Eddie Martucci, a trailblazer in digital therapeutics and co-founder of Akili, is joining me today. With a bold vision of transforming medicine, Eddie has played a pivotal role in developing a groundbreaking video game treatment for ADHD. Akili is revolutionizing the way we develop and experience medicine.
With an inventive blend of neuroscience, creativity, and cutting-edge video game development, Akili is boldly challenging the status quo of traditional medicine. Their therapeutics EndeavorRx and EndeavorOTC are the first of their kind treatments for children and adults with ADHD delivered through an immersive video game experience. In this episode, we will dive into Eddie’s journey, the evolution of Akili Interactive, and the amazing work they’re doing to transform healthcare delivery through video games. Thank you for joining us today, Eddie. How are you?
Awesome, Thanks, Bryce. Happy to be here. Yeah, I really appreciate you joining us and taking the time to kind of share your story with us.
Could you tell us a little bit more about your background, Eddie, and how did you kind of experience in pharmacology and molecular biophysics and kind of your very impressive background? Kind of where did you get started? Sure, sure.
Yeah, if you go all the way back, I was in a healthcare family. So my parents owned an independent pharmacy in Connecticut. Apologies for my dog there. I worked in a pharmacy starting at like 12 years old. And so I got to see the delivery of medicine. I went to college and I really was fascinated with biochemistry and biology. So as a biochem major, I started to take my career after college, I went to grad school at Yale. And I was trained as a biochemist and biophysicist. And so I have ended up getting a PhD in biochemistry and biophysics doing novel drug design. But what really inspired me was that you could take this same level of deep scientific rigor, but also the magic of new science and new amazing technologies. And you could apply them anywhere. Like I was classically trained to look for small molecule drugs. And I still love that field very much. It’s close to my heart. But you know, I got to meet entrepreneurs and people from different walks of life.
And what I found was that almost everything that was not a drug per se was thought of as less than medicine. And so that was always in my head is like, could we take the same level of deep science into all these other fields? And so I think that was, that’s the only thread of my background to what I do today, that probably is connected there.
Well, I know, I know, when you co-founded the Key League with a obviously with a very bold vision, could you share a little bit more about the inspiration and what what kind of made you want to be that that challenge, that challenge the status quo and kind of go the route of delivering medicine through a video game?
Sure. So myself and my co-founders, I was at Pure Tech Health at the time, which is a biotech company and firm here in Boston. And at the time we were a group of us were looking at essentially how we can create new therapeutics out of cutting edge science and technology?
And I think in the case of Akili Interactive, what captured our imagination was that, you know, if you think around 2009, 2010, when I really started looking at this with a team, it’s when the technology platforms in our pocket started to do things a lot more than just communication, right? And so what really captured us was, okay, you can now bank on your phone, you can do your finances, you can obviously communicate, people started playing games, and they were like incredibly immersive games. So entertainment. So it’s hard for us to rewind over 10 years ago, but that’s where the field of technology was. And what got us interested is I was working on a couple other neuro neurological device companies at the time. And I think what really was the key inspiration was, could we merge these two fields? Because one of the biggest problems in neurological medicine, whether it’s psychiatry or neurology, you know, at any age spectrum, any of those conditions that fall in those buckets, is the experience of getting medicine is horrible, right? super stigmatized. Drug medicines come with tons of side effects.
So people are very scared about them, or they resist them entirely, or they use them, but they have dose limiting toxicity. Or people are left to like, try these really crude devices or behavioral therapy approaches, which feel like the dark ages. So what I think inspired us most was, okay, if we could build a real medical product, but fully leverage the beauty of, for lack of a better term, the iPhone, right, the fully leverage the beauty of smartphones and everything it could do, you can have for the first time in neurological therapeutic that people actually wanted to use that they were excited to use.
And that could, could transform their life, not just by treating the disease, but actually by engaging patients in a brand new way.
And another thing I love about it is, you know, especially nowadays, everyone, you always always have your cell phone, so you never forget your medicine. You know, if you’re using Endeavor, OTC, or even RX, you almost always have your medicine with you, which is so cool. As somebody who, I would take one diabetic myself and have to carry, you know, insulin with me 24 seven. And that can be an issue. Just just just simply being a man and trying to, you know, remember your stuff all the time. So that is another thing that’s so cool to me. And my next question is, you know, how is Endeavor different from, you know, I guess I’m sure some people have the question of, okay, well, what makes this different than temple run on my phone? What is this? Or how is this different from other other apps and other video games?
Sure. So to understand this, you have to really zoom back to what is what we are trying to treat? And what’s the core of technology? So the area we decided to focus on for this first of its kind technology, and now again, we have to rewind, right? Because now you fast forward to 2023 2024. And there’s now dozens of digital therapeutic companies out there. There were none in 2010-2011. So there was really nothing that was a template for what it looks like to build the therapeutic that’s delivered in an app or through your phone. The area we decided to focus on, and we wanted to make a truly amazing medicine company out of this was cognitive functioning, right?
We felt like within the neurology and psychiatry fields, one of the biggest issues was cognitive functioning, so how well you’re paying attention or processing information, how well the brain’s working on a very minute-by-minute basis, or frankly, millisecond-by-millisecond basis. That’s actually what has not been solved in neurology medicine, right? So most traditional medications will work on some of the other symptoms and the other circuitry in the brain, like, you know, the some of the overt symptoms of conditions, but what’s actually happening, like very quickly for us to become humans and interact in the world.
Um, there are parts of the brain, um, such as the anterior cingulate cortex, and I’ll come back to that. But this part of the midline prefrontal cortex, which actually controls how to process the world around us and basically allocate our attention in complex environments, um, that is really inaccessible with molecular means. What we found, however, is that, um, some amazing researchers who had been studying how to activate those parts of the brain through sensory stimulus or motor stimulus, you actually could do it.
So these areas of the brain that you can’t specifically target with molecules with drugs actually could be targeted by sensory stimulus. And so, um, what makes this product different and this product platform, because we’ve, we’ve built a number of products off of this core technology is that it’s based on a decade’s worth of research and patented technology, that it’s a very specific way that the sensory and motor challenges are delivered to you, that it reproducibly and very strongly activates that part of the brain called the anterior cingulate cortex.
We’ve published this now in six different, um, peer-reviewed publications in kids all the way up to, you know, 50 plus adults showing that this part of the brain, we can repetitively and predictably activate. And then that correlates with major gains in things like attention and processing of the world around people. So what’s different here is that this is a patented way.
You know, if you play other video games, you might, you know, 1% of the time by chance, activate the part of the brain you want, but you know, you’re just activating a lot of stuff in the brain. This is a very targeted, very specific and patented way to make sure that every moment of the experience, yes, you’re playing a game, but every moment of the experience, you are activating the part of the brain you need to, to control attention functioning. And so in that way, it’s, it’s a really exquisite piece of technology, um, that is frankly, just as standardized and controlled as a medicine.
You know, I say this all the time to people, you know, when you get a medicine or a pill, that medicine needs to have specifications. You need to know that every molecule in that pill is exactly the same. And every pill contains exactly the same moles or grams of that molecule. It’s the same way here with our technology is we have a specification of the exact algorithm that we’ve patented and have taken through clinical trials. And we know that, uh, that’s, what’s getting delivered every single minute to a patient. And that’s what’s activating their brain.
And actually Deborah is, it is the first prescription video game to receive FDA clearance, correct? Is that correct? It’s the first and only still.
Um, so yeah, in 2020, uh, received FDA authorization as a treatment for children with ADHD. Just recently, a few weeks back, actually, um, it received, uh, its second FDA authorization, which is now for teens because we have clinical trials in teens. So now it’s authorized for eight year olds, all the way up through 17 year olds as a prescription product. Um, and of course with endeavor OTC that adults can now buy directly without a prescription on the app store. Um, that is the first video game that’s directly treating attention function and has clinical data behind it. Um, that is non-prescription. So we’re, we do, we like to do a lot of firsts at Akili Interactive.
Yeah, it’s very, it’s really very impressive. Um, so I know, I know one thing that, um, Endeavor focuses on is the focus, the focus score. Um, how, how does that help people track their progress while using the app?
Yeah, that’s great. I’m glad you brought that up. That is an innovation that is years in the making. Um, so the, so focus score, I’ll define it for everyone and then, um, and then I can go back and sort of what that is. Um, so focus score is a, is a, um, a cognitive metric. It’s a metric in the product that you get after your first couple of minutes of play. And so we like to give it as part of the, um, first on ramp between the free trial and your, and your first therapeutic sessions that you get a score that actually tells you, and it’s normalized on a scale of zero to a hundred. It tells you how well you’re focusing based on all the measurements we have in the app. Um, now what’s interesting about this.
So a couple of things, this is only today available in Endeavor OTC. Okay. So this is, and that’s because that’s where it’s been most heavily validated. So we’re a medicine science company. We want to make sure everything we do is heavily validated. So this is available today for people that buy Endeavor OTC on either the Apple app store or Google play. And you get in your first couple of sessions, you get a focus score and then you get a trajectory that says, if you keep playing, here’s the confidence interval of how much you’ll improve that. Um, when I say it’s a couple of years in the making, uh, this really demonstrates the power of digital treatments. So think about traditional treatments, you take them and then you kind of hope you get better. Right. And you try to notice symptoms in real life. In our case, um, we actually not only give you stimulus every second of the experience, we actually measure, um, 30 frames a second of everything you’re doing in the app.
And after completing clinical trials that encompass thousands of patients, we were then able to finally build a composite score of the gameplay data itself. So as you’re the treatment and there are sessions in there that are really meant to more assess you instead of treat you, we’re able to distill out from that a metric that, um, that is actually cross-validated across hundreds of participants. That is a first principles based way, meaning based on the cognitive science, it is a metric of attention, but the cooler part and way better is that it’s based on our clinical trials of hundreds of participants that improvements in that focus score directly correlate with improvements in clinical functioning and symptoms.
So this score is not only the first, you know, weight number analogy for the brain, right? We don’t have anything like this for the brain, for the body, you have a scale, you have weight, you have, you know, blood glucose, you have, you know, your hemoglobin a one C we don’t have anything like this for the brain. So this is the first clinically validated score of your attention functioning, how well you’re focusing and paying attention.
Um, and we have the data that says, you know, at least for people with ADHD, if you improve the score, you have a high chance of improving the rest of your symptoms and daily life. Yeah. So it’s something I’m really proud of. We needed to build ourselves as both a medical company, but also a tech company because this is the result of, you know, a whole team of data scientists working for years on building a score that not only is cool, but actually works and is validated.
Yeah, that is really the definition of groundbreaking, which I love so much. And and with this generation coming up as video games and being on your cell phone is so man, it’s just when I when I heard about when I heard about Akili’s story in your story, I was like, just like, wow, we have got to get this. We’ve got to get Eddie on. We’ve got to talk about this. This is so cool. My wife’s a pharmacist. And I told her, I said, I said, baby, I said, you’re not gonna believe I said, I said, we ‘re interviewing Eddie Martucci next week. I said, they have never heard of Endeavor RX Endeavor OTC. She’s like, no, pull the website up and show her and she was really blown away by that. And it’s a very, very, very cool product. So my next question is, Akili values include, you know, obviously challenging the status quo combining top science with entertainment and kind of in creating that engaging user experience. What impact do you hope to achieve by kind of redesigning and re-delivering this new medicine?
Yeah, there’s, I probably could fit that into two categories. So when I started the company, there were two things that I really would hope to leave as a legacy here. And I think I still feel that today, even though I’ve gone, I was our first and only CEO for about 11 years. And then I recently transitioned to chair the board. But every one of my years, you know, leading the company, it still was in our ethos. So I think it still maintains today. And that’s number one, we are a medicine company. And therefore, the patients that we are looking to serve that we run clinical trials with, that we’re trying to help give a new treatment for, we want to see improvements in their life, right? We want to see quality of life improvements. That’s it. And we want to have high trust and credibility and confidence that we’re doing that. And so that hat, in my view, has to be your number one guiding North Star for any medicine company. I think in this world of like med tech and health tech, sometimes people get told now you got to think about yourself like a consumer company. But truly, the guiding North Star for us is like, are we helping people? And are we helping more people more dramatically every day?
So that’s, that’s number one. And so for us, that started with children with ADHD, and then teens and adults with ADHD. And now we’re serving all of those populations on the market. And then we’ve run clinical trials and shown positive benefits in adults with depression, even adults who have suffered from COVID infection and now have long COVID or COVID brain fog. And so those populations we’re looking forward to bringing products to as well. But the second, and this is unique, I think, compared to a typical medicine company. Like I said, when we founded the company, there were no companies like this, right? There now are. And we’ve also now treated 10s of 1000s of patients in the market.
And one of the things I’m most proud of, is we hear from patients every day, that not only have we helped their symptoms, but we’ve empowered them in a new way. Because what has happened historically with medicine for the brain is you’re almost like, I don’t want to say ashamed to take it, but you take it as a, like all of us take these medicines, hoping to be done with it, right? And hoping that we can take as little as possible, and we can take a pill and forget it.
And I don’t really want to think about that on my medicine. I think one of the unintended consequences of that, that we need medicine in society, certainly for the brain, right? Neurological medicine has transformed society. But one of the unintended consequences is that I think psychologically, that makes us almost feel like we have this crutch that we’re hoping helps us and then we never want to think about it again. The difference with these interactive medicine products, like the Endeavor products, and like other companies out there, is you have to put in work. And you have to, you have to actually bring yourself to the table every day and put in work. But the difference is, you’re actually treating yourself, you’re getting the benefits because you’re putting in work. So, you know, if you don’t put in the work, you’re not going to get the benefits. But when you get the benefits, it’s because you have sat there, you’ve done 20 or 30 minutes a couple days a week, and it’s hard sometimes, right?
You’re modifying your brain. So in many ways, we get what has never really been thought of in medicine, but is absolutely thought of like the physical fitness world is when you make a change with yourself, you have pride, right? People are like, I did this, I sat with a 12 year old once in front of our entire company at an offsite, because we brought an early patient from Endeavor Rx. And I said, Hey, did Endeavor make you a better student? Because he was getting A’s now. And he said, like, without pause, he said, No, I did that. He’s like, because I worked on this. And it overwhelmed me. And so I know that’s a super long answer. But when, when you say what are we hoping to change in the world? I think it’s that, you know, in some cases, we don’t have to be ashamed of or just tolerate medicine, we can actually be proud that we accomplished something with our medicine. And so when I hear adults or kids talk about, hey, I’m paying attention better.
And by the way, I’ve never felt so empowered in my life. Like I feel like a, a person who has better confidence and self worth and all that, like, man, that’s a, that’s a double whammy that, that few people I think get to experience. And so I’m hoping that Akili and other companies that are creating these digital interactive treatments really lean into that. And I think it’s something that can really change our mindset of how we think about medicine for the future.
Yeah, I love that. I absolutely love that answer. How, and leading into that, how do you look at the future of digital therapeutics and especially in kind of treating that in cognitive impairments? How do you see the future, you know, 10 years from now, five, 15 years from now going, like, what’s the next in digital? What else can we, what else can we treat, we think?
Yeah, it’s the one thing I could say is pretty clear at this point that it’s inevitable, right? So there’s a lot of stuff in the medical system, like mostly dealing with insurance and insurer coverage, like that’s kind of the next big hurdle. And that might take a year or more than one year to knock down. But what is very clear is, you know, there are a number of products, I think there’s seven or eight products on the market that are clinically validated digital therapeutics, probably more if you go beyond those that are FDA authorized. I actually happen to sit on the board, I’m a founding board member of the Digital Therapeutic Alliance.
So I get a view of all the products coming. And there’s, there are literally like 100 or more that are coming in the next few years. So when you look at products like the Endeavor products, which have now treated like over 50,000 people, and then there’s more than you know, there’s like, say 10 or more products like that on the market or getting to that point, and then there’s 100 in the hopper that are coming to market, it’s pretty clear that this is a wave that you’re not going to stop, right? And then people want these products. What’s coming is interesting. So for the first, for most of the life of Akili, I’d say Akili was on an island in that the vast majority of products were, I’ll call them like versions of therapists on your phone, right? So the vast majority of digital therapeutics were like behavioral therapy techniques that were put on your phone that could help you self manage a condition. Those are great. But Akili was always a bit different in that it was like futuristic medicine, right?
Something that feels like entertainment, but is actually treating you. What I think I’m seeing with the next generation of products coming is a lot more of that kind of eye opening magical technology that really just blows you away and makes you go, whoa, holy crap, I didn’t think that was possible. So for instance, you know, there’s a product called Luminopia One, which treats amblyopia or lazy eye, but it is doctoring cartoons in a VR headset. So it’s changing the input of cartoons, but you’re essentially watching TV to get your medicine. That’s incredible. There are products coming that are different types of light stimulus and sound stimulus that, you know, you could be watching a light show or you could be essentially like listening to certain types of beats and that’s going to treat you.
And that’s, it’s always been the stuff of like science fiction, but it’s actually happening. There’s a product from a company called Metarhythms called Intandum, which is for people dealing with stroke and walking issues, gait problems, and they’re now listening to music that is being altered to sync with their steps to actually improve their walking post, you know, stroke. And then eventually Parkinson’s like, this is where this field is going is that I think in 10, when you say 10 years, that’s a long time. I think we’re all going to have products in our household, on our phones, on our body that are digital ways of helping our disease that go right alongside our medications that we take. And I think it’s going to feel very natural. It’s not natural today. You know, the Endeavor OTC users downloaded the product today on the app store, they’re still early adopters, but I think it’s going to be super. I think exactly. I think in a couple of years, it’s going to be very natural for anyone with, you know, most medical conditions to be using a digital product along with their pill or infusion.
For sure. Can you share any upcoming projects or developments that Akili might be, if you’re able to, obviously, if you can, any peek behind the curtain at Akili with our audience?
Unfortunately, we’re a public company now. So we’re listed under that. That has totally changed the type of stuff we’re able to say. So I can’t give any specifics. What I can say is we’ve always envisioned ourselves as a multi-product company. We’ve started that with work across age ranges. So Endeavor RX for kids and teens, Endeavor OTC for adults. Those products are starting to diverge. So every new update to those products kind of customizes that for the population.
But like I said, we have data in depression, in COVID fog, in multiple sclerosis, and we’re committed to building a product platform where we can be treating many conditions down the road. So without being too specific on timing or roadmap or anything like that, it is still our vision to be able to bring products across different markets. And some of that work we’re working on on the regulatory front, we’ve published some of that work, clinical trials, and then some of the stuff, you know, we won’t be able to talk about it until there are updates there. But suffice to say, our small but mighty team is very busy.
Yeah, definitely. And wrapping up here, Eddie, given the very unique nature of what Akili does and what your work is, what insights would you offer to others aiming to kind of revolutionize the healthcare delivery in the healthcare industry like you guys, like Akili?
Yeah, that’s a great question. There’s a couple. So the first is, I do think it’s critical to not cut corners on the clinical trial side. I mean, I think I get it in this environment, cash is hard to come by, capital is hard to come by. Most of my career so far has been someone that has to raise money. So I get it. It’s hard. And it’s harder now than it was a decade ago. But it’s very, very clear that the products that will win and that will scale to patients and see the light of day are those that have incredible clinical data, right? It’s the only way. And actually, I mentioned that there’s, you know, 100 or more products coming, the more products are in the marketplace, even more clinical data will differentiate, right? Because then you’ll have a lot of options. And the only way to know the products you can trust will be those that have invested in really good clinical trials and proven their outcomes. So I always tell people, number one, it’s to, you know, really invest in the early days in the clinical trial work and don’t skimp there. I think the second is to really listen to users, right?
So one of the beauties of interactive products is you can actually do user research early on. And I mean, like real user research, put products in their hands, think about what are the features they like and don’t like, you know, think about the Ford and buggy or car analogy, you don’t have to build for them, but like, what are the things, how do they want to experience products in the future? And I think that’s really important because sometimes we as innovators can get blinders on, which is like, this is our roadmap on paper.
And here’s all the steps I’m going to do to bring it to market. But it is really important to be constantly updating how you think users will respond to things. And then the last thing, and we are a case study, and I’m a case study in this, fortunately or unfortunately, is I think you have to be flexible on the business model. So what we have seen, unfortunately, in the digital health world over the last couple years, is businesses that had a singular business model that was capital intensive and had kind of rigid investments around that model. When the model doesn’t go as planned in a tough economic environment, those companies essentially have to call it quits. And so what we’ve done is we’ve really built ourselves with the ability to be flexible. It’s one reason why we heard loud and clear from adult patients with ADHD that they do not want to go to their doctors. They don’t want to spend that time. And by the way, insurance isn’t covering it anyways.
And so we pivoted really quickly. And we said, great, for the adult market, we’re actually going to do an OTC model. And we had that inherent flexibility built into our thinking and our mindset as a business. And I think in these kinds of times where it’s unstable economically, and from a medical assistance perspective. And so you’ve got to have that ability to be flexible. Because the way you chart out your business on paper is almost never going to actually happen that way. So sometimes you get lucky if you’re rigid, but more often than not, I think it is a handicap. So I always tell people, look, believe in your idea, but don’t believe in too specific of your idea.