Cognito Therapeutics Brings Payors to the Table Early to Meet a High Bar for Reimbursement in Alzheimer’s

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Cognito Therapeutics’ nondrug therapy for Alzheimer’s disease defies categorization. It’s a neurostimulation device for home use, while going after pharmaceutical endpoints. Like a digital therapeutic, it is software enabled, both for the sake of improving adherence and for data-gathering. Because of its complexity, Cognito has assembled a payor advisory board at a rather early stage, to design its path forward based on the input of payors, integrated delivery networks, and physicians.

Cognito Therapeutics Inc. is developing a novel neuromodulation therapeutic for Alzheimer’s as well as other neurodegenerative diseases. Just beginning its Phase III pivotal trial, the company is getting a jump on its strategy for getting paid for its innovation. Cognito’s disease-modifying therapeutic, which treats patients in their homes, delivers noninvasive neuromodulation through a system that includes a headset, controller, and software to enhance compliance. In a single platform, the company combines aspects of pharmaceutical drug development, medical device development, and the data-enabled aspects of digital health. (See “Digital Therapeutics for Alzheimer’s Blur Industry Boundaries,” MedTech Strategist, January 2022.) 

CEO Brent Vaughan notes that Cognito isn’t looking to change the way Alzheimer’s therapies are prescribed and delivered—after diagnostic testing, the therapy will be prescribed by neurologists. But with a product that defies neat categorization, Cognito has invited a set of relevant stakeholders to the table to make sure it demonstrates the right kinds of value to potential payors.


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