By OPEN MINDS Circle
The Oklahoma Medicaid program and Pear Therapeutics entered a value-based access agreement for Pear’s reSET and reSET-O prescription digital therapeutic (PDT) addiction treatments. The agreement went into effect on January 1, 2022. OHCA has not disclosed the specific performance and outcomes-based benchmarks being monitored under this agreement. OHCA intends to evaluate usage of the two Pear products at the end of the year. The two PDTs are 12-week programs for use by adults in outpatient addiction treatment settings under the supervision of a clinical professional.
The PDTs are available to adult beneficiaries enrolled in the Oklahoma Health Care Authority (OHCA) SoonerCare program who are diagnosed with addiction disorder (reSET) or more specifically opioid use disorder (reSET-O). The aim of each software application is as follows:
- reSET is a software application that provides cognitive behavioral therapy as an adjunct to a contingency management system. It is intended increase the consumer’s abstinence level and increase retention in an outpatient treatment program. It is not intended for adults on opioid replacement therapy, or for those who use alcohol or opioids as their primary substance of abuse.
- reSET-O is a software application that provides cognitive behavioral therapy as an adjunct to outpatient treatment for opioid addiction that includes transmucosal buprenorphine and contingency management. It is intended to increase treatment retention in outpatient addiction treatment.
Although utilization and consumer engagement will not be tracked on a weekly or monthly basis, there are agreed-upon outcomes that OHCA will be looking for at the end of the contract year. If the agreed-upon outcomes (benefit to SoonerCare members) are achieved, then OHCA will deem the agreement to be successful. If the outcomes are not achieved, then Pear may be at financial risk if reSET or reSET-O have not performed as agreed upon. OHCA said the contract does have other performance benchmarks that could be measured if the “successful treatment” measure is achieved. However, OHCA and Pear both said these additional benchmarks are confidential to the agreement.
OHCA has not disclosed the terms of payment. However, OHCA did recently clarify that under this agreement, OHCA pays for the use of the Pear products. Payment is not linked to treatment starts, user engagement levels, or generally offering access.
The agreement leverages an Oklahoma State Medicaid Plan Amendment to implement voluntary Medicaid value-based drug purchasing agreements. About 44% of the 1.2 million people are enrolled in SoonerCare are over age 21, and so would be eligible to use reSET or reSET-O if they needed addiction treatment. Based on 2020 data, about 16% of adults in Oklahoma have an addiction disorder. Most do not receive treatment.
Pear Therapeutics develops and markets PDTs for multiple therapeutic areas. Three of its PDTs have been authorized by the U.S. Food and Drug Administration for commercial use; they are reSET® for addiction, reSET-O® for opioid addiction, and Somryst® for the treatment of chronic insomnia. The PDTs are designed to engage consumers in treatment and provide tracking tools for clinical professionals. Its PDTs are designed to collect real world data for use by prescribing clinical professionals and for population health management by payers and health systems.
Pear started marketing reSET and reSET-O in January 2019. It launched Somryst for chronic insomnia on November 17, 2020. For the year ended December 31, 2021, Pear reported that more than 14,000 prescriptions for its three PTDs were written during the year. The pace of prescribing has picked up. For the six months ended June 30, 2022, more than 20,000 prescriptions had been written. The public reporting does not split out prescriptions by PDT. The average selling price was $1,338.
In its second quarter earnings report released on August 11, 2022, Pear reported that year-over-year product revenue grew significantly, which was primarily due to an increase in sales of reSET and reSET-O. For the three months ended June 30, 2022, revenue was $3.0 million, compared to $1.0 million the previous year for the three months ended June 30, 2021. Product revenue for the six months ended June 30, 2022, was $5.7 million, compared to $1.3 million for the six months ended June 30, 2021.
At the end of December 2021, Pear said its pipeline included PTDs in development for several mental and physical health conditions. However, on August 11, 2022, in the second quarter earnings announcement Pear said it had decided to narrow its business focus and reduce its workforce due to the macroeconomic environment. The decision affects commercial operations, pipeline candidates, discovery programs, business development, and its PearCreate dual discovery and development platform. As part of this decision, Pear laid off 25 of its more than 250 employee workforce.
For more information about Oklahoma Medicaid and its approach to offering the Pear PDT, contact: Melissa Richey, Chief of Communications, Oklahoma Health Care Authority, 4345 North Lincoln Boulevard, Oklahoma City, Oklahoma 73105; 405-605-9805; Email: Melissa.Richey@okhca.org; Website: https://www.okhca.org/
For more information about Pear overall, contact: Meara Murphy, Senior Director, Corporate Communications, Pear Therapeutics, 201 Mission Street, San Francisco, California 94105; Email: meara.murphy@peartherapeutics.com; Website: https://peartherapeutics.com/