In conversations with colleagues, fellow entrepreneurs and even musicians over the last decade, Daniel Ek often abruptly shifted the topic to something that really annoyed him: healthcare. “I was determined to fix the problem,” Mr. Ek, Spotify’s boss, told DealBook. He viewed the industry as a bloated and inefficient behemoth that needed to be disrupted.
The problem: Mr. Ek had neither a plan nor the time or money to do much about it. He’s been busy taking on Apple, YouTube and Amazon Music in the streaming wars. In his free time, Mr. Ek leafed through medical journals. And he routinely measured his vitals with a Fitbit, Apple Watch or Wii Fit tracker—the more data, the better one could see how his body was holding up to the rigors of running a business. He believed that such tracking could provide a clue to living longer and healthier lives. “I was just playing around with ideas in healthcare,” he added.
That changed in 2018. Spotify went public and made Mr. Ek a billionaire. It was time, he decided, to turn his side hustle toward his next venture. He knew who to turn to: Hjalmar Nilsonne, a Swedish technology entrepreneur whom Mr. Ek had met the year before at the Brilliant Minds event, an annual meeting that Mr. Ek had created. Mr. Nilsonne was also enthusiastic about upending the status quo. At the time, he was focused on climate change and his startup Watty, which aimed to remove waste from the energy grid.
Initially, Mr. Nilsonne rejected Mr. Ek’s suggestion. But Mr Ek finally convinced him. (It helped that Watty ran out of money and it was eventually sold to a German company.) Mr. Ek, a former computer programmer, and Mr. Nilsonne, an engineer, focused on developing a better diagnostic tool. Your goal: disease prevention and life extension. The company they founded, Neko Health, opened its doors in Stockholm last year and is set to open in London, its second market, this summer.
Longevity has become something of an obsession for tech moguls. Sam Altman, Peter Thiel and Mr. Ek are among those who believe that smart ideas, the right technology and pools of capital can help people live longer. Mr Ek, 41, has invested millions personally and through his investment firm Prima Materia in such start-ups across Europe. Neko Health is the only company for which he has received the title of founder.
The company says its full-body scans can detect the onset of a variety of cardiovascular and metabolic diseases, as well as skin conditions. The scans, which cost about $230 or 2,500 Swedish kroner, are billed as a “health check for your future self.”
Full body scans have been around for some time. However, thanks to artificial intelligence and social media, they have experienced a major resurgence in recent years. Kim Kardashian helped put a buzzy rival, Prenuvo, on the map last summer when she called its MRI scanner a “life-saving machine” in an Instagram post. Another company, New York-based Ezra, said in February that it had raised $21 million to expand into 20 North American cities by year’s end.
Despite the booming interest, medical experts say proactive screening technologies have not yet proven they can produce better outcomes for patients’ health or longevity. And the verdict on the business model is still out.
“I would be super happy if I didn’t make money from this, but we actually solved real problems in the world for real people,” Mr. Ek told DealBook in his first English-language interview about Neko Health.
He compared the challenge to the streaming wars. When Spotify launched in 2008, the music industry was plagued by piracy and declining revenue. “Everyone told me this is a terrible business. Please don’t do this,” he recalled.
Mr. Ek acknowledged that adopting health care may be even more difficult. Like Spotify, Neko Health has big growth ambitions, but faces a long road ahead to get the green light to enter new markets. And in some ways, the Neko founders’ vision is more ambitious than their competitors. Their goal is to make early diagnosis of disease affordable so that full-body scans become as routine as an annual exam. This could help reverse a depressing pattern in which life expectancy growth has slowed in many wealthy countries over the past decade despite rising health spending. “Almost every trend is in the wrong direction,” said Mr. Nilsonne, 37, who is also chief executive of Neko Health.
In a Neko health scanner
There are about as many approaches to body health scans as there are companies offering them. Most involve repackaging existing medical technology and adding proprietary software. Prenuvo, the startup Ms. Kardashian promoted on Instagram, was founded by entrepreneur Andrew Lacy. His supporters include Eric Schmidt, the former CEO of Google, and supermodel Cindy Crawford. It sells one-hour magnetic resonance imaging sessions for $2,499 and then uses AI-powered software to examine the scanned images for warning signs of cancer, aneurysms and liver disease. Ezra hopes to shorten the full body scan to 15 minutes and charge $500 for it.
Neko Health does not perform MRIs or X-rays at its lower price. Instead, it uses about 70 different sensors and a mix of proprietary and off-the-shelf technologies to non-invasively measure heart function and circulation and photograph every inch of a patient’s body.
“The visual metaphor early on was about the airport scanner,” Mr. Ek said.
At a Neko Health clinic in Stockholm, where I recently paid for a scan, I understood the comparison. After being handed slippers and a thin cloth coat, I entered a room with a floor-to-ceiling scanning chamber that looked straight out of Star Trek. Soothing instrumental music in a spa-like setting.
I entered the device and was instructed to extend my arms to my sides. The round door slid shut, and a voice recording – a woman with a soft English accent – told me to close my eyes, take a deep breath, and prepare for a bright beam of light. A series of wall cameras flashed. The entire scan, which took over 2,000 high-resolution images of my body and mapped and indexed every one of my flaws, took about 20 seconds.
The second part of the test began outside the chamber. This included a blood draw and tests of grip strength, eye pressure and blood pressure. At one point, a device peering out of a grid in the ceiling measured my heart rate with a laser Sensor. As a green light shone on my outstretched arm, a live, enlarged image of my forearm appeared on a monitor on a nearby wall, showing blood pulsing through my arteries. (The illuminated patch of skin was measured for blood flow and arterial stiffness, an indicator of cardiovascular health).
Most Neko patients pass the examination with a clean bill of health. But in a recent sample of 2,707 patients, life-threatening problems were found in about 1 percent of cases, according to the company. (About a quarter of them were under 50 years old). And 9 percent of that cohort were found to have previously undiagnosed problems that later turned out to be diseases such as heart disease, skin cancer and diabetes.
Dr. Andreea Valdman, Neko Health’s lead GP, walked me through my results at the end of my exam. All 400 suspicious-looking spots and moles on my body that were mapped using AI were harmless, Neko’s dermatologists confirmed.
Type 2 diabetes runs in my family. And my father suffered his first stroke at age 54, so the anticipation of my blood sugar level – HbA1c – made me nervous. The verdict: no risk of diabetes or stroke.
It felt reassuring to know that I was doing something right and that I needed to work on it.
The company said the waiting list in Sweden had grown to 20,000.
“Bending the cost curve”
In the United States, most major health insurance companies typically do not cover such exams. And some in the medical field question their effectiveness. “To date, there is no documented evidence that whole-body examinations are cost-effective or effective in prolonging life,” the American College of Radiology said last year. One problem is false positive results, said Dr. Nils-Eric Sahlin, professor of medical ethics at Lund University in Sweden, told DealBook. He said that could lead to a surge of healthy people seeking second opinions, potentially overburdening the most burdened parts of the health care system and adding costs for potentially unnecessary follow-up treatments.
Mr. Nilsonne dismissed that criticism, calling the status quo healthcare model, in which a patient is often treated long after the disease has progressed, poor public policy. Health care, he said, should bring with it a new stream of data: from healthy people. That will lead to smarter policies, he argued.
“We need to lower the health care cost curve,” Mr. Nilsonne said. “The best dollar you spend on health isn’t when you’re super sick; It’s supposed to help you avoid getting sick in the first place.”
Investors see potential. According to Pitchbook, venture capitalists invested a record $4.7 billion in longevity startups in 2022. But in the wake of Theranos, Elizabeth Holmes’ failed blood-testing startup that promised to usher in “a new era of health care,” the scrutiny is also huge. “Disasters” like Theranos, Mr. Ek said, risk undermining “public trust in all companies to come.”
Last summer, thanks in part to Mr. Ek’s connections, Neko raised 60 million euros ($65 million) from investors including Atomico, General Catalyst and Lakestar. Mr Ek contributed a further 30 million euros. But the capital required for brick-and-mortar expansion of health clinics differs from the economics of launching an app like Spotify. The regulatory hurdles are also high. “Hundreds, if not thousands, of documents need to be submitted,” noted Mr. Nilsonne.
The startup says it is on track to deliver about 50,000 scans by the end of the year. When asked, Mr. Ek did not want to talk about five- or seven-year growth targets or the return on his investment. Instead, he focused on technology. “You can actually save lives with it,” he said, adding, “and we have.”
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2024-04-27 12:00:24
www.nytimes.com
