Better Therapeutics
The business, the turning points, and the decisions behind them.
01 / WHAT IT BUILT
What the company did
Better Therapeutics was a San Francisco prescription digital therapeutics (PDT) company founded in 2015 by CEO Kevin Appelbaum. It built app-based cognitive behavioral therapy programs, prescribed by physicians, aimed at the root behavioral causes of cardiometabolic disease: type 2 diabetes, hypertension, high cholesterol, liver disease and obesity. Its flagship, AspyreRx (BT-001), won FDA de novo clearance in July 2023 - the first digital therapeutic authorized for type 2 diabetes - and BT-004 for liver disease received FDA breakthrough device designation in February 2024. The company went public in October 2021 via a SPAC merger with Mountain Crest Acquisition Corp II (ticker BTTX), raising $110 million. In March 2024 it ceased operations, terminated its employees and sought strategic alternatives including a wind-down; its assets were subsequently acquired by Click Therapeutics.
02 / Better Therapeutics FAILURE REASONS
Failure factors supported by the current evidence
MedTech Dive (15 March 2024) reports Better Therapeutics wound down after struggling for money: September cash of $6.6 million was only expected to last into Q1 2024 (accumulated deficit $134.3 million), cash reserves were running low, and a ~20-cent share price left it poorly placed to raise more capital to commercialize AspyreRx.
MedTech Dive, citing company filings, says Better ended September with $6.6 million cash expected only into Q1 2024 and that cash reserves were running low as it delisted.
The article states a share price around 20 cents left the company poorly positioned to raise money to buy time to grow AspyreRx sales.
03 / EVENT HISTORY
Events in the structured record
- Operations ended
Company Exhibit 99.1 to the 14 March 2024 Form 8-K states that at a 13 March 2024 special board meeting Better Therapeutics decided to terminate employees and explore strategic alternatives including assignment for the benefit of creditors and/or a wind-down, and requested Nasdaq delisting.
- Asset sale
MassDevice (22 May 2024) reports Click Therapeutics acquired assets of already-shuttered Better Therapeutics, which had ceased operations in March after terminating employees.
04 / CONTEMPORARY REBUILD ASSESSMENT
Difficulty of rebuilding this project today
Material for this section is being gathered and checked. It will appear here once ready.
Overall assessment: Not completed
05 / CAUSAL CHAIN
How the factors connect
- 01
FDA clearance is not reimbursement: AspyreRx won de novo clearance in July 2023 but payer coverage (CMS) never materialized in time.
- 02
The digital-therapeutics business model was unproven at scale: Pear Therapeutics went bankrupt the same way a year earlier.
- 03
SPAC money has a fuse: $110M in 2021, staff cuts (35% in March 2023), companywide pay cuts in 2023, dead by March 2024.
- 04
Runway planning must assume slow payers: Better waited on CMS approval while burning cash - the math never worked.
- 05
Science can outlive the company: Click Therapeutics bought the assets in 2024 to pair them with GLP-1 therapies.