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Knownwell nabs $20M Series A for U.S. push

Illustration of a bathroom scale with a dollar sign formed by the indicator in the weight scale window.

Illustration: Aïda Amer/Axios

Knownwell, an in-person and virtual weight management company, raised a $20 million Series A to expand out of the Northeast, CEO Brooke Boyarsky Pratt tells Axios.

Why it matters: GLP-1 agonists are expensive, in short supply and not right for every patient, creating an opening for more holistic obesity management providers like Knownwell.

Details: The round was led by Andreessen Horowitz with participation from existing investors including Flare Capital Partners.

  • Other existing backers include Flybridge LTV Operator Fund, Oxeon, Larry Summers, Mirror's Brynn Putnam, Dia & Co's Lydia Gilbert and Nurx's Varsha Rao.
  • Knownwell has raised $24.5 million to date, most recently taking in a $4.5 million seed in January.

What's next: The company operates in New England and will use these proceeds to expand across the U.S., Boyarsky Pratt says.

  • The executive declined to specify the new regions Knownwell is targeting.
  • The round gives the company as much as three years of runway.

How it works: Knownwell provides in-person and virtual primary care and metabolic health services including obesity treatment, nutrition counseling, psychotherapy, stress and sleep management, and prescription medications.

  • Knownwell also partners with major pharmaceutical companies to conduct and participate in clinical trials.

Zoom in: The company is focused on expanding partnerships with payor and providers in 2024, as Knownwell pushes for a more holistic approach to weight management beyond just GLP-1 prescribing.

  • "First, we're trying to change the conversation with partners," Boyarsky Pratt says.
  • "People shouldn't be looking for a GLP-1 solution; they should be looking for a comprehensive, longitudinal program for patients with the chronic disease of obesity," she says.
  • Knownwell is encouraging partners to explore older, less expensive medications for more patients who may respond well but haven't tried them yet.

Be smart: The reimbursement landscape for obesity management is wildly geographic-dependent, and commercial coverage for treatment is more akin to a benefit like fertility services, Boyarsky Pratt says.

  • In Northeast markets, "commercial payors tend to cover a broader range of obesity treatment (whether that's seeing a physician, nutritionist or pharmacotherapy) than in some other parts of the country," she says.
  • Commercial insurers are more focused on utilization management programs and medication spend management for GLP-1s in particular, without much movement on general obesity services, she says.
  • "We also see the PBMs playing in this space as well in a way that they weren't at the beginning of the year — in particular, CVS and OptumRx."
  • The executive has seen traction in Medicare and Medicaid covering weight management.

Between the lines: With high costs and uncertainty around how long patients should be taking GLP-1s, the weight-loss drugs are increasingly being paired with bariatric surgery.

State of play: The obesity management space has been active, with legacy players and startups vying for market share.

  • Alfie, which uses AI-powered clinical decision support to treat weight loss, raised $2.1 million in seed funding in June.
  • Metabolic monitoring startup Levels, which offers biofeedback on how food impacts health, raised its $7 million Series A extension in January.
  • Weight Watchers acquired weight management telehealth platform Sequence for $132 million in March and this month launched a telehealth service focused on weight management.
  • Meanwhile, this year Noom began offering expanded access to GLP-1s.

What they're saying: Boyarsky Pratt worries over the lack of clarity around how long patients have to take GLP-1s, noting that the potential to regain weight after going off the drug could hurt the market overall.

  • "I am concerned that programs [are] going into place that we know are setting patients up for failure and that the sinking tides will sink all boats," she adds.
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