Emocha Mobile Health, a Baltimore-based health technology startup, is expanding its mobile application that helps people takes their medications as prescribed to opioid addiction treatment with a $1.7 million federal grant and $1 million in private funding.
With the Small Business Innovation Research grant from the National Institutes of Health, emocha will work with the University of Washington in Seattle and Boston Medical Center to test the effectiveness of its technology for keeping people who have been prescribed take-home buprenorphine on their medication schedule.
Buprenorphine is an alternative to methadone that is commonly used to treat people who are addicted to heroin or other opioids.
At the same time, emocha is pressing into the commercial addiction treatment market with the $1 million influx of cash from private investors and partnerships with treatment clinics.
As the epidemic of opioid addiction continues to escalate as a public health threat, the substance abuse treatment market is expected to balloon to $12.4 billion by the end of 2024, according to Transparency Market Research, a research and consulting firm in Albany, NY.
There's also a yawning gap between people who need help and available health services — the federal government estimated that in 2015 only 20 percent of some 2.4 million Americans with an opioid-use disorder got treatment.
That disconnect and the projected market growth create an enormous opportunity for investors and businesses that can find ways to slow the rising financial and human cost of what countless public health officials have deemed a public health crisis.
"For a long time this was an ignored patient population," said Bethany DiPaula, an associate professor at the University of Maryland School of Pharmacy. "Now we're starting to recognize this is a patient population that needs treatment and innovations are starting to become available."
In the past, stigma about working with patients seeking help for opioid addiction may have kept entrepreneurs and investors at bay, said DiPaula, who is also the director of pharmacy at Springfield Hospital Center in Sykesville and works with substance abuse clinics.
But that's starting to change.
Pear Therapeutics, which has offices in Boston and San Francisco, raised $20 million last year to support development of its software-based substance abuse programs. The company's reSET-O is a mobile application paired with medication to treat opiate dependency.
Addicaid is a mobile app that connects users to support groups for a range of addictions and behavioral disorders, and offers tools to aid in recovery.
Last year, the U.S Food and Drug Administration held a mobile app development contest as a way to drum up new ideas for improving how quickly opioid users, their personal networks and first responders respond to an overdose using naloxone, a medication that reverses the effects of an overdose.
"It's a really exciting time from an entrepreneurial standpoint but also an investor standpoint — whoever can come up with solutions to address the whole person," said Stuart M. Sutley, a partner at TCP Venture Capital in Baltimore.
The firm manages the Propel Baltimore fund, a venture fund backed by the Abell Foundation and the France-Merrick Foundation that contributed to emocha's latest round of funding.
Sutley said emocha appealed to him as an investment because the company's technology could allow clinics to expand their treatment and client base without having to hire lots more staff members, which they often can't afford to do.
Through emocha's mobile application, miDOT, medical professionals can watch patients take their medication on video, track symptoms and keep in touch with patients they may otherwise see infrequently.
The application was built on technology developed at Johns Hopkins in 2008 as a tool for global clinical health research. Co-founders Sebastian Seiguer and Morad Elmi licensed it in 2013. The company is based at Hopkins' FastForward incubator in East Baltimore.
"There's a lot of noise in mobile health," said Seiguer, emocha's CEO. "Our strategy has always been, in addition to building a great technology and getting it to market, to get the most respected people in the clinical and research field to help us design it and test it with patients."
Emocha has used the program in the past among patients being treated for tuberculosis and hepatitis C — illnesses with lengthy drug treatment regimens that typically require patients to take medication in front of a doctor.
The program is intended to save clinics time and money, by making it possible to treat patients more efficiently and ensuring they actually take their medication, reducing the need for additional treatment.
The federally funded clinical trial emocha is conducting with University of Washington and Boston Medical Center will track how effective the program is among patients being treated for opioid addiction.
The two-year trial will include a total of 80 patients who will be monitored to determine whether those using the app have a higher success rate in sticking with the medication regimen.
The trial is intended to validate the technology, with "independent data from top researchers in the field," Seiguer said. "It's going to carry a lot of weight."
Some clinics aren't waiting for the results.
Pathway Healthcare, a Dallas-based organization that provides drug and alcohol addiction treatment, plans to use emocha's program with patients as it expands across 10 states.
Pathway CEO Scott Olson said he thinks the technology will help his organization better understand and respond to patient needs, and treat patients in a more cost effective way.
Patients being treated for opioid addiction or dependence often must report to a clinic to receive medication, such as methadone or buprenorphine. Prescribing the take-home version of buprenorphine would free up medical staff and be more convenient for patients, but there's no way for clinics to be sure patients are taking the medication as prescribed, Olson said.
"The combination of medicine, behavioral information and data we're getting is in some respects changing how we treat addiction and dependency," Olson said. "The old model of residential and weekly touches... it's very costly and the data has shown it doesn't work that often."
Baltimore City Health Commissioner Dr. Leana Wen said technology could be a key to improving access to treatment, which she considers the most pressing challenge in addressing addiction in the city.
"At a time of a public health emergency, we need every tool at our disposal to help our patients," Wen said.