Q&A: Telehealth’s position in combating the opioid epidemic

Within the midst of the COVID-19 pandemic, U.S. drug overdose deaths have surged. The CDC estimates that greater than 107,000 folks died in 2021, a rise of practically 15% from the greater than 93,000 deaths in 2020. 

However the pandemic additionally has introduced a sudden increase in telehealth utilization. Rules surrounding telehealth prescriptions of managed substances have been loosened through the public well being emergency, permitting for suppliers and startups to supply medication-assisted therapy like buprenorphine for opioid use dysfunction. 

A kind of firms, Bicycle Well being affords digital care in addition to prescriptions for remedy. CEO and founder Ankit Gupta and Medical Director Dr. Brian Clear sat down with MobiHealthNews to debate the therapy panorama for sufferers scuffling with opioid use dysfunction and the startup’s current $50 million Collection B increase. 

MobiHealthNews: Why do you assume that telemedicine works effectively for this inhabitants?

Dr. Brian Clear: It’s all about entry. So, we all know that just one in 10 sufferers with a substance use dysfunction is definitely getting therapy previously 12 months. There are a number of causes for that, largely surrounding geographic entry. Forty p.c of counties in the USA do not also have a supplier who’s registered to offer you buprenorphine for opioid use dysfunction. 

There’s additionally stigma. Particularly in cities the place folks of their well being system or their neighbors know who they’re, sufferers are reluctant to indicate up at these packages, that are licensed licensed packages for dependancy specialty care, and it is identified that these packages provide dependancy specialty care.

In our program, we discover that 30% of sufferers reaching out to us have by no means been recognized with opioid use dysfunction earlier than and have by no means accessed take care of opioid use dysfunction earlier than, which is admittedly exceptional. Which means we’re interesting to individuals who in any other case do not entry every other stage of care. We’re lastly breaking that cycle of simply serving the identical small, tiny subpopulation of sufferers time and again.

Ankit Gupta: Yeah, and I am going to offer you an instance. There is a new regulation in Alabama that went dwell not too long ago, the place an in-person examination is required inside the final 12 months to prescribe a managed substance. We, for the final nearly two months, had a complete process pressure working tirelessly to assist our tons of of sufferers discover native suppliers in Alabama. 

In spite of everything of that effort, we nonetheless discovered that lower than 20% of sufferers really discovered an area supplier. It is as a result of the suppliers weren’t out there. They weren’t reasonably priced. There was a number of stigma like Brian talked about. We have had reviews the place sufferers do not wish to be seen strolling into clinics; they do not wish to have their automobile parked outdoors. So, we have been in dire straits. 

We needed to actually fly a few suppliers to Alabama and spend per week there simply to adjust to the regulation in order that we will proceed caring for the sufferers we have now. We’re not enrolling any new sufferers, however to proceed caring for the sufferers we have now, till we discover a appropriate possibility for them on the bottom. And so, there’s only a huge, huge lack of entry. 

MHN: There was a rise in overdose deaths over the previous few years. What have you ever heard from sufferers about their experiences accessing care?

Clear: It is all the time been dismal, and entry has not gotten worse over the previous two years. What has occurred is that fentanyl is now current nearly universally within the illicit drug provide. So, sufferers who’re utilizing illicit opioids are more likely to overdose than they ever have been previously. 

COVID stored folks of their houses for a really very long time and made folks much more reluctant to entry the sources that have been already very restricted. Now, I believe we’re beginning to get previous that, and individuals are returning to extra regular lives. So, I can not say that COVID restrictions are retaining folks out of care anymore. 

However we’re now in a spot the place it isn’t simply fentanyl; it is new analogues of fentanyl — which can be much more potent — which can be within the illicit drug provide. 

Gupta: We despatched a survey to sufferers about 4 or 5 months in the past. There have been about 1,000 sufferers, and we requested them many questions, considered one of which was about their outlook on restoration and dependancy therapy throughout COVID. 

And what we discovered was fairly totally different from the narrative on the market. We discovered that 77% of our sufferers stated that the pandemic has not made sustaining or attaining restoration harder. In truth, 42% stated that it has made it simpler. So, once more, it goes to indicate how telehealth can actually enhance entry.

MHN: Bicycle Well being not too long ago raised a $50 million Collection B. How do you intend to make use of that funding?

Gupta: To this point, we have now been fairly profitable at reaching sufferers; we have served over 17,000 sufferers to date throughout 26 states. However we’re nonetheless getting began. 

We’ll use this funding to proceed growing entry to opioid use dysfunction therapy. That features hiring medical suppliers to have the ability to develop the capability to see sufferers, constructing our expertise that helps us each ship the care in addition to improve the standard of care by way of knowledge analytics and affected person engagement instruments that we have constructed in-house by way of our randomized at-home drug testing program.

We have additionally been fairly profitable at partnering with well being plans. We’re seeing robust demand, each from industrial in addition to from Medicaid managed care plans, to each improve entry by lowering price of this affected person inhabitants. So, we’re investing in growing these partnerships. 

We have now began receiving inbound curiosity from suppliers who wish to work with us, both referring sufferers to us or co-managing sufferers. We wish to use the funding to additionally improve our partnerships with medical suppliers, case managers, discharge planners, particularly within the correctional well being setting but additionally with employers to achieve sufferers.