femtech startups that have also supported the opportunity to offer support for menopause-related treatment, she says: "We believe that we are the only one that has a contract with a pharmacy and the prescription is delivered by mail. Service. "

He also notes that the hormonal therapy prescribed by the CurieMD service, and delivery "directly to the door in a discreet package", is a plant-based "FDA-approved" bioidentical treatment, suggesting that this is another point of differentiation for your approach.

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