Cerebral leaders say the company’s new opioid use disorder (OUD) treatment program will stand apart from an increasingly crowded virtual medication-assisted treatment (MAT) space.
The San Francisco-based telemental health company announced in March that it had launched the new business line. Cerebral CEO Kyle Robertson said in a LinkedIn post that the new business line was important to the company because “mental health and addiction often go hand in hand.”
The new MAT program is live in Florida only. But Robertson, Chief Medical Officer Dr. David Mou and New Products and Innovation Kelsy Anderson said in a joint statement to Behavioral Health Business that it will expand into new states in the coming months.
The executives didn’t disclose where Cerebral would roll out the MAT program. But they did say how they are thinking about their expansion plans.
The two leading factors are the prevalence of OUD in a state and the state’s regulation of virtual MAT that’s managed via telehealth.
The states and territories with the highest rates of death by opioid overdose per 100,000 residents in 2020 were West Virginia (73.9), Washingt0n, D.C. (53.9), Maryland (47.7), Delaware (47.2) and Kentucky (44.3), according to data from the Centers for Disease Control and Prevention’s WONDER Online Database.
For 2018 and 2019, states and territories that had the highest rate of residents reporting opioid use disorder in the last year were Washington, D.C. (1.8%); Kentucky and Ohio (1.5%); and Delaware, Vermont and Maine (1.3%), according to the Kaiser Family Foundation.
Behavioral Health Business has reported on several startups and innovators in the virtual MAT space over the years. These include Bicycle Health, Minded Inc., Ophelia and Boulder Care to name a few. Many of them have landed major investment rounds in the last few years. This particular subsector of behavioral health appears to attract new entrants every few months, making it increasingly crowded.
“We believe that a high-quality mental health care system should be able to treat patients with multiple comorbid diagnoses,” Cerebral’s statement to BHB reads. ‘The demand for opioid use disorder treatment far surpasses the supply and availability of treatment options today. … We’re grateful that there are other companies also focused on helping to provide care for those struggling with addiction.”
A major struggle that any behavioral health company faces that tries to incorporate telehealth into their MAT programs is a shortage of clinicians that have special clearance from the federal government to prescribe the medications that help treat addiction.
About 102,600, or 5%, of the roughly 1.7 million physicians, nurse practitioners, pharmacists and clinical psychologists in the U.S. are licensed to prescribe these medications by holding something called an X-waiver.
About 40% of counties in the United States do not have a single X-waiver-licensed health care provider available to prescribe medication to treat opioid use disorder.
In part, Cerebral plans to grow its own workforce in this realm. The company will pay clinicians to complete the needed training to get an X-waiver and has developed a “custom training program with psychiatrists that are experts in this type of treatment.”
“Cerebral is expanding the supply of trained clinicians by supporting its existing medical professionals to get credentialed and receive additional training in treating those with opioid addiction,” the statement reads. “By supporting clinicians in receiving this credential and developing our training program, we’re building the supply of trained clinicians to provide care to this vulnerable population.”
Cerebral declined to specify how many clinicians it has that can prescribe controlled substances or who hold X-waivers. In total, the company employs over 4,600, according to the statement.
It also declined to comment on whether or not it has ambitions to consolidate the virtual MAT space through acquiring potential competitors in the space.
Cerebral certainly appears to have the capacity to buy a bigger footprint in the virtual MAT space. In December, Cerebral announced it raised $300 million in Series C investments — bringing its total investments to $462 million — at a valuation of $4.8 billion.
The three company leaders also appear bullish on the prospect that the regulatory environment will continue to be friendly to virtual MAT providers. In March 2020, the U.S. Drug Enforcement Administration waived a requirement for an in-person visit to go along with prescribing controlled substances — which include some MAT medications — via telehealth. There is an effort by U.S. senators to get the DEA to make the waiver permanent without legislation.
“Cerebral has joined 300 other companies and organizations in encouraging Congress to extend the telehealth waivers and gather data to modernize current telemedicine laws and regulations as we remain focused on improving access to care,” the statement reads. “We feel strongly that clinicians need to be able to use their independent professional judgment to prescribe medications as needed, especially since data shows a virtual visit can be just as effective as an in-person visit in many cases for behavioral health services.”
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