An Over-the-Counter Video Game for ADHD with Akili CEO Eddie Martucci
We’re continuing our series on gaming and ADHD this week. So far, we’ve explored how gaming ignites creativity and can expand perspectives and horizons. But what if we told you there was a game that is designed and build expressly to aid in treatment of attention disorders?
That’s EndeavorOTC, the latest release from Akili Interactive. This is a company that cut its teeth on the FDA-Authorized pediatric game, EndeavorRx, the first and only prescription treatment delivered through a video game. With EndeavorOTC, they’re looking to help adults.
Eddie Martucci is CEO of Akili and joins us today to talk about the game, how it works, and what it just might be able to do for you.
Links & Notes
Learn more about EndeavorOTC
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Pete Wright:
Hello everybody, and welcome to Taking Control, the ADHD Podcast on TruStory FM. I'm Pete Wright, and I'm here with Nikki Kinzer.
Nikki Kinzer:
Hello everyone. Hello, Pete Wright.
Pete Wright:
Nikki, I'm a little bit gobsmacked that this game exists. I don't understand how it exists. I don't understand how it works, but it exists. We're talking today about a number of different things, but one, that this game exists for kids. It started as a game that is prescription, game, video game. How does that even work? We're talking about EndeavorRX, and EndeavorOTC, and I'm so excited that we're going to be talking to the CEO of the company behind it, and all the fantastic stuff that they are doing in this space, and beyond this space. They do an awful lot. Have you played it yet? Have you spent the morning playing it?
Nikki Kinzer:
No, I have not. I have not.
Pete Wright:
Okay. This is going to be new.
Nikki Kinzer:
I'm going in as a listener, trying to figure out what it is, but I have a feeling we are going to have our questions answered.
Pete Wright:
Oh my goodness, I played it so hard. I've avoided so many spiky things.
Nikki Kinzer:
And your son, too, I understand.
Pete Wright:
Oh my God. We've both done our session today, and oh man, it's hard. It's hard to put down. I don't understand why it does that to me, but it's hard to put down. Anyway, we're going to be talking all about it. Before we do that though, you know the drill. Head over to takecontroladhd.com to get to know us a little bit better. You can listen to the show right there on the website, or subscribe to our mailing list, and we'll send you an email each time a new episode is released.
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And today, I'm actually... I might be premature in saying this out loud, but I'm going to do it. Caution, meet Wind. Apparently Patreon now, at long last, syncs with Spotify. Spotify listeners, I have flipped the switch. If you are interested in checking out, apparently in Spotify now, if you are a Patreon, you sign in with Patreon. If you sign in with the same account, somehow magic happens, and you'll see a little lock next to all of our shows in Patreon, and there will be a link to sign up to get the member version of the show in Patreon. I don't know, magic, but now it exists. It has been the one holdout for our member community, for those who listen to the show, listen to their podcasts in Spotify, now the member Patron Feed is in Spotify. Magic has happened.
Nikki Kinzer:
Great.
Pete Wright:
I don't know, we'll see. Let me know if you have any trouble, find me in Discord, you know how to DM me there. Okay. patreon.com/theADHDpodcast, to learn more and sign up. Did I say that already? That's what it is. Okay everybody. You know what time it is. I mean it, it is time for me to talk about my favorite invisible tool in my tech tool stack. It's Text Expander. It's always there, running in the background, just waiting for me to type my sweet, sweet abbreviations, or snippets in Text Expander speak. And when Text Expander sees my snippets, it just goes to work instantly, expanding from just a few characters on my keyboard to words, sentences, paragraphs, entire pages of text.
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We are continuing our series on gaming and ADHD this week. So far, we've explored how gaming ignites creativity, and can expand perspectives, and horizons, but what if we told you there was a game that is designed and built expressly to aid in treatment of attention disorders? That is EndeavorOTC, the latest release from Akili Interactive. This is a company that cut its teeth on the FDA authorized pediatric game EndeavorRX, the first and only prescription treatment delivered through video game. With EndeavorOTC, they're looking to help adults. Eddie Martucci is the CEO of Akili, and joins us today to talk about the game, how it works, and what it just might be able to do for you. Eddie, welcome to the ADHD Podcast.
Eddie Martucci:
Thank you, Pete. Happy to be here.
Pete Wright:
Welcome.
Eddie Martucci:
Thanks, Nikki.
Pete Wright:
Sometimes it's hard for me to come to these shows in a state of mind being blown. Do you know what I mean? I have been playing the game all morning, and I'm eager to talk about it, but I have to ask first, from the looks of it, you should be in a pharmacology lab. What is a guy who spent his academic years in biophysics and biochemistry doing at a game company?
Eddie Martucci:
It goes farther than that. I grew up in a pharmacy, so my dad is actually still a practicing pharmacist, and we had Martucci's Family Pharmacy in West Hartford, Connecticut, so I grew up, my job all growing up was medication, which is awesome. And then I went to college, and grad school to do the same. What really got me is I was partway through my doctoral work in grad school, and I met some entrepreneurs who had taken new innovations, and instead of being the ones researching them deeply, had taken new innovations, and started companies out of them. And that just... That concept, and talking to a few people, it caught me. It was like the hook set in.
And so I started working with a group right after school, here in Boston, called PureTech who builds companies. I think the kind of jump from pharmacology and medication into something totally different, once we go through this, hopefully at the end of our talking, it won't seem so crazy, but it's really what started to capture my interest is, we in society can put such a restrictive box on what we call medicine, but you can take the same level of rigor, and the same level of inspiration, and amazing science, and apply that to anything that helps people, and validate it. It doesn't have to just be a pill. And so that's what really got me interested. As soon as we said, "Whoa, this can be done in software," I was all in.
Pete Wright:
Done in software. And that's one of the things that I love so much about just talking about this treatment delivered through a video game. It can be delivered through an injection, or a pill, or nutrition. I mean it could be diet, it could be all these things, but you're right, we do put pills on a special platter, it feels like, a special pedestal. You're doing all kinds of stuff. Just before we dig in strictly to the game, as somebody who lived with his own dose of COVID brain fog, you're doing research on all kinds of stuff outside of this at Akili, right?
Eddie Martucci:
That's right, yeah. We started, and our whole company is built around trying to treat cognitive conditions, or rather to address and help people with different types of cognitive conditions, and really focused on attention, and speed of processing, and those issues are what people want help on exist. Obviously, ADHD is a big one that people look for help in, but really almost anything that touches the brain, different conditions, whether they're chronic, or acute, like a COVID infection, can lead to at least for some people, to have real serious impairments in these areas.
And so I'll tell you about the technology, but yes, we've done research in, I think at this point, nine different patient populations, including COVID, we have some ongoing work with results coming out soon there, and it's really amazing. Software is pretty malleable, so that it doesn't actually depend as much on the "disease label," as much as it depends on what are people struggling with, and what can we help them with.
Pete Wright:
Okay, so the game.
Eddie Martucci:
Yeah.
Pete Wright:
When you talk about the game, we have two things going on here, right? We have EndeavorRX, which I feel like we should talk about first, even though our audience, we don't have kids in our audience, but we do have parents. Let's talk about what EndeavorRX is, and how it purports to help kids. What are you doing to help kids?
Eddie Martucci:
Yes, great, and I'm glad you set up at the beginning, the pills have their own pedestal, so medications we tend to put on pedestal, we say, "That's medicine and everything else maybe can help you." When we started Akili, we said, myself and my co-founders, and now probably every employee in our life over the last 10 years, has said one of our kind of North Star goals is that we bring software based medicine, meaning something that is delivered entirely through software, but really treats you, we bring that at the same level, the same pedestal as pills in medicine.
And the way you do that is by running... First of all, getting a technology that actually works, and then validating it in clinical trials. And so, EndeavorRX is the outcome of about a decade of research, probably two decades of research if you follow it back to its core technology. And this product is, you're right, it's delivered as a mobile video game. It looks, and feels like a racing video game, but what's going on is every second of the experience, and you can talk to this now, Pete, having used the version, every second of the experience is actually running a patented algorithm that we licensed out of University of California San Francisco, which puts things on the screen, and makes you respond to what's going on in this racing game, in such a way that it activates the part of your brain that controls attention.
So, it's called the midline prefrontal cortex. So, it is a small area that sits in the middle frontal part of your brain, and that's the part of your brain that really governs how much attention capacity you have, how do you apply your attention to things you want to do, or sometimes don't want to do, but have to do.
And the way this works is you kind of feel like you're playing a game that gets progressively harder, but what's happening is it's designed to stimulate that part of your brain over and over and over, and force you to have to, for lack of a better term, exercise that muscle. And so, that algorithm has been validated in, at this point, dozens of clinical trials. We ran a long clinical trial program comparing it to another game. We've compared it to treatment as usual, and then we took it all the way through the FDA.
So, EndeavorRX is a video game that's on mobile devices, phones, tablets, iPhone and Android, but it's available only through a prescription from a doctor, pediatrician, or psychiatrist, and soon psychologist. And that prescription unlocks this mobile video game treatment. And I can get into the whole background of why that is, but that's what EndeavorRX is, and it's meant for children eight to 12 years old who have ADHD, and we've got work under review with the FDA, to hopefully expand that label to all teenagers.
Nikki Kinzer:
So I have a question. So I noticed in the bio that the FDA clearance and CE mark approval in Europe, is that also in the US too?
Pete Wright:
Yeah, FDA is US approval.
Nikki Kinzer:
It's all the same. Okay.
Pete Wright:
That's what FDA means.
Eddie Martucci:
Just by a random... One of the most random coincidences, the FDA approval, which is United States, and the CE mark, which is Europe, happened to come the exact same day, totally, after years and years of research, and working with regulatory authorities, literally the same day, but total coincidence. So no, those are two separate. So, we actively are commercial. We sell the product here in the US. We don't do that yet in Europe, but it is also the only European approved video game treatment, US and Europe.
Nikki Kinzer:
So, is it a pretty common... I mean, are you finding that a lot of doctors and psychologists, or psychiatrists, or whoever is able to prescribe this to people? Is it common, or is this still a very new idea?
Eddie Martucci:
It's new. So, we launched a very small sales force, around 20 to 25 people, three quarters ago, so at the end of last year. And what we've been doing with that sales force is, this is a medical sales force, so they're out there every day, educating doctors, but there's like 100,000 pediatricians and specialty psychiatrists that treat pediatric ADHD. So, it's slow and steady. Awareness is out there. Every month, about half of our... Under half of our prescriptions, but it's a substantial amount, do happen to come from people that we've never had a sales interaction with. So, doctors are hearing about it, but by and large, it's an education effort, just like any new medicine.
Pete Wright:
Yeah.
Nikki Kinzer:
If somebody listening to this, they could actually bring the attention to their doctor and say, "Hey, I heard this on a podcast. It sounds really interesting." If they don't know about it, they can look into it, then.
Eddie Martucci:
Oh yeah. If they have a child that they think this is a fit for, I mean EndeavorRX.com has a ton of information, including we did a lot of work to give a couple handouts, and simple things that you can print out to take to your doctor, and talk about it.
Nikki Kinzer:
Oh, great.
Eddie Martucci:
So yes, there's a ton of information there for anyone that has a kiddo that they feel like this could be a really good option for.
Pete Wright:
Well, and that gets to a question that I have around just getting professionals to take it seriously as an alternative for their kids, which this is a new thing. I don't know of any other, I mean, you would know, any other games, as prescription based games. Is that a market that already exists?
Eddie Martucci:
It's the only one.
Pete Wright:
This is the only one?
Eddie Martucci:
Nope, the only one. Yeah.
Pete Wright:
That's amazing. Somebody's got to climb Everest first. So, what do they say to you, when you walk to a doctor and say, "Okay, I need you to prescribe this video game?" What do they say before they close the door when you're on your way out?
Eddie Martucci:
So it's not as bad as you might think. You're right, there's resistance, and docs are busy. Our medical system kind of forces docs to churn through patients, so there's not a lot of airtime to educate about new things. There's always a little bit of hesitation, and a little bit of intrigue. And the hesitation, of course is because like you said, it's the only thing like it. The intrigue, or the acceptance, is because they're like, "Yeah, we know that what people are looking for."
They're essentially not satisfied with the limited options we have today, which essentially are medication and behavioral therapy for the very small percent of Americans that can find good, and afford good behavioral therapy. So they know that that's a huge need. And so, there's open-mindedness. Where the conversation changes is the clinical data. So, the reason we spent the better part of a decade... We were very rare, as a technology and software company, we got a lot of pressure from investors and others to just put a product out, just put something out, right? Don't worry about the validation.
Pete Wright:
Better part of a decade is a lot of runway though.
Eddie Martucci:
It's a long time. We had to put a lot of money into this, because we wanted to validate it. We wanted to prove to ourselves, to patients, to doctors that this worked. And so we have in our FDA label, we have five different clinical trials. Two of them are randomized controlled trials, where you're randomizing patients. So, the gold standard of clinical trial evidence, and we see things like after two months in these trials that about 70, high sixties percent, so about 70% of children, their daily life functional impairments have improved clinically, clinically meaningful response. A big jump up, like the things that hold them back in daily life are getting significantly better. And there's a whole bunch of other clinical outcomes that we can share, that were studied.
So when we show the data that this is studied just like a drug, this was run through clinical trials just like a drug, but it's different. It has a much better safety profile. And then here's the really cool thing. You don't have to choose this or drug, it can be used along with medication. We have the clinical data to show that too. The conversation changes. So I think data, and evidence has always been the thing that opens doors in medicine, and that's why we've invested in it, and it's slow and steady is how I'd call it, right now. We convert a couple hundred, at this point it's a few to 500 new docs a month that are starting to prescribe, and that's pretty steady over the last nine months. So, it's good, it's slow and steady.
Pete Wright:
Let's go back to the how does it work part, because here, I've been playing the game, as I told you, I did my session this morning, and we should set up a little bit, your recommended guidance on the game is five sessions per week, each session, 20 to 25 minutes of play. Is that right?
Eddie Martucci:
Yes, that's right. And with the prescription product, it's a little more regimented. We haven't talked about yet, I'm sure we will, the EndeavorOTC, which we can when you're ready, and that is more of a guidance, but yes, you don't have to play it every day, but the more consistently you play it, the better. It doesn't seem to need more than about 25 minutes, and the game cuts you off when you're done for the day.
Pete Wright:
Okay. So it's like Wordle, you get one shot, you get your 25 minutes and then you're done. That's great.
Eddie Martucci:
Yeah. I guess there's an analogy there.
Pete Wright:
It's really good for me, too. It's really good for people like me. So, I've collected my magical creatures, I've got a few of them under my belt. I've been avoiding spiky things. I've been hitting my magnet, to bring the speed pads toward me. I'm doing all the things. You told me that it's triggering that focus center in my brain, in my game, I'm all in. But, is it getting harder? Or is it just testing me to the point of mental fatigue?
Eddie Martucci:
Both. So, we have a whole set of algorithms that we've patented over this decade of research, and what it does is it actually gets you to that, we call it the threshold point, right? Your threshold point where you're just able to, and you probably felt this, you're just able to do the task, but man, it's right on the edge. It could fall off at any moment. And as you conquer that, the game subtly and in a personalized way, it's different for everybody who plays it subtly works the difficulty up.
So what's pretty amazing is what you're doing now, which is you're driving an alien, you're catching creatures, it's kind of fast. It feels fast to you today. And if you stick with this with EndeavorOTC, the non-prescription version that you're probably using, if you stick with this for a couple weeks, your world will be far more complex. There will be five different things that you're trying to do, and make decisions on, and you'll probably be going about twice as fast, but it will still be right at the edge of your difficulty level.
So what that means is, your brain is processing that much more zoned in, or focused, and at a higher level, and the game just continually adapts to it. So, the example I always give is imagine you had a treadmill, because people can understand this a little better. Imagine you wanted to train for a marathon, and every day you got on the treadmill, and it knew exactly where you were that day, in terms of you're right at the edge of your ability level, and where it needed to push your legs and your lungs, and it just incremented up or down the difficulty every moment. Over the course of the month, it would get faster and faster, but you would just feel like it was kind of a smooth progression, if that makes sense.
Pete Wright:
Yeah, yeah, it absolutely does. And I mean, it's one of those things, like that level of fatigue is real. You have me doing so many things so quickly, it already feels like, how did they train me in this game to use both my thumbs, and my fingers, and the steering, the tilting of the device, and all of the things at once? It already feels like a level of complexity that... But I can't quite describe, and I'm somebody who plays games, and I can't quite describe how this feels a little bit different. It tickles-
Eddie Martucci:
I think I can help.
Pete Wright:
It scratches a different itch.
Eddie Martucci:
Let me try, and then you tell me if I'm way off or if maybe I'm getting into it. And I think the reason is it is hard. It's meant to be hard. Most video games have... In some ways, almost all video games are in some way a choose your own adventure. And I don't mean adventure in story mode, but I mean in whatever thing you have to do, there's a couple different ways you can get there. And what humans tend to do is choose the path of least resistance, or the path that seems most amenable to them, that they resonate with the most.
Pete Wright:
Right.
Eddie Martucci:
What EndeavorOTC and EndeavorRX do, is forces you to do the thing that is hardest. So, the reason you're saying it feels complex is every moment of the experience, if you... So for people that don't have a visual, you're tilting the screen to drive a character, and you're catching things on the screen by tapping. Let's say that you're getting really good at tapping, and your brain starts to say, "You know what? I'm just going to start to ignore the driving a little bit so I can tap these things." The driving thing goes, "Uh-uh," and the rewards actually reconfigure, to force you to make sure you're still driving at your peak ability.
Pete Wright:
Yeah.
Eddie Martucci:
So I think that's why it's unique. It is unique in that it can be difficult. Not every single day of people getting treatment are they loving it, because it's hard, sometimes it's like a workout. But what people will say is they'll often equate it to a workout. They'll say, "Wow, I feel worked out," but after a couple days or weeks, they're like, "A, I look forward to it." Just like you might look forward to getting out there and pushing yourself on something that you want to do. And once a couple of weeks are by, and people start to see the results, it's really rewarding, because not only is it helping you, but you've put in the work to actually do this. That's the thing I love the most about these products, is you are doing it.
Pete Wright:
Yes.
Eddie Martucci:
We're not giving a pill that magically works. You are actually putting in the work, you are conquering what you want to conquer. We just gave you a video game to help.
Nikki Kinzer:
I want to talk to you about what happens in the real world. So, here we are playing this game, which with ADHD, I can imagine that they're going to be... A high dopamine level is going to be high, that dopamine is going to be high, just playing something, playing a game. So, you're teaching them to make those decisions, to focus, to have that attention. But how does that go into the real world, where I don't want to check my mail, or I don't want to do my dishes, or I don't want to pay my taxes? How does that help?
Pete Wright:
Or stay focused in meetings, or yeah, all of those thing.
Nikki Kinzer:
Right, right.
Pete Wright:
Yeah.
Eddie Martucci:
Totally. No, it's a great question. So, the whole key behind what we did, and why we spent all this time, was it doesn't help anyone if you just get better at the game. So, this technology, which had been developed over a decade, like I mentioned, this was built to build the muscle that gives you the ability to do things in daily life. So, all of our clinical outcomes for our FDA approved product, that is the prescription in kids, for EndeavorOTC, which is available without a prescription for adults, that we just ran a clinical trial and released those results a couple months ago, all of the clinical trial results are on gold standard assessments, that are outside of the game itself, that are in daily life, or in the real world.
And the way it works is because when it strengthens that part of the brain, just go back to that running analogy. If you train enough on the treadmill, and you really beef up your legs and your lungs, you can go do a bunch of things in daily life better. Same analogy here. We're building that part of the brain, and so all the clinical outcomes we have are things like, "How has this helped you in daily life?" Or, "How has this actually specifically benefited in the things that you want to do better on in daily life?"
So, I'll give you a little read, an example here. Generally there's a scale in the adult trials. There's this scale in the clinical trials, it's a well sort of accepted incredible scale of quality of life. And what that means is forget the game, forget the treatment you're on. How has your day-to-day quality of life changed? And 70% of adults, after just six weeks of using this treatment, had a clinically meaningful improvement in day-to-day quality of life.
That's cool. But to get specific, and this is really where you're asking, some of the biggest areas that improved, the highest percent of people after just six weeks were things like completing projects. So, people would report, "I've never completed projects before, now I'm concluding projects." Balancing multiple tasks at once. People who have busy jobs, keeping track of important items, that really pops up a lot, where like my keys, my wallet, these are all things that are measured on these clinical scales, and they improved in a pretty dramatic way. So, that's kind of what... Everybody's different, and just like any medical product, you can't guarantee results for everybody, but those are the types of outcomes that in general, we see after six weeks of use of these products.
Pete Wright:
Do you have anything that goes longer than that, right? You're focused on six weeks, but do you have any results at six months?
Eddie Martucci:
Yeah, we have. So, we have a couple different things. So, this is meant to be, I call it chronic, but episodic. So we don't want to say this is a video game you have to use five days a week for the rest of your life. That's not the intent here. The intent is you're building up strength in this attention functioning that will last you some time.
But it is meant to be episodic. Just like again, I guess on this podcast, I keep going back to muscle building, but it fits here, is you would not expect to maintain muscle building if you do an intense training session for a few weeks, or months, and then you give up forever. But, once you do it, you get it for some period of time. So what we've seen in kids, for instance, with EndeavorRX, in clinical trials, is after a month of treatment, if you take a full month off, most of those effects maintain, you get a little bit of slippage back to baseline, but you're still clinically better than you were two months before you even started the treatment. So, you can take at least a month off.
In some of our clinical trials we've seen a month, a few months, sometimes out to six months, but I think that's probably more rare. So, the paradigm that we're continuing to research is, use this for four to six weeks, take a break if you need to, even within weeks, you can take a break of a day, or two, here and there, take a break once you've done your four, six weeks and then come back to it a couple weeks later. And that can be kind of the on off thing that might be the most effective for people long term.
Nikki Kinzer:
We've been talking about gamifying things for the last few weeks in this series, and Pete, what I wanted to direct to you is, it feels like this game is a great addition to trying to gamify your life. So, we talk about how can you put a game around doing chores, so that it's more engaging, it's more fun, it's more of a challenge.
And I see this game, I can just imagine playing the game for six weeks, and then going into the real world, real life, and then trying to make a game out of it, just like I was playing. I can see the momentum building, because it's like, "Okay, I've got this great base of how to pay attention, and I can just keep doing that." It just feels like a really great addition.
Pete Wright:
It was interesting, just my first experience with it, after playing for even 25 minutes, I put the game down. I noticed that feeling of exhaustion, like I just finished a good rowing workout or something. I feel kind of tired, but also, there's the inverse relationship of feeling charged batteries. Like I'm kind of excited. I put it down and I'm... Am I just totally gaslighting myself? I feel like I'm really excited to do what's next, like it's easy-
Eddie Martucci:
Kind of zoned in, right?
Pete Wright:
It's easy to be skeptical about something like this, because you hear so many other services that attempt to tune your brain, and have been debunked in some way, shape or form, right?
Eddie Martucci:
Totally.
Pete Wright:
When I play this, and feel myself having that charged battery experience, I wonder if I'm just lying to myself.
Eddie Martucci:
Well, this is exactly why we invested in running real clinical trials, and actually having a differentiated, very specific patented technology, because I think you're right, and people are right to be skeptical. There's a lot of just junk out there that will purport to help you. We did all the clinical research so that people, when they say, "Man, is this really helping me like this?" We can point you right back to the clinical trials and say, "Probably because look at the clinical trial results."
It's so interesting, Nikki, your point about, can you take what you're experiencing here, the concept of it, into your daily life? So, I've been told it's one of the most rewarding things a few times recently, like EndeavorOTC, the non-prescription product that is available today for purchase on the App Store, in Apple today, we'll bring Android soon. It's only been out about eight weeks at the time we're recording this. So, we're getting the earliest read on the early users, and I'm hearing some of the coolest things in talking with people, and I think there's even a few reviews on the App Store about this, where people are saying, "I find myself in daily life saying, 'Okay, here we go, just like I'm about to catch that fish.'"
Nikki Kinzer:
Yeah, totally.
Eddie Martucci:
They're kind of zoning themselves into what they're used to doing in the game. They're referencing that to say, "All right, I got to get that fish that's slipping away, so time to charge up my hovercraft." And they're kind of using those as anchors in their daily life, and slipping into the right focus zone. And that's pretty cool.
Nikki Kinzer:
Mop that bathroom as fast as I can.
Pete Wright:
As fast as I can. You got to get the Speedo pad. Look, so you brought up the OTC. That is... People have already been asking questions in the thing like, "Oh, well it's prescription only." But wait, wait, wait, there's more. Eight weeks it's been out. By the time people hear this, it'll have been about 10 weeks, and that is the OTC version. Anybody can get it. It is a paid game. You get a seven-day trial if you pay annually, and we'll talk about pricing in a minute, but first and foremost, what is the difference between the OTC version, besides its being able to be played by adults 18 and older, what's the difference in function?
Eddie Martucci:
Great question. So, first thing, I've mentioned the name a couple of times, but I probably forgot to define the OTC. So OTC, it stands for over the counter, and what it's referencing is like Prilosec OTC, or Claritin OTC, right? So based on the exact same technology as the first and only prescription video game, our product, but available "over the counter," in this case, over your App Store for direct purchase. So that's why it's called that. The game is very similar, the core game, the core technology, because the tech inside, all the algorithms I was talking about, identical. Has to be identical, because that's what is-
Pete Wright:
That's the engine.
Eddie Martucci:
That's the engine, exactly. Even the delivery of the game itself. When we got our clinical trial results in adults, and adults with ADHD, they were so good, they were even better than in kids, frankly. And we're in a moment where, because of a shortage of ADHD medication, and because of what's happening out in the market of people talking about it, adults with ADHD are really seeking new options. So, we decided to get this out quick. And so, what we did was we essentially put the version of the game that is the pediatric game, we put that on the market, but we made some big differences.
So we stripped out all of the stuff that connects the data flow to, for instance, the doctor. All of the things that you need to do to get the prescription. So all of those tracking features, there's actually an app for the prescription product that pulls data, and feeds data into the product, but really pulls data from the treatment, so that parents can look at it. So it's like a monitoring app, that's gone.
So it's really stripped down to just the core game and engine that has the clinical benefits. That's where it is today, as of eight or 10 weeks on the market. But, we're already differentiating those products. So, we're releasing updates very soon that will allow scoring, and progress tracking, that are very specific to the adult product, because adults want to have a really simple way to see, what's my focus, and how do I track that over time? And then there will be continual theme, and updates that, for lack of a better word, start to age it up, for what adults really want to do. But, I don't know, as you've said Pete, and experienced, some adults really like this interface, even though even the game itself is designed for kids, but it'll change over time.
Pete Wright:
There's a sort of frivolity to it that keeps it separate from the other stuff I do in my day, and other games that I play. It seems... I think that the design of it brings me in because it looks so different than other stuff I play.
Eddie Martucci:
We don't want that to change.
Pete Wright:
I think this next question will be interesting to maybe a very small subset of a subset of our listeners, but I'm going to ask it anyway. Any indications as to whether you're able to tie this game into the platform health apps like Apple Health, or as you say, when you bring it to Android, Google Health?
Eddie Martucci:
Maybe. So once we have... So, it's interesting, it's not kind of on our highest priority roadmap. Really, what we're focused on is, what do users, patients in the market, customers, what do they want to see in the product like ASAP, to help them, and basically what are the features that will help them best maximize their first six weeks of treatment, and then their ongoing after that?
So as you alluded to, for the vast majority of users, that's not those types of tracking features. So, they're a little bit lower on our list. I do think as we collect more and more data, and we have kind of thousands of users already right now, and I think that will hopefully grow dramatically, I do think we'll have a lot of really fascinating data to do population analysis and benchmarking. And so at that point, it could make a lot of sense to think about the scoring, and the metrics we have in the product. There's kind of nothing in your health kit stuff that reads out on your brain function. So, maybe this is the first, but that's not in there today, just to be clear.
Pete Wright:
Yeah. Okay. So, pricing, the pricing for over the counter, it's not priced like another game in the App Store, for sure. It is priced maybe closer to medication.
Eddie Martucci:
Somewhere in between. Yeah.
Pete Wright:
It's in the ballpark. Talk to us about your pricing model, and what is the thinking that went into pricing it the way you priced it in the App Store?
Eddie Martucci:
Sure. Yeah. The way it is priced today, and by the way, it is varying, because we're still in these early days of testing, and optimizing what we think is the best pricing, and pricing model. Where it sits today is that if people sign up for a year plan, it equates to less than $15 a month. That's kind of where it is, and will likely stay for the near future. It's a little bit more expensive than that on a monthly basis, but they don't have to sign up for the full year. But sometimes in the 20 or 25 a month for the... If you're just going month to month.
Like you said, we're testing, we have... Most consumers today will get the option for a free trial. That's really important to us. And so, most people that go on will be served a kind of free trial, where you can try this for seven days, and then convert in if you're liking it and seeing the benefit.
The reason we thought about this pricing model is that it is a medical product, so it's not a video game that is... In fact, we don't even want people who want to pick it up for a day or two, and then put it down. That's not what... We're not trying to have someone that wants to do something fun on the train while they're bored for a day. We're really trying to serve a person who says, "I want this as an important part of my life, and it's going to help me in my treatment journey." So, we didn't want this to be as expensive as medication, but we do think it's really important that it's viewed as a medical product, and it's a powerful, patented technology that really does lead to strong clinical benefits.
Pete Wright:
Has there been any discussion, or is... Maybe you know off the top of your head, can you use HSA funds, health savings accounts to pay for this stuff? Is it-
Eddie Martucci:
Yep. Yep.
Pete Wright:
If it's prescribed, I imagine it is.
Eddie Martucci:
Yeah, EndeavorRX for sure, and also EndeavorOTC should be covered. We can't guarantee 100%, but it should be covered by most healthcare spending accounts, as almost all OTC products are. So I think that's also really valuable, when people think about it. It's interesting. Sometimes we get feedback that, often we think medicine, and so, we think about copays and what's my willingness to pay there. But then sometimes people think about this in the fitness realm as well, or meditation, and fitness meditation apps. And I think interestingly, all of those things really do coalesce around a similar price on a per month basis. So, if they're meant to be really deeply used, and have real benefit in your life. So, that's how we're thinking about it.
Pete Wright:
Well, and that's the sort of cognitive challenge. If you're just coming to the game with experience in games, this looks like a casual game on the surface. That means it's competing with other casual games that don't cost like this.
Eddie Martucci:
You're dead on. That's why we want to get the word out in forums like this, so thank you guys. But yes, 100% is, there's an education hurdle, and that's on us, to make sure that we show customers why, and we do get feedback. It's the minority, but we get feedback where people... Maybe we haven't made it as clear how this is studies, that it's based on an FDA approved product, and maybe it looks a little too much like a casual game. So, the more we can spread and get the word out, the more I think everyone will be satisfied and happy.
Pete Wright:
Well, and we all know that App Store reviews are really a bastion of intellectual prowess. I'm sure people have spent a lot of thought, a lot of time thinking about their words before they jot them into an App Store review, so I'm sure you have a lot to work with. I think it's fascinating. Nikki, I've monopolized now, with my nerd talk. Did you have another question? I feel like I've interrupted you [inaudible].
Nikki Kinzer:
No, this is great. I'm excited to go, and play with it a little bit, and check it out.
Pete Wright:
Yeah, I am too, I feel like just my experience with it this morning, that battery charged feeling, that sort of electric feeling, I want that again. I want to have that again. So, I am grateful for the free trial. We absolutely are on board, like anybody else, just in case you are worried about how we're using the game, I've got the free trial, and I am seriously thinking about this as a way to augment my own daily practices.
Nikki Kinzer:
And something I would add too, as somebody who works with a lot of ADHDers, it's always good to have another treatment. It's always good to look at what else can help you. Not everybody likes to take medication. Not everybody is able to take medication. And like you said, you can use this along with medication. But I think just having different opportunities, and choices to help treat your ADHD is a wonderful thing. You've obviously done your research. You keep saying slow and steady, and I'm thinking you must have had that in your mind over and over again, with the patience you must have had to get to where you are today. Doing all of these studies. It'd be hard to be patient. I just want to know, is it working?
Eddie Martucci:
It took some time. That is for sure. And I'm so glad you mentioned it, Nikki, that this is... I've talked about it often. I've been quoted about it, that what I think I might be most passionate about is not to say that this is the best option for everyone. I'm sure for some people this is not a great option. I'm sure for some people they want to use it along with medication or therapy, and some people, maybe this is their primary option. The point is to have another pillar of treatment, that's scalable, because the problem is we only have one scalable type of treatment today. It's medication. We have a pretty non-scalable type of treatment, which is behavioral therapy, so most people don't get it, and that's it.
And when you have one mode of treatment for a complex human being, and all the heterogeneity across humans, it's just not enough. So, our hope is that this just becomes a really important part, in the way you both said it, a really important part of what can help people, but it doesn't have to be the silver bullet, doesn't have to be the primary thing. For some people, it will be, for some people it won't.
Pete Wright:
You mentioned Android coming soon. Do you have a rough timeline on what soon means?
Eddie Martucci:
No, no. It's on our roadmap. We want to do that. We know that there's a lot of people who primarily use Android devices, so we're looking at how quickly can we do that, and how does that fit in with other priorities to really help get this product to people.
Nikki Kinzer:
Great.
Pete Wright:
We so appreciate you doing this, Eddie. Thanks for being here and for-
Nikki Kinzer:
Yeah, thank you.
Eddie Martucci:
Thank you.
Pete Wright:
Pulling back the curtain. This has been a real treat, and a truly fascinating product, and brand new space. Wow. Absolutely fantastic. Thank you for hanging out with us. Thank you everybody for downloading, and listening. We sure appreciate your time, and attention. Don't forget, if you have something to contribute to the conversation, we're heading over to the Show Talk channel in our Discord server, which you can access by becoming a supporting member at the deluxe level or better. On behalf of Eddie Martucci and Nikki Kinzer, I'm Pete Wright, we'll catch you next week, right here, on Taking Control, the ADHD Podcast.
