Janssen Pharmaceutica NV, one of the Janssen Pharmaceutical companies of Johnson & Johnson, plans to collaborate with digital mental healthcare company Koa Health. Together, the two organizations will research ways to pair the delivery of digital cognitive behavioral therapy (dCBT) with pharmacological treatments to help treatment-resistant major depressive disorder (MDD) patients.
The collaborative agreement was facilitated by Johnson & Johnson Innovation. The partnership will include a US multi-site feasibility study to assess the use of dCBT in conjunction with a pharmacological treatment for treatment-resistant depression (TRD).
Oliver Harrison (OH), Koa Health CEO, told Outsourcing-Pharma (OSP) about the collaboration, and the challenges posed by coming up with solutions for TRD.
OSP: How did you come to collaborate with Janssen? Have you worked with the company before?
OH: Just to prove the value of conferences, a Koa team member saw a presentation by a member of the Janssen team and they got talking. It turned out that Janssen was interested in deploying digital CBT alongside some of its pharmaceuticals and this kicked off the discussions that have led us to our collaboration.
OSP: Could you please tell us how use and understanding of dCBT has evolved in recent years?
OH: CBT is an excellent candidate for digital therapeutics because it has been very well validated as an efficacious treatment for a range of mental health disorders and, importantly, it is very structured and lends itself to the task of creating a software based program. In recent years we have seen several internet-based CBT programs (iCBT) developed and used to varying degrees of success, but these are typically less than user friendly and have had poor engagement and uptake.
More recently the sector has expanded to include all forms of online dCBT which is now focussed on mobile apps. While welcome, we believe that the majority of dCBT solutions are simply the same CBT programs we started with, now delivered through a mobile app rather than a website; they fail to take advantage of the unique possibilities presented by the mobile platform where we can pace the treatment to suit the user and really integrate care in their lives in a way that works for them.
The next phase will see context and usage drive improvements in personalization and integration that will ultimately improve outcomes for users.
OSP: What are some of the solutions that have been explored for MDD in recent years?
OH: There has been a general shift away from perceived over medication in many countries which has led to an exploration of alternatives, but in a very scientific way. Modern face-to-face therapy now includes a range of well validated programs such as CBT, Acceptance Commitment Therapy and Mentalization Based Therapy, often combined with mindfulness practice; all of these lend themselves to mobile app frameworks and so have contributed to the emerging field of digital therapeutics.
There has also been progress in the field of noninvasive brain stimulation, where magnetic or electric fields are applied to the cortex to modulate neuronal activity and disrupt maladapted circuits linked to depression.
Finally we have seen a renewed interest in psychedelics and psychoactives such as psilocybin, MDMA and ketamine for the treatment of MDD with very encouraging results. While we are developing standalone dCBT apps for patients we also believe that there is a massive opportunity to manage and improve outcomes by providing complementary interventions and support to patients receiving these treatments.
OSP: Is there anything you’d like to add that I didn’t touch upon above?
OH: This collaboration is as much about establishing a long-term relationship as it is about this particular project. There are several potential projects in the pipeline that will build on our technology and the shared point of view we are developing across our teams to improve outcomes and experiences for patients.