Latest / Vanguards of Healthcare by Bloomberg Intelligence / Virta Health’s Push to Reverse Metabolic Disease at Scale

Transcript

Virta Health’s Push to Reverse Metabolic Disease at Scale · Vanguards of Healthcare by Bloomberg Intelligence

0:20
Speaker 1: Welcome to another episode of Bloomberg Intelligences Vanguards of Healthcare podcast,
0:24
Speaker 1: where we speak with the leaders at the forefront of
0:26
Speaker 1: change in the healthcare industry. My name is Jonathan Palmer,
0:29
Speaker 1: and I'm a healthcare analyst at Boomberg Intelligence, the in
0:31
Speaker 1: house research arm of Bloomberg. Today's guest is someone who
0:34
Speaker 1: has built a career out of tackling impossible challenges, whether
0:38
Speaker 1: that's disrupting the real estate market, rowing across the Pacific Ocean,
0:42
Speaker 1: or trying to reverse a chronic disease the medical establishments
0:45
Speaker 1: once considered a life sentence. I'm thrilled to welcoming Sammy Incoden,
0:49
Speaker 1: the CEO and co founder of Burt of Health. Sammy's
0:52
Speaker 1: a serial entrepreneur who many know is the co founder
0:55
Speaker 1: of Trulia, which he led through a successful ipl and
0:58
Speaker 1: the eventual acquisition Zilla. Since founding Verta in twenty fourteen,
1:03
Speaker 1: he's been on a quest to reverse type two diabetes,
1:06
Speaker 1: utilizing a model that challenges the traditional pharmaceutical heavy status quo. Sammy,
1:12
Speaker 1: thank you so much for joining us today.
1:14
Speaker 2: Well, Jonathan, thank you so much for having me here.
1:16
Speaker 2: And that was a very kind introduction on boshing here
1:18
Speaker 2: a little bit, but yeah, excited to be here.
1:21
Speaker 1: Well, why don't we set the stage for our listeners
1:23
Speaker 1: and how do you define the mission of VERTA And
1:25
Speaker 1: maybe just a few sentences, and maybe more importantly, why
1:29
Speaker 1: did you choose to build a country around the reversal
1:33
Speaker 1: of metabolic disease when you know, we think about the
1:35
Speaker 1: traditional medical establishment as always really focused on management of
1:39
Speaker 1: the disease.
1:40
Speaker 2: Yeah, well, the mission is very simple because it's printed
1:43
Speaker 2: everywhere and you could wake me up, boy im and
1:45
Speaker 2: I can tell you Our mission is to reverse metabolic
1:49
Speaker 2: disease in one billion people. Reverse metabolic disease in one
1:53
Speaker 2: billion people, and we achieve that with a combination of
1:57
Speaker 2: what I call intensive telemedicine and nutrition nutritionally is the therapy.
2:01
Speaker 2: But to answer your question, why that? And obviously I
2:05
Speaker 2: can tell you the story how I ended up stumbling
2:07
Speaker 2: into healthcare myself, and maybe I'll start from there, but
2:10
Speaker 2: let me answer the why that absolutely directly. Well, if
2:14
Speaker 2: you can reverse a very costly condition that usually leads
2:17
Speaker 2: to amputations, the debts and measurable life obviously used to
2:21
Speaker 2: do that, and today, as I like to say, menapologic
2:26
Speaker 2: disease which leads into conditions like talk two diabetes, O
2:29
Speaker 2: B city cutive ascutis and so forth, so forth. That
2:33
Speaker 2: is the defining health epidemic of our generation. And before
2:38
Speaker 2: we started I mentioned that I stumbled on CDC website
2:41
Speaker 2: and even there they now say ninety percent of our
2:44
Speaker 2: five trillion health care costs is driven by chronic disease.
2:48
Speaker 2: It's insane, like, this is it? And why wouldn't you reverse? Sadly,
2:55
Speaker 2: for the last thirty four years, all we have done,
2:58
Speaker 2: and some of it that many of it, it's been useful.
3:00
Speaker 2: All we have done is we've managed these dozen or
3:04
Speaker 2: so chronic conditions on a symptoms level. So if you
3:07
Speaker 2: have type two diabetes, hyph blot sugar, okay, well, don't
3:09
Speaker 2: you orry, take insulin, high blood pressure okay, well, here's
3:13
Speaker 2: plot presure medications. Take that, don't you worry, and let's
3:16
Speaker 2: bring you part pressure down. But all we have to
3:19
Speaker 2: show objectively now is more people with metabolic disease and
3:25
Speaker 2: higher total costs and higher unit cost So something's wrong
3:29
Speaker 2: and that's what we are trying to fix with VERT
3:32
Speaker 2: and say hey, there's a better way we can reverse this.
3:34
Speaker 1: That's a good start. I mean, I think I'd love
3:36
Speaker 1: to hear about where the kernel you know, kind of
3:39
Speaker 1: developed for the company and your journey from you know,
3:42
Speaker 1: a tech heavy world into this very sophisticated arcade world
3:47
Speaker 1: of healthcare.
3:49
Speaker 2: Yeah. Well, I'll try to be very brief, but honestly, Again,
3:52
Speaker 2: you mentioned there in the intro that you know, I'm
3:54
Speaker 2: a sort of technologist and a physicist by training. In fact,
3:57
Speaker 2: started micro in a nuclear power plant in Finland before
4:00
Speaker 2: I came to America, so I'm not a healthcare person
4:04
Speaker 2: per se to come in and while building truly as
4:08
Speaker 2: an as you mentioned, we went public twenty twelve and
4:11
Speaker 2: then this a lot acquired. If you had asked me
4:13
Speaker 2: during those years, like, hey, let's go and solve metabolic disease, diabetes, obesity.
4:18
Speaker 2: This is an embarrassing to say, but this is what
4:20
Speaker 2: I would have thought. Probably not said, but I would
4:23
Speaker 2: have thought, that's ridiculous. Let's just be completely honest. The
4:28
Speaker 2: reason we have this chronic disease metabal disease crisis is
4:32
Speaker 2: people just don't do what they know they should do.
4:36
Speaker 2: They just damn eat too much and they don't exercise.
4:39
Speaker 2: Like this is a willpower problem, this is a society problem.
4:42
Speaker 2: I have no idea how to solve that, and I'm
4:45
Speaker 2: pissed because people are sick and I pay too many
4:47
Speaker 2: taxes because of that. That was my attitude. But I
4:51
Speaker 2: was one hundred percent wrong. And the sort of accidental
4:55
Speaker 2: stumble that led me to this I guess discovery. If
4:58
Speaker 2: you will is I will. I was personally a high
5:01
Speaker 2: performing and runs athlete. I did the Hawaii Aramn World
5:05
Speaker 2: Championships triathlon seven times back to back. I won the
5:09
Speaker 2: World Championships in my age group, so very very fit. God,
5:12
Speaker 2: And after all that, I found out that I was
5:16
Speaker 2: pre diabetic myself, and I was like, wait a second,
5:21
Speaker 2: I'm not one of those middle of America lazy people
5:24
Speaker 2: who eat too much. What is going on here? And
5:27
Speaker 2: so honestly it was that experience. I was pissed. I thought, well,
5:32
Speaker 2: I thought, I knew what I'm doing, and if I
5:34
Speaker 2: don't have a chance to avoid pre diabetes type two
5:38
Speaker 2: diabetes metabolia, nobody has a chance. Well guess what. Ninety
5:41
Speaker 2: three percent of American adults are metabolically unhealthy. Sixty percent
5:46
Speaker 2: of American adults have diabetes, so pre diabetes, and so
5:49
Speaker 2: that got me interesting, very curious and in full disclosure,
5:54
Speaker 2: I'm not a medical doctor. I don't play one on
5:56
Speaker 2: the internet. And so I ended up teaming up with
6:00
Speaker 2: kind of a stand for trained doctor PSHC from MIT,
6:03
Speaker 2: my co founder scientists who had researched nutrition and metabologic
6:07
Speaker 2: health all his life, and then we launched further. But
6:11
Speaker 2: that's what got me in, and I think I'll say
6:14
Speaker 2: one more thing. The realization was that the way we
6:17
Speaker 2: have tried to use nutrition to address metabolic disease and
6:21
Speaker 2: weight loss has been kind of backwards upside down for
6:25
Speaker 2: the last thirty forty years, relying on willpower and the restriction.
6:28
Speaker 2: It just doesn't work. And so I thought, there's a
6:32
Speaker 2: better way, and if this works at scale, it's going
6:36
Speaker 2: to be incredible and super rewarding as a founder.
6:39
Speaker 1: When you guys got together originally, and I guess you
6:42
Speaker 1: were probably trying to solve the problem for an end
6:44
Speaker 1: of one at the on the onset, But what did
6:46
Speaker 1: you want to build initially? You know, what did you
6:50
Speaker 1: see kind of envision VERDA from the start? What was
6:52
Speaker 1: your initial vision that maybe pitched to investors in VCS.
6:56
Speaker 2: Yeah, yeah, absolutely, and I'll go in and do it second.
6:59
Speaker 2: But I'll just sharpened the point on mi. What was
7:02
Speaker 2: the inside that my co found actually taught me, and
7:05
Speaker 2: it was sort of twofold. Number one was he really
7:09
Speaker 2: hammered into my head that Sammy, you are absolutely wrong
7:13
Speaker 2: gaining weight developing metabolog disease. It's not a lack of willpower,
7:17
Speaker 2: it's not a personal choice. It is driven by metabolic disease,
7:21
Speaker 2: but that the underlying driver is nutrition. And then a
7:25
Speaker 2: second point, which is really the key, is that restriction.
7:30
Speaker 2: Despite me as a physicist believing in first law thermodynamics
7:33
Speaker 2: just does not work. Willpower runs out usually laters at
7:37
Speaker 2: the wedding photo. And so in order to address metabologic
7:41
Speaker 2: disease nutritionally, you have to change appropriately what people eat,
7:47
Speaker 2: not restrict how much, because how much is going to
7:50
Speaker 2: be a losing battle. So anyway, so we kind of
7:52
Speaker 2: build the science and the whole kind of approach around
7:56
Speaker 2: those principles. But to answer your question very specifically, it
8:00
Speaker 2: was a complex decision. We knew me and my co
8:04
Speaker 2: founder early that if you address the root cause of
8:06
Speaker 2: metabologic disease, many conditions would improve, meaning type two diabetes
8:12
Speaker 2: pre diabetes be paid cut off. After decisions markers improved blood,
8:16
Speaker 2: person comes down, information comes down, maybe kidney, maybe liver.
8:20
Speaker 2: But we knew that if we launched a company, and
8:25
Speaker 2: by the way, this was around the time of there
8:26
Speaker 2: On us and if we start talking about all these conditions,
8:29
Speaker 2: we are going to be laughed out of every single stage.
8:32
Speaker 2: It's not going to work. So we have to choose
8:35
Speaker 2: a narrowly defined path, and for us, that initially was
8:40
Speaker 2: we are trying. We're going to try and develop evidence
8:44
Speaker 2: to reverse type two diabetes. So our pitch initially was
8:48
Speaker 2: we can take late stage type two diabetes so someone
8:52
Speaker 2: on insulin and help reverse that condition, get the person
8:57
Speaker 2: off of insulin, which, by the way, even the American
9:00
Speaker 2: Diabetes Association did not acknowledge that you could systematically put
9:05
Speaker 2: diabetes into remission, so it was kind of an outland
9:07
Speaker 2: this outrageous claim, but that's where we started and the
9:11
Speaker 2: reasons where we didn't want to go too broad because
9:13
Speaker 2: it sounds too good to be true. And then also,
9:16
Speaker 2: when you have a company where nutrition is the core
9:19
Speaker 2: and you don't need FB approval, if you talk about
9:22
Speaker 2: weight loss, you lose your credibility immediately because the world
9:25
Speaker 2: is full of snake oil and bullshit. Quite honestly around
9:29
Speaker 2: weight loss, and so we knew that we kind of
9:31
Speaker 2: have to choose our lane pretty carefully, and the lane
9:35
Speaker 2: was type two diabetes reversal.
9:37
Speaker 1: That's a great definition of what your initial goal was.
9:40
Speaker 1: You know, what did you build and what did.
9:42
Speaker 2: The model look like back then?
9:45
Speaker 1: You know, if I was somebody going onto the VERDA platform,
9:49
Speaker 1: how did my life change initially?
9:52
Speaker 2: Yeah? Well, first I will say that we chose a
9:57
Speaker 2: step that was very uncom mentional for my investors. So
10:02
Speaker 2: you know, I again I had built truly my investors
10:04
Speaker 2: were Sequoia and Excel and all this is all tech investors.
10:08
Speaker 2: Most of my early investors for Verta were also kind
10:11
Speaker 2: of you know, San Francisco Silicon Valley tech investors. And
10:14
Speaker 2: I said, guess what, We're going to run a five
10:16
Speaker 2: year prospective clinical trials, five year trial, And of course
10:20
Speaker 2: I got eye rolls like, give me a break, you
10:22
Speaker 2: just rate seed funding and you do do five years
10:25
Speaker 2: of our revenues from twenty fifteen and twenty twenty, which
10:29
Speaker 2: pretty much ended up being the case. But I mentioned
10:33
Speaker 2: that because we knew that we want to be very
10:35
Speaker 2: outcome spaceed, very evidence based. After generating evidence and So
10:40
Speaker 2: the starting point was how on earth could we somehow
10:47
Speaker 2: reverse type two diabetes and show that it works and
10:50
Speaker 2: do it one hundred percent virtually. So I would say
10:54
Speaker 2: the initial funding principles for product are still the same
10:58
Speaker 2: today with one main difference and I'll explain it in
11:01
Speaker 2: a second. So focus was on outcomes and we wanted
11:04
Speaker 2: to do it virtually, and the therapy was nutrition, but
11:08
Speaker 2: one hundred percent through lifestyle change. So we don't, you know,
11:11
Speaker 2: produce any food, sell food, ship food, no no shakes,
11:15
Speaker 2: no portions, no magic. And so those are the two principles.
11:21
Speaker 2: We are going to have to somehow remotely change what
11:24
Speaker 2: people eat, so that's kind of the lifestyle chain piece.
11:27
Speaker 2: And then secondly, we have to deliver this virtually, so
11:30
Speaker 2: we need to have doctors, some staff who manage medications,
11:33
Speaker 2: We need to have maybe coaches, some staff who help
11:35
Speaker 2: with the kind of emotional piece and individualize, and then
11:39
Speaker 2: of course huge load of software to kind of take
11:43
Speaker 2: people on this journey to change their eating and reverse
11:49
Speaker 2: metabolic disease. And what is different from then and today
11:54
Speaker 2: it is that we kind of choose the Tesla approach
11:57
Speaker 2: to building the VERTA platform in that we want to
12:00
Speaker 2: build an amazing product that works on day one, but
12:03
Speaker 2: we have a driver on a seat sort of grabbing
12:05
Speaker 2: the steering wheels of the Tesla. And then we as
12:08
Speaker 2: symptotically introduced software, initially machine learning and now of course
12:12
Speaker 2: jen AI to make it more and more not just
12:16
Speaker 2: self driving, but more delightful for the patient. And so
12:20
Speaker 2: as opposed to the venmore approach, sorry, way more approach
12:23
Speaker 2: where obviously wanted to create a self driving car and
12:26
Speaker 2: go from zero two hundred in the beginning, but we
12:29
Speaker 2: didn't have that luxury and we knew that we need
12:31
Speaker 2: to focus on outcomes and safety. And so that's been
12:35
Speaker 2: probably the only difference from twenty fifty today that the
12:39
Speaker 2: core principles are still the same, but there's way more
12:42
Speaker 2: software and AI that's giving our internal teams superpowers but
12:46
Speaker 2: also superpowers for the individual patient. And then let me
12:51
Speaker 2: post then I'm happy to go and do this sort
12:53
Speaker 2: of nitty created patient experience if that's interesting.
12:55
Speaker 1: Yeah, no, I think that would be fantastic. I mean,
12:57
Speaker 1: I'm thinking about my own health and I don't mind
13:00
Speaker 1: sharing it. But if I look at my A and
13:02
Speaker 1: C levels from ten years ago, it was maybe five
13:05
Speaker 1: and now it's ten years later, five point five. You know,
13:08
Speaker 1: I'm not pre by by by the standards, I'm not
13:11
Speaker 1: pre diabetic, but I could see at some point getting there.
13:14
Speaker 2: So for somebody like me who maybe moves into that.
13:17
Speaker 1: Zone, and you know, I'm offered the VERTA program, you know,
13:22
Speaker 1: walk me through that journey as a patient or a
13:25
Speaker 1: member on the platform.
13:27
Speaker 2: Yeah yeah, well yeah, I'll try to be as kind
13:30
Speaker 2: of practical and pragmatic as as possible. So when you won't,
13:35
Speaker 2: you know, interested in VERTA. Our clinic is virtual, so
13:38
Speaker 2: it's back in the days the best diabetes care was
13:41
Speaker 2: within i don't know, ten mile driving distance to your house.
13:44
Speaker 2: Now hopefully the best diabetes and pre diabetes care is
13:48
Speaker 2: available anyway, which is a website. So step one, you
13:52
Speaker 2: come to a website, which of course we work with,
13:55
Speaker 2: you know, Fortune five hundred employers and helplines, so they
13:57
Speaker 2: usually kind of promoted specifically. But you come to a
13:59
Speaker 2: website step one and you basically apply to become a
14:03
Speaker 2: patient or we call them members. That's step one. Step
14:06
Speaker 2: two is you actually have a synchronous telemedicine visit with
14:11
Speaker 2: one of our doctors. And before that you can already
14:14
Speaker 2: ask questions if you're like, oh, I'm wondering how does
14:16
Speaker 2: this work, and kind of study like is this right
14:18
Speaker 2: thing for me? But step two, synchronous telemedi is in
14:22
Speaker 2: visit with our doctors and you can ask questions, so
14:25
Speaker 2: we get your health history and also we get your
14:27
Speaker 2: lab results, so in your case, it's not just a
14:30
Speaker 2: one C but like a comprehensive double health panel because
14:33
Speaker 2: we form a patient physician relationship, so we want to
14:36
Speaker 2: make sure we know exactly what's happening with you. So
14:39
Speaker 2: that's step two. Step three, if assuming you start the treatment,
14:44
Speaker 2: we send you what we call a verta starter, a
14:47
Speaker 2: kit kit that has all the remote monagoring tools that
14:53
Speaker 2: we use to monitor your biomarkers. And I can explain
14:56
Speaker 2: that in a second what that means. And then as
14:58
Speaker 2: part of that, when we ship the kid, we assign
15:01
Speaker 2: you a human coach. Sure we use AA and software,
15:04
Speaker 2: but we kind of never fake it, so you know
15:06
Speaker 2: that you have a dedicated coach who's going to help you.
15:12
Speaker 2: And then the next step is really the therapy starts,
15:16
Speaker 2: and the therapy really is nutrition based. And it's one
15:20
Speaker 2: challenge with nutrition is when you use nutrition as a
15:24
Speaker 2: therapy is that we all make two to four medical
15:26
Speaker 2: decisions today, that is every time we eat. So it's
15:29
Speaker 2: very very complicated. Of course this is perfect problem for
15:33
Speaker 2: software and AI, but it's very complicated because if Jonathan
15:36
Speaker 2: tells you, tell you your coach, I'm vegan, for example,
15:40
Speaker 2: I'm making this up. We can't tell you to have
15:44
Speaker 2: eggs and bacon for breakfast because we're going to lose
15:46
Speaker 2: you immediately, and vice versa. So you have to do
15:48
Speaker 2: crazy amount of individualization. And you know, we work with
15:51
Speaker 2: Native American tribes who work in casinos that get access
15:55
Speaker 2: to food there, US foods, truck drivers work sorry eat
15:59
Speaker 2: at McDonald on the roadside, and then we have you know,
16:03
Speaker 2: people who shop at Hole Foods and cook and home.
16:05
Speaker 2: So you have to individualize. But when the care starts,
16:08
Speaker 2: we basically help you within your own lifestyle to make
16:13
Speaker 2: the right initial changes. That's step one every day, and
16:18
Speaker 2: then we track your buyer markers to see how your
16:21
Speaker 2: body is responding to the therapy that we recommend and
16:24
Speaker 2: based on that, either software or the coaches that you
16:27
Speaker 2: work with adjusts the recommendation for tomorrow. So that is
16:31
Speaker 2: kind of the closed loop that we spin every single day.
16:34
Speaker 2: So we are less interested in you tracking every piece
16:37
Speaker 2: of food you eat. Instead, it's kind of like a
16:41
Speaker 2: self driving car. It doesn't really care how you turn
16:43
Speaker 2: the steering wheel. It tracks where the car is on
16:47
Speaker 2: the road, and that that's what we do, and then
16:49
Speaker 2: we kind of keep repeating that, spinning that wheel, if
16:53
Speaker 2: you will, to achieve the outcomes that we want. And
16:58
Speaker 2: on a practical level, we are essentially addressing the root
17:02
Speaker 2: cause of insurance systems. So that usually means or almost
17:05
Speaker 2: always means eliminating sugar and processed carbohydrates quite significantly. And
17:11
Speaker 2: then we try to encourage eating real foods as much
17:14
Speaker 2: as possible. But again it's not feasible for some people.
17:17
Speaker 2: For some folks it's you know, mapp it's the only
17:20
Speaker 2: place where you get full. But that's kind of how
17:22
Speaker 2: it works out. I'll throw one data point because this
17:25
Speaker 2: always question comes up. Oh nutrition and amazing outcomes your
17:29
Speaker 2: reverse diabetes. People lose thirteen percent body weight and more,
17:33
Speaker 2: but nobody's going to stick to it. Like, there's just
17:35
Speaker 2: no way people are going to stick to it. Our
17:38
Speaker 2: adherence or retention or whatever you call it, at one
17:41
Speaker 2: year is twice as high as taking a GLP one
17:46
Speaker 2: drug twice as high, so eighty three percent in one year,
17:49
Speaker 2: and whose data you look at it is like thirty
17:51
Speaker 2: to forty percent for LPI one. So it's we've been
17:53
Speaker 2: able to make you work and unsustainable.
17:57
Speaker 1: Well, So that that leads to a whole bunch of
17:58
Speaker 1: questions for me. But maybe let's briefly just chat about
18:02
Speaker 1: outcomes which you mentioned. Can you just head at a
18:04
Speaker 1: high levels the most common ones that you see every year?
18:09
Speaker 2: Yeah, so some of the outcomes of this all publish
18:11
Speaker 2: and PIRI and I'll highlight if something's not so these days,
18:15
Speaker 2: I like to say that it's Verta delivers or zepic
18:18
Speaker 2: like results, but without the drug. With nutrition. So we
18:20
Speaker 2: have thirteen weight loss on an intent to treat basis,
18:25
Speaker 2: So not just speaking the ones who do something, but
18:28
Speaker 2: thirteen percent weight loss sustain at two years. People coming
18:32
Speaker 2: in with type two diabetes, sixty percent have type two
18:35
Speaker 2: diabetes reversed, which means blood sugar bilow diabetes limit and
18:39
Speaker 2: off of all diabetes specific medications like insulin. We improve simultaneously,
18:45
Speaker 2: cardiovascuar dicisions markers, blood pressure comes down. We have a
18:49
Speaker 2: paper coming out very very soon that shows we actually
18:53
Speaker 2: track these bases four years, not just one year. Fifty
18:56
Speaker 2: four percent reduction in strokes, heart attacks, and debts. Fifty
19:01
Speaker 2: four percent reduction strokes, heart attacks, in debts, which is
19:03
Speaker 2: kind of unheard of to be able to show with nutrition. Similarly,
19:08
Speaker 2: we have a paper that's coming out that shows reduction
19:14
Speaker 2: in progression to chronic kiddy disease and even chronic dyes
19:17
Speaker 2: is reversal from three B. It's KD three B and backward.
19:22
Speaker 2: And then also stopping progression of fatty liberty is so mash.
19:28
Speaker 2: So these are broad metabolic disease outcomes, not just again
19:33
Speaker 2: type two diabetes reversal, but very very broad outcomes. And
19:36
Speaker 2: then lastly I'll mention again our B to B clients
19:40
Speaker 2: are plan sponsors, so this is you know, self insured
19:43
Speaker 2: employers and help plans. While the love language of American
19:46
Speaker 2: healthcare is money, so for them, we of course always
19:50
Speaker 2: lead with savings. Like how much we say, which is
19:52
Speaker 2: about six hundred dollars per pation per month or more
19:56
Speaker 2: than seven thousand a year on a growth saving spaceis
20:00
Speaker 2: and it's a huge freaking number, but it is because
20:04
Speaker 2: metabolic disease and the chronic conditions that follow from it
20:07
Speaker 2: are very very very expensive, and so when you reverse it,
20:10
Speaker 2: it used to save insane amount of money. And I
20:13
Speaker 2: often say that there's two ways to save money or
20:16
Speaker 2: make healthcare deflationary. It's one is better, faster, cheaper, and
20:21
Speaker 2: sure we do that. Everybody should be doing that better, faster,
20:24
Speaker 2: cheaper and espersonally with tech. But then the other one
20:26
Speaker 2: is the hotter one, which is make people healthy. And
20:31
Speaker 2: that is if you want to save like fifty percent
20:33
Speaker 2: of healthcare, because that's what you need to do. And
20:35
Speaker 2: the better, faster, cheaper is usually one percent, five percent,
20:37
Speaker 2: ten percent. But our job and our mission is make
20:40
Speaker 2: people healthy.
20:41
Speaker 1: Maybe a little bit of a segue or a tangent here.
20:44
Speaker 1: You know, when I think about the B to B market,
20:46
Speaker 1: you know there's always pushback and adoption of new programs,
20:52
Speaker 1: new technologies. I guess what is some of the common
20:55
Speaker 1: more common pushback that you've gotten, you know, whether it's
20:59
Speaker 1: from self and jerny eployers or health plans. You know,
21:02
Speaker 1: I think you and I probably go to this a
21:03
Speaker 1: lot of the same conferences, and you know, there's a
21:05
Speaker 1: discussion about you know, the plethora of different solutions that
21:08
Speaker 1: are out there and it's so hard for you know,
21:12
Speaker 1: a benefits manager to make that choice of which which
21:15
Speaker 1: solution to implement this year. So I'm curious from your perspective.
21:19
Speaker 1: You know, the numbers all sound amazing, the outcomes sound amazing.
21:23
Speaker 1: You know, where do you get pushed back?
21:25
Speaker 2: Yeah, a lot of it. In fact, if somebody wants
21:28
Speaker 2: to google Sammi ink and why not to start a
21:31
Speaker 2: healthcare company, there's a post that I wrote some years
21:33
Speaker 2: ago that's seven reasons why not to start a B
21:36
Speaker 2: to B two C healthcare or digital health company. So
21:39
Speaker 2: I have a lot of them, and I will say now,
21:43
Speaker 2: you know, I always say it's day one. Job's never done,
21:47
Speaker 2: We've never been successful. But I just before I answer
21:50
Speaker 2: that question, you know, we spend five years in a
21:54
Speaker 2: clinical trial mode, essentially zero revenues, and then over the
21:57
Speaker 2: last two five years, the second half of our first
22:00
Speaker 2: decade of VERDA, we've scaled from you know, about zero
22:03
Speaker 2: revenue to more than two hundred million revenue run rate
22:06
Speaker 2: and grew more than seventy five percent your video last year.
22:09
Speaker 2: So I can say that we've made over the first
22:13
Speaker 2: hill or chasm. But it's been incredibly hard. Okay, So yeah,
22:18
Speaker 2: I'll just mention a few. So one, whenever your cost
22:24
Speaker 2: savings are probabilistic versus deterministic, it's very, very very hard
22:31
Speaker 2: to convince people. What do I mean by that? Well,
22:33
Speaker 2: if a help plan negotiates with say Stanford Hospital, that
22:37
Speaker 2: last week the night er night was ten thousand, this
22:40
Speaker 2: week is six thousand, that's deterministic. You put a new
22:44
Speaker 2: number into a contract and that's much easier to sell.
22:47
Speaker 2: But anything that's probabilistic, like you know, Oka, although the
22:50
Speaker 2: outcomes are stunning, it's like, well, what if it doesn't
22:54
Speaker 2: work in my people? Right, it is probabilistic. It's it
22:58
Speaker 2: works on a population level, but if you take a
23:00
Speaker 2: one random person, you may not. So that's number one.
23:04
Speaker 2: Anything that's probabilistic is an issue. Second one is when
23:09
Speaker 2: you don't need FDA approval, which we don't need no
23:12
Speaker 2: matter how many clinical trials we've run, given there are
23:17
Speaker 2: one thousand other solutions who run clinical trials and wave
23:20
Speaker 2: their hands and say this is what we do. The
23:23
Speaker 2: distrust towards any statement that a company makes is very
23:31
Speaker 2: very high, and so you kind of you have to crawl, walk, run.
23:36
Speaker 2: So it's usually pilots and people talk to their peers.
23:39
Speaker 2: So that's the second one. The third one is when
23:42
Speaker 2: you start from scratch, you have no support from benefits consultants,
23:47
Speaker 2: not from help plans, not from the ecosystem players if
23:50
Speaker 2: you will, and when you don't have that, and by
23:54
Speaker 2: the way, they don't, they usually back winners, and when
23:56
Speaker 2: you're new, you're not a winner yet. So that's the
23:59
Speaker 2: third issue that you usually have. And then a fourth
24:03
Speaker 2: I'll just mention, even in the best of times with
24:06
Speaker 2: the best company, the sales cycles can be very, very long,
24:08
Speaker 2: and they don't really fit into the sort of venture
24:11
Speaker 2: capital funding cycles. So it's very, very hard. And so
24:14
Speaker 2: I've often said that sadly, US healthcare is where innovation
24:20
Speaker 2: comes to die. And one reason is, even if you
24:23
Speaker 2: have amazing outcomes, you need kind of a hundred million
24:27
Speaker 2: dollars in five years to get anywhere. It's just that expensive.
24:31
Speaker 2: And I hope companies coming after US will somehow shortcome that,
24:35
Speaker 2: but it's incredibly hard, even if you have amazing outcomes
24:40
Speaker 2: and you deliver savings, deliver outcomes, and you put your
24:43
Speaker 2: money kind of where your mouth is, but it's very hard.
24:46
Speaker 1: It's interesting as you describe your journey I can't help
24:49
Speaker 1: but think of a couple of cycles that we see
24:52
Speaker 1: since you started the company, and you know, we had
24:55
Speaker 1: you were in kind of the critical trial or build
24:57
Speaker 1: mode for a number of years, and then we hit
24:59
Speaker 1: the pandem and virtuals, all the rage, and you know,
25:03
Speaker 1: there's a lot of high rounds and easy money during
25:05
Speaker 1: that time. You know, we saw a retrenchment, and now
25:09
Speaker 1: we're in this AI cycle. So I guess maybe compare
25:12
Speaker 1: and contrast how you're thinking about managing the company and
25:16
Speaker 1: maybe where you're spending your time today, knowing that we're
25:20
Speaker 1: in the I don't know, the latest cycle versus maybe
25:23
Speaker 1: where you were a couple of years ago.
25:26
Speaker 2: Yeah. Well, one benefit that I have, hopefully mostly it's benefit,
25:30
Speaker 2: is I'm old enough that I started my very first
25:32
Speaker 2: company April actually May two thousand. I raised a little
25:38
Speaker 2: money and then internet bubble burst. Then I was building Trulia,
25:41
Speaker 2: and honestly, the financial crisis really was started from the
25:47
Speaker 2: residence of real estate, right, So this is two thousand
25:50
Speaker 2: and eight, two thousand and nine, So clients go bankrupt.
25:52
Speaker 2: So I went through that obviously. Then we went public.
25:55
Speaker 2: Company was very successful, and now it's kind of the
25:57
Speaker 2: same thing in healthcare, the COVID craziness. Then we have
26:01
Speaker 2: deserb zero interest rates and you know, everything's about future
26:05
Speaker 2: and valuate some multiple science saying and then deserve bubble
26:09
Speaker 2: kind of burst and now we're here and now we
26:11
Speaker 2: have the AI. So number one thing to me is
26:13
Speaker 2: the following, which is you have to be adaptable as
26:17
Speaker 2: a leader and a CEO. And I always chuckle when
26:19
Speaker 2: I read these kind of posts like oh are you
26:21
Speaker 2: a wartime CEO or peacetime CEO? And I'm like, are
26:25
Speaker 2: you a car driver that only turns right? It's like
26:28
Speaker 2: it's funny. It's like if you're building of anything of significance,
26:33
Speaker 2: it's you know, it's it's minimum ten years of something,
26:37
Speaker 2: and within that ten years as a CEO, you have
26:39
Speaker 2: to do all kinds of things. So I think adaptability
26:42
Speaker 2: is number one thing. And so then it comes beyond that.
26:47
Speaker 2: It kind of comes to the basics that you have
26:48
Speaker 2: to reassess and see, Okay, what do we have to
26:51
Speaker 2: do now? And as a leader and a communicator, I
26:55
Speaker 2: always try to be grounding in reality, like truth and
27:02
Speaker 2: facts and not bullshit. When things are going very well
27:04
Speaker 2: and things are not going so well, like grounding reality
27:07
Speaker 2: but be optimistic about the future, and that's helpful in
27:11
Speaker 2: the best of times and the worst of times. And
27:14
Speaker 2: obviously we are not public yet, so I don't need
27:16
Speaker 2: to deal with the daily stock price. But it's kind
27:18
Speaker 2: of the same thing where it's like, when something's going
27:20
Speaker 2: up like crazy, you want to be like, Okay, well
27:22
Speaker 2: we're not quite that good. Let's ground in a reality
27:24
Speaker 2: this other business growing. And then when something's crashing, you're like, well,
27:28
Speaker 2: let's ground in a reality. We have an amazing thing
27:30
Speaker 2: going on. We have happy clients. Maybe we're a little
27:33
Speaker 2: bit better than what the market might be telling. So
27:35
Speaker 2: I think that's that's been essential. And then to lastly
27:40
Speaker 2: give practical examples, we raised money, truly are right before
27:44
Speaker 2: the kind of Lehman Brothers collapsed. There was somewhat accidental,
27:48
Speaker 2: but we didn't need the money, but we raised it,
27:50
Speaker 2: and so I knew when this verp hit, I was like, Okay,
27:53
Speaker 2: we don't need the money, but I'm going to raise
27:55
Speaker 2: some capital. And sure enough, then our last published equity
28:00
Speaker 2: round for us in March twenty twenty one, that's five
28:05
Speaker 2: years ago, and so I'm glad we raised it. But
28:08
Speaker 2: then right after kind of the bubble burst. I told
28:11
Speaker 2: my whole company, I said, okay, guess what We're going
28:14
Speaker 2: to start what's called product independence, project independence, and that
28:18
Speaker 2: means the same as we all have to do in
28:21
Speaker 2: our home households, which is we have to be profitable,
28:24
Speaker 2: get to profitability through kind of careful growth and not
28:27
Speaker 2: spending money. So that was one pragmatic example where I
28:30
Speaker 2: knew that, you know, new times ground in reality, share
28:35
Speaker 2: the numbers, tell where we are, and then be optimistic.
28:38
Speaker 2: We have a good business, good product. Clian Slavist, let's
28:40
Speaker 2: scale the profitability. We did that, and now of course
28:43
Speaker 2: we have AI, and it's essentially it's the same approach.
28:46
Speaker 2: Obviously it's a different thing, but yeah, that's kind of
28:51
Speaker 2: the approach that I've taken. And I'm excited with what's
28:55
Speaker 2: possible of course with generative AI and what's coming. And
28:59
Speaker 2: of course there's a lot anxiety because nobody really knows,
29:02
Speaker 2: but I'm glad that we are at the point where
29:06
Speaker 2: we are as a kind of I would say, is
29:08
Speaker 2: scaled startup, so we have tools to play with, so
29:12
Speaker 2: it's not like an e stantial fight every week anymore.
29:15
Speaker 2: That's a good comment there around AI, and you know,
29:19
Speaker 2: the competition. I guess as I think about it, you
29:23
Speaker 2: know AI is going to create these winners and losers,
29:26
Speaker 2: and it's a tool that you know, nobody has just
29:29
Speaker 2: one model that you know they have to go to
29:31
Speaker 2: Open AI or anthropic for you. Can you talk about
29:35
Speaker 2: how you.
29:35
Speaker 1: Build a moat around your business with AI, because as
29:39
Speaker 1: I sit here thinking today, I'm like, well, there's a
29:41
Speaker 1: bunch of people going after chronic care and metabolic disease.
29:45
Speaker 1: There's a bunch of different there's a bunch of different
29:47
Speaker 1: AI tools that they can use, and I'm curious how
29:50
Speaker 1: you're thinking about making sure, you know, you keep your
29:53
Speaker 1: position as as the leader in this space.
29:56
Speaker 2: Yeah, I know that's a good question. Well, well there's
30:00
Speaker 2: sort of couple of things. First of all, First I'll
30:04
Speaker 2: address the kind of B to B sass because people like, oh,
30:06
Speaker 2: clients are going to be vibe coding your software and
30:08
Speaker 2: who wants to buy software and text solutions? And I
30:12
Speaker 2: think this is public So I con mentioned so United
30:13
Speaker 2: Airlines is one of our very valued, amazing clients. Let
30:17
Speaker 2: me tell you, United Airlines is not going to vibe
30:19
Speaker 2: code metabologicise and type two diabetes. They are not kind
30:23
Speaker 2: of up. They have way better uses for AI. So
30:26
Speaker 2: that's not kind of something I think about when we
30:30
Speaker 2: have human lives literally and their safety on the line,
30:34
Speaker 2: like we especialist said that, and so our clients aren't
30:36
Speaker 2: going to be vibe coding. But in terms of competitive modes,
30:41
Speaker 2: the AI hasn't changed. It has actually enabled some things.
30:44
Speaker 2: But here's kind of how I've always thought of it.
30:47
Speaker 2: Number one as a sentence, using nutrition to make people
30:50
Speaker 2: health is so simple, and sometimes people even ask like
30:53
Speaker 2: why do you need to build a company around that.
30:55
Speaker 2: I'm like, are you kidding me? Like this is the
30:57
Speaker 2: biggest health they've been in our generation, me tweeting like
31:00
Speaker 2: eat healthy. I I tried that. It did nothing. It's
31:04
Speaker 2: actually incredibly hard puzzle, Like nobody has been able to
31:09
Speaker 2: deliver even one year sustained weight loss with intrution, not
31:13
Speaker 2: to say two years, and we have public five. It
31:16
Speaker 2: is such a hard problem to solve. So step one
31:19
Speaker 2: is just too like the complication of repeating what we
31:23
Speaker 2: do is it's just insanely hard. Otherwise everyone would have
31:26
Speaker 2: already done it with or without AI. So in semi hard.
31:30
Speaker 2: Second piece is when you're operating in organized healthcare b
31:33
Speaker 2: to B two C for example, trust and credibility is
31:37
Speaker 2: earned over years with clients with outcomes with longevity or
31:41
Speaker 2: results with safety record, and then of course publish period
31:44
Speaker 2: papers and we need to earn it every day and
31:48
Speaker 2: build more every day, and you can also lose it
31:51
Speaker 2: in a minute. But that's another actually incredibly valuable mode
31:56
Speaker 2: in healthcare, and I think that would apply to I
31:59
Speaker 2: don't know, may Anderson Cancers Center, Like when something goes wrong,
32:03
Speaker 2: you go to the place that you trust, not like, hey,
32:07
Speaker 2: we have this AI which is sure we might still
32:09
Speaker 2: use AI do as the second third opinion, So that's
32:12
Speaker 2: the second one third piece in this kind of sustainability
32:17
Speaker 2: is once you get to this point over the debt
32:21
Speaker 2: value of B to B commercialization, then you actually have
32:25
Speaker 2: a lot of ecosystem partners This is PPMS, large health
32:28
Speaker 2: plants is so partnerships, benefit's consultants getting in there is
32:32
Speaker 2: nearly impossible. Once you get there, it's a pretty sustainable brush.
32:37
Speaker 2: So you have that. And then to be very specific
32:39
Speaker 2: about the AI and data. I'm sure everybody says this,
32:43
Speaker 2: but it's actually true for us, which is we have
32:48
Speaker 2: the largest database of daily biomarkers, specifically around reversing metabolic disease.
32:54
Speaker 2: And this is not just CGM BUTLD Google's data. Nobody
32:58
Speaker 2: has that data set, like nobody in the world because
33:01
Speaker 2: we've not treated one hundreds of dozens of patients, some
33:03
Speaker 2: up to ten years. So we all know AI is
33:07
Speaker 2: as pretty much as good as the data. And sure
33:11
Speaker 2: we have built our own AI platform where we can
33:13
Speaker 2: swap different lage language Large language models. LLM is not
33:18
Speaker 2: going to reverse metabolic disease or type two diabetes. You
33:22
Speaker 2: absolutely need the therapy on top of it, and so
33:24
Speaker 2: that's obviously our expertise. So so that's kind of how
33:28
Speaker 2: I see it. And yeah, it's every data, every patient
33:32
Speaker 2: we treat generates more data, and that data can be
33:34
Speaker 2: used to improve the therapy, the outcomes, the retention, and
33:38
Speaker 2: so that the wheel should keep spinning. And that's kind
33:43
Speaker 2: of how I think about it. And personally, truly and honestly,
33:49
Speaker 2: I will say this. While it's it's kind of there's
33:54
Speaker 2: positive paranoia, like oh my god, what I'm going to do,
33:57
Speaker 2: there's way more opportunity for us, especially now that we
34:01
Speaker 2: are kind of at scale early scale then like risks
34:05
Speaker 2: and fears around AI because we've got the We've got
34:09
Speaker 2: the garage full of tools, the massive around data, and
34:12
Speaker 2: we can actually use the AI to do something useful
34:15
Speaker 2: versus starting from scratch today. And I'll say one more thing,
34:20
Speaker 2: the fact that we actually have doctors who are full
34:22
Speaker 2: time employees and coaches. If I were starting a company today,
34:25
Speaker 2: I don't I probably wouldn't do that because you want
34:29
Speaker 2: to be all AI, but then you wouldn't be able
34:31
Speaker 2: to do what we do today. So I actually feel
34:33
Speaker 2: privileged that we have what we built and now we
34:37
Speaker 2: can use AI to take the next it. But you know,
34:40
Speaker 2: hopefully not wrong.
34:41
Speaker 1: Well that's that's interesting because I guess one of the
34:44
Speaker 1: questions that just came to mind is is there a
34:46
Speaker 1: limiting factor in your ability to sign up doctors and
34:49
Speaker 1: coaches as you scale?
34:52
Speaker 2: Is that one of the friction points. We don't take
34:55
Speaker 2: it lightly. But I may have said this before some
35:00
Speaker 2: this is absolutely true. It is much easier statistically to
35:04
Speaker 2: get to undergrad Harvard or Stanford then get a job
35:10
Speaker 2: at VERTA in a clinical team. So we essentially we
35:13
Speaker 2: have way more applicants wanting to join than we can hire.
35:21
Speaker 2: By the way, it's probably not a surprise because most
35:24
Speaker 2: people in internal medicine and primary care. Many the people
35:27
Speaker 2: go there because they love the job and making people healthy.
35:31
Speaker 2: But in today's kind of corporate healthcare environment, the jobs
35:34
Speaker 2: what I hear, what people tell me this suck is
35:38
Speaker 2: you know, ten to fifteen minute visits, all this admin stuff.
35:41
Speaker 2: And then a company like Verta where oh, we make
35:44
Speaker 2: people healthy. Your job is to take people off of
35:46
Speaker 2: medications in majority of the cases. And so that is
35:51
Speaker 2: not a that's not a Bouttleneck at all, bottlen exile elsewhere.
35:56
Speaker 1: Okay, so where are the bigger Bahamas?
35:58
Speaker 2: That's yeah, no, it's it's fair. It's a fair and
36:01
Speaker 2: I can be very open honestly, it's it's it's it's
36:07
Speaker 2: really this god to market, which is to say that
36:11
Speaker 2: since we are another direct to consumer company where we say, oh,
36:13
Speaker 2: let's just raise billion dollars and advertise on every channel
36:17
Speaker 2: and you know, go from whatever zero pass two million overnight,
36:23
Speaker 2: this B to B two C. As I mentioned, we
36:25
Speaker 2: had zero revenues first five years. And then you asked
36:28
Speaker 2: earlier of the kind of the objections and everything. Yeah, sure,
36:30
Speaker 2: we've scaled from zero to more than two hund million
36:33
Speaker 2: revenues in five years. So it's been pretty fast, but
36:37
Speaker 2: it's not two billion in revenues, and the TAM the
36:39
Speaker 2: number of people struggling with manabolic disease is massive, So
36:44
Speaker 2: it's a fair question why isn't it two billion? And
36:46
Speaker 2: my answer is it just there's a maximum speed at
36:52
Speaker 2: which you can scale in B T B two C,
36:55
Speaker 2: especially if your cost of capital is real, and it's
37:00
Speaker 2: real for us. There were some companies that raise crazy
37:03
Speaker 2: amount of money twenty twenty one and maybe twenty twenty
37:07
Speaker 2: and then threw it all into sort of B to
37:10
Speaker 2: B two C commercialization. And obviously it's very unprofitable scaling,
37:13
Speaker 2: but if you cost the capital is low, you can
37:16
Speaker 2: kind of make that leap. But they're literally is like
37:18
Speaker 2: how many employers can you sign up? How coming can
37:20
Speaker 2: you launch? How many help plans? That is I think
37:24
Speaker 2: it's a redulmiting factor. But you know, growing seventy five
37:29
Speaker 2: percent or more year of a year off of a
37:31
Speaker 2: base of one hundreds of millions of dollars, obviously that's
37:34
Speaker 2: fast by any standard, but it's not as fast as
37:39
Speaker 2: some of the AI companies today.
37:41
Speaker 1: Those would be very aspirational. I think for any of
37:43
Speaker 1: anybody in healthcare, you know just reading between the lines.
37:47
Speaker 1: I mean we talked about retention before and you being
37:49
Speaker 1: two x GLP ones. So is the challenge utilization within
37:55
Speaker 1: some of these self employed organization? I mean, is is
38:00
Speaker 1: the utilization and I don't know the single digits relative
38:03
Speaker 1: to you know, if it's available through the corporate benefits website?
38:07
Speaker 1: You know, is it three percent or using don't? I
38:10
Speaker 1: don't know what the right number is. But is the
38:12
Speaker 1: challenge getting that utilization number higher for us?
38:16
Speaker 2: I wouldn't even say capital C challenge. I would say
38:19
Speaker 2: it's it's a never ending improvement story and our mature
38:26
Speaker 2: clients are way in the double digits in our treatment
38:31
Speaker 2: of the eligible population. But I will say that it
38:38
Speaker 2: has been a learning process for us over the last
38:41
Speaker 2: I would say three years. You can't take it for granted.
38:46
Speaker 2: And so when if you build a scale a company
38:49
Speaker 2: like VERTA, sure initially is like you better have the goods.
38:53
Speaker 2: Hopefully you have products and outcomes like in now of case,
38:56
Speaker 2: reverse a metable disease and value to clients. Then you
39:00
Speaker 2: have to figure out the go to the B to
39:01
Speaker 2: B go to market. Then we talked about all the
39:03
Speaker 2: challenges there, but then after that you have another marketing
39:08
Speaker 2: challenge because you can't take it for granted that you
39:11
Speaker 2: work with a large employer and then they you know,
39:14
Speaker 2: they'll do the marketing for you. Sure they'll help, but
39:18
Speaker 2: the world is very noisy. It's very, very noisy. And
39:21
Speaker 2: I know, you know, as a CEO, if I send
39:23
Speaker 2: an email to my whole company and say click here
39:25
Speaker 2: and you get on a Bucks, I don't know, thirty
39:29
Speaker 2: percent of the people might click at the end of
39:31
Speaker 2: the week and I'm talking click here to get on
39:32
Speaker 2: a Bucks. It's so how do you break through that?
39:35
Speaker 2: So we've really focused on that over the last three years.
39:39
Speaker 2: But I don't think it should never stop.
39:42
Speaker 1: I mean maybe just as we kind of get to
39:44
Speaker 1: the end of our time here. You know, if we
39:46
Speaker 1: think about where do you want to take Verda over
39:48
Speaker 1: the next five years, can you talk about, you know,
39:51
Speaker 1: whether the roadmap is from a technology perspective or you
39:55
Speaker 1: know the financials, you know, where do you want to
39:57
Speaker 1: be in five years?
39:59
Speaker 2: I keep repeating the it's always day one. It's always
40:01
Speaker 2: day one for my team internally, and quite honestly, the
40:07
Speaker 2: first one is just execution, execution, execution. So we objectively
40:13
Speaker 2: now have a product that is fundamentally working hundreds of
40:17
Speaker 2: happy clients, sort of profitability profile that we are not
40:21
Speaker 2: dependent on VC strip feeding, so we control our destiny.
40:26
Speaker 2: And I keep telling my team, I'm like, there are
40:30
Speaker 2: there's one hundred and fifty million plus American adults who
40:34
Speaker 2: could be unverted today and should be probably to reverse
40:38
Speaker 2: or improve their metabolic disease. So number one thing for
40:40
Speaker 2: us is execution, execution, execution, to just scale with what
40:45
Speaker 2: we have. So that's one thing. Second one is hopefully
40:49
Speaker 2: as a result of scaling and publishing more of our
40:52
Speaker 2: clinical outcomes, and we have very exciting stuff coming out
40:56
Speaker 2: this year, like reversing metabolic disease editions that is sort
41:01
Speaker 2: of mind blowing, like, wait, can you improve that as well?
41:05
Speaker 2: I would hope that without scale, in five years, the
41:10
Speaker 2: common sense thing to do when someone goes to the
41:13
Speaker 2: doctor and their doctors type two diabetes or other conditions
41:16
Speaker 2: and metabolit disease is to initially try to reverse it
41:19
Speaker 2: with nutrition, Like that's to be the common sense thing
41:22
Speaker 2: to do, And for listeners, I just want to highlight
41:26
Speaker 2: that the common sense thing to do today when someone
41:29
Speaker 2: is let's say, uncontrolled type two diabetes patient and they
41:33
Speaker 2: got the LAPRICI. It's like, oh my god, we're going
41:35
Speaker 2: to put you an insulin, come back in six months,
41:38
Speaker 2: will increase the dose, and then come back in a
41:40
Speaker 2: year or two and will probably amputate your legs, and
41:42
Speaker 2: then it's going to be a miserable ending. Like I
41:45
Speaker 2: know this sounds horrible, but this truly is the common
41:47
Speaker 2: sense thing, and that has to change. It will change,
41:51
Speaker 2: and my hope is that VERTA will be one of
41:54
Speaker 2: the catalysts with our outcomes in scale to make disease
41:58
Speaker 2: reversal like a common sense thing to do, because it
42:01
Speaker 2: should be. And then lastly I will mention, of course AI,
42:05
Speaker 2: it's insanely exciting time to use AI to improve our treatment,
42:10
Speaker 2: make it more scalable, divide our users more. And of
42:13
Speaker 2: course financially, the more we can squeeze margins, the more
42:17
Speaker 2: we can control our destiny and plow more money back
42:21
Speaker 2: into the business. So it's an exciting time to me
42:26
Speaker 2: to be doing this. And then I guess I'll say
42:29
Speaker 2: one more thing, because healthcare has been hit kind of hard,
42:32
Speaker 2: sadly in the markets, and of course there's uncertainty around
42:37
Speaker 2: what's the covernment policy and kind of what are the reimbursements.
42:41
Speaker 2: The beautiful thing in reversing metabolic disease is that it's
42:44
Speaker 2: very bipartisan, like truly everyone, truly everyone wants people to
42:50
Speaker 2: be healthy, better outcomes, and lower costs, and like everybody
42:53
Speaker 2: loves that. So I feel kind of pretty good about
42:56
Speaker 2: our positioning versus having a crazy expensive kind of healthcare
43:00
Speaker 2: treatment where it's sort of a political decision that should
43:03
Speaker 2: be come of that those should be not cover. And
43:05
Speaker 2: by the way, the JILB one drugs kind of fall
43:06
Speaker 2: into this category like should we cover or not? So
43:10
Speaker 2: I'm excited about the years ahead and hopefully we can
43:14
Speaker 2: scale very fast.
43:15
Speaker 1: So if I if I think about the metabolic treatment
43:19
Speaker 1: market in two thousand and thirty twenty and thirty two,
43:24
Speaker 1: you know where where a GLP one is going to
43:26
Speaker 1: fit into that. And I guess, you know, how has
43:29
Speaker 1: that changed your thinking about what you how you manage
43:33
Speaker 1: patients and what you build for them.
43:36
Speaker 2: Yeah, well, maybe all listeners have heard of JILB one drugs,
43:40
Speaker 2: so we don't have to kind of go what do
43:42
Speaker 2: they do? But I'll say I'll start from a high
43:44
Speaker 2: level and say these are pretty wonderful pharmaceutical innovations jilb
43:49
Speaker 2: ones in the context of obesity and type two diabetes
43:52
Speaker 2: and anabolic disease, especially compared to previous drucks and in
43:58
Speaker 2: this category, and most importantly, they change your appetite and
44:03
Speaker 2: how much you eat as it relates to nutrition. So
44:06
Speaker 2: they change how much you eat, but they don't change
44:09
Speaker 2: what you eat. And unless you change what you eat,
44:13
Speaker 2: you're going to be in a world of hurt. And
44:15
Speaker 2: so I often say metabolog disease is fundamentally a food problem,
44:19
Speaker 2: and we cannot fix a food problem with drugs. We
44:24
Speaker 2: cannot fix a food problem with drugs. So I would
44:27
Speaker 2: say my kind of initial summary is that there have
44:30
Speaker 2: useful tools in a toolkit and a wonderful pharmaceutical innovation.
44:34
Speaker 2: But this idea that we put let's say ozembic into
44:38
Speaker 2: tapwater and it's free and everyone's going to be healthy,
44:41
Speaker 2: it's completely mistaken. It doesn't work like that. So I
44:45
Speaker 2: see these drugs as a useful tool in a toolkit,
44:48
Speaker 2: and the foundation before, during, and after and as an
44:52
Speaker 2: alternative always has to be and will be nutrition. It's
44:55
Speaker 2: just that nutrition is incredibly hard. And I hope there's
44:58
Speaker 2: more companies like Verted that makes it work. But that's
45:01
Speaker 2: how I see the big, big, big picture. And then
45:04
Speaker 2: on a more short, mid term basis, there's been a
45:08
Speaker 2: lot of demand by employers and help plans to hire
45:11
Speaker 2: Verta to make most out of the GLP one investments
45:15
Speaker 2: if they cover them. And again, we don't make many
45:17
Speaker 2: money off the drugs. We just want make people healthy,
45:19
Speaker 2: patients healthy, and our providers are experts at managing GLP
45:23
Speaker 2: once were needed. So there's been a huge amount of
45:26
Speaker 2: demand to say, hey, if I'm covering these drugs, how
45:29
Speaker 2: do I do it responsibly? How do we make most
45:32
Speaker 2: out of it? And then the people who are not covering,
45:35
Speaker 2: there's more pressure to do something with nutrition because if
45:38
Speaker 2: you don't, you have a bigger problem in your hands.
45:41
Speaker 2: And then if you end up opening up the checkbook
45:44
Speaker 2: and say hey, we're going to cover these TOPI WANs,
45:47
Speaker 2: it's going to be the more expensive. So it's definitely
45:49
Speaker 2: been a tailwind for us, although again we are not
45:52
Speaker 2: an online pil mill that's selling drugs online.
45:55
Speaker 1: No, thank you, Sammy. One of the ways I like
45:57
Speaker 1: to wrap these conversations up is to ask the asked
46:00
Speaker 1: about something either from their personal or professional life that
46:03
Speaker 1: really guides what they see as their mission. Is there
46:06
Speaker 1: something you could share that that fits that? Vein?
46:10
Speaker 2: Yeah, what kind is my mission? I guess it's the
46:14
Speaker 2: same thing that led me to start Verta after Trulia,
46:17
Speaker 2: and you know, truly I was very successful and financially
46:20
Speaker 2: successful and as an entrepreneur. Then like, okay, what now?
46:24
Speaker 2: What now? Like? Am I what am I supposed to do?
46:27
Speaker 2: Be an angel investor? Or sit here? I don't know,
46:31
Speaker 2: start helping non Like what do I do? And one
46:35
Speaker 2: realization that I had actually while growing across the Pacific
46:40
Speaker 2: Ocean with my wife was that, well, first of all,
46:43
Speaker 2: life is very very short, and we only have a
46:46
Speaker 2: few years to play this game called life. And I
46:51
Speaker 2: realized that one of the most satisfying things for me
46:54
Speaker 2: in life, outside of kind of my kids and family
46:57
Speaker 2: and friends, is using my creativity to create something that
47:02
Speaker 2: helps other people. So using my creativity to create something
47:06
Speaker 2: that helps other people, and Verta is that And so
47:10
Speaker 2: that's kind of my guiding light and not star and
47:13
Speaker 2: the fact that we have for profit company, it's kind
47:17
Speaker 2: of an afterthought because I figured out that I can
47:20
Speaker 2: use my creative you write a book, it's not going
47:23
Speaker 2: to change anything. But if we harness the American capitalism
47:27
Speaker 2: behind an innovation, we're going to have way more positive impact.
47:31
Speaker 2: So that's my kind of personal thing. I enjoy using
47:36
Speaker 2: my own creativity to do something that's helping as many
47:40
Speaker 2: people as we can.
47:42
Speaker 1: That's fantastic. Thank you so much for sharing. So with that,
47:45
Speaker 1: I think we'll wrap up here. That's been Sammy Inkinen,
47:49
Speaker 1: co founder and CEO of Verta Health, thank you so
47:52
Speaker 1: much for joining us for our latest episode, and please
47:54
Speaker 1: make sure to quick the file button on your favorite
47:56
Speaker 1: podcast app or website so you never miss a discussion
47:59
Speaker 1: with the leaders in help care innovation. I'm Jonathan Palmer,
48:02
Speaker 1: and you've been listening to the Vanguards of Healthcare podcasts
48:05
Speaker 1: by Boomberg Intelligence. Sammy, thank you once again