App-based obesity therapy


One of the first approved DiGA

Among the first digital health applications reimbursed by the German standard care system is an app-based therapy developed by aidhere GmbH. The start-up is located at the Health Innovation Port in Hamburg, a start-up infrastructure founded by Philips and further partners such as the Asklepios Kliniken.

Zanadio is available as an app for iOS and Android and accompanies people with obesity in the areas of exercise, nutrition and behavior change. (Picture: ©aidhere GmbH)
Zanadio is available as an app for iOS and Android and accompanies people with obesity in the areas of exercise, nutrition and behavior change. (Picture: ©aidhere GmbH)
App-based obesity therapy

Digital therapies ready for take off

It took Germany only 15 months to develop its healthcare reimbursement system for digital therapies with the arrival of the Digital Healthcare Act [DVG]. Since October 2020, the first digital healthcare applications [DiGA] have been approved by the Federal Institute for Drugs and Medical Devices [BfArM]. These included the obesity app zanadio, developed by Hamburg-based aidhere GmbH. “We prepared specifically for this process and are delighted that we got through it so quickly,” enthuses co-founder Nora Mehl. The business was only established in 2019, together with co-founders Tobias Lorenz and Henrik Emmert, and with the support of start-up financing from the Landesinvestitionsbank in Hamburg. Emmert was the initial driving force behind the company. He had spent nine years as a consultant at the Boston Consulting Group and wanted to grow his own digital health business specializing in obesity. Via the Internet he came across Nora Mehl, who had been researching obesity behaviors for the Max Planck Institute for Cognition and Neuroscience in Leipzig for some time. “I was becoming increasingly disillusioned because all of my publications ended with the realization that the results had to be transferred in a real-life setting,” recalls Mehl.

Porträtbild von Frau Dr. Nora Mehl, Co-Founder & Managing Director, aidhere GmbH

Dr. Nora Mehl, Co-Founder & Managing Director, aidhere GmbH (Picture: ©aidhere GmbH)

E-learning modules combined with fitness and food tracking

With Emmert and Lorenz at her side, she took the plunge and switched to self-employment. Together, the trio developed an app-based obesity therapy that offers tailored online support to sufferers trying to change their own behaviors – based on the latest guidelines and customized for each user. “Up until now, there were few genuinely effective therapies available to people with heavy obesity and most were very costly,” says Mehl. The zanadio app combines e-learning modules with fitness and food trackers. The start-up’s expert panel of nutritionists, psychologists and sports scientists develop a bespoke program for each user based on the details they provide.

“The program only sets targets that can actually be achieved, so it is very patient centric.”

– Dr. Nora Mehl

The goal is to reduce their calorie intake while increasing their calorie requirements. “The program only sets targets that can actually be achieved, so it is very patient centric,” emphasizes psychologist Mehl. She understands that setting realistic goals is a key factor for getting results. Since November 2020, the app can be prescribed and reimbursed as a digital healthcare application in Germany and generates first revenues for the young company. However, the BfArM approval is only a conditional on a one-year basis. A clinical trial with the University of Leipzig will run in parallel to examine how the app affects the user’s quality of life, well-being and weight. “We will draw on these data with the aim of receiving final approval after a year and enter into final negotiations with health insurers,” says Mehl. At the same time, the team hopes to increase awareness of the app and to collaborate with rehabilitation clinics, specialists and health insurers to establish further partnerships in the market.

Digital health is becoming attractive

The team has garnered support from organizations such as the Health Innovation Port (HIP), where the young company has its office. This campus in Hamburg was established by Philips, along with partners such as the City of Hamburg and health insurer Techniker Krankenkasse to offer start-ups the opportunity to work closely with health experts. Today, further partners such as the Asklepios Kliniken are also part of the HIP. “We work with a growing number of national as well as international start-ups to support them accessing the market in Germany,” says Philips representative Lukas Hoffmann, who is responsible for the start-up collaborations at the HIP. Since digital healthcare applications have become possible under the reimbursement regulations in Germany, HIP has started to offer a targeted consulting program. “We aim to help businesses make solid decisions on whether this could be a feasible route for them,” says Hoffmann. According to him, the DVG has made Germany much more attractive as a digital health market. “We are increasingly receiving international enquiries from start-ups that want to sell their products here in Germany,” says Hoffmann. Likewise, the new Hospital Future Act [Krankenhauszukunftsgesetz] due to come into force in Germany in 2021, will be a further milestone for digital solutions. Henning Schneider, Chief Information Officer at Asklepios Kliniken, also believes this to be true. “For the first time, the new law will allow us to claim the costs for digital structures from the Federal government and to make targeted investments. We will concentrate on solutions that can be implemented independent of a single location.” Schneider is without a doubt an advocate of using platform-based approaches that network together different providers. “We need excellent interfaces and must avoid island solutions at all costs.”

HIP offers access to global innovations

The way the HIP is organized helps Asklepios to channel and structure its collaborations with e-health start-ups. “We are bombarded with start-ups that approach us with their solutions. Everyone is interested in data available in clinics. The HIP allows us to target specific partnerships and launch pilot studies”, says Schneider and emphasizes: “We are concerned with the patients and doctors for whom digital solutions must also represent improvements.” He also sees a need for applications that make the admission process in hospitals more straightforward, make it safer to dispense drugs, or aid the use of mobile devices in clinical settings, such as for wound treatments. The HIP also enables Asklepios to search for innovations worldwide. “We don’t need to wait for a start-up to come to us with the ideal solution, we can actively seek them out,” says Schneider.
Author: Sandra Wirsching

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