27 million Europeans suffer from serious anxiety. Due to a shortage of psychotherapists, 87% of them are not properly treated. Waiting times for treatment exceed six months across Europe. As such, anxiety treatment is a massively underserved European market with a revenue opportunity of over EUR 15bn.

Sympatient has succeeded in digitizing the gold standard for the treatment of anxiety disorders.
Invirto is the first digital solution on the European market to offer VR-based exposure therapy paired with app-based cognitive behavioral therapy.

Unlike other digital mental health applications, Sympatient works with therapists rather than replacing them. Therapists can prescribe Invirto to patients diagnosed with anxiety, eliminating long waiting times and freeing up therapists’ time to treat more patients. In Germany, Invirto is reimbursable as a digital health application (DiGA) by all health insurers. The product is sold by general practitioners, psychotherapists, psychiatrists, and specialized hospitals.

Sympatient now wants to go one step further. Its goal is to digitize the whole anxiety treatment process by creating an end-to-end digital clinic that will cover diagnostic, therapy and aftercare. With Invirto already successfully launched in Germany, Sympatient will also be expanding internationally.

How has anxiety been treated traditionally, and how is it treated today with Sympatient’s digital approach?
In the past, the system was clearly broken. Patients might not even be aware that they suffer from an anxiety disorder, which means that this condition is often left undiagnosed and untreated. The waiting lists for therapy places are long. Many times patients do not even receive the gold standard of treatment, exposure therapy, which was developed to help people confront and overcome their fears. Furthermore, this therapy costs a lot and is a burden on the health system. Sympatient has changed all of this. We offer our digital therapy nationwide, and there is no waiting time after a diagnosis. Our product is approved as a medical device and reimbursed by every health insurer in Germany. People get a specific therapy called cognitive behavioral therapy in the comfort of their homes. But they’re not left alone, trained therapists will answer the questions they might have.

Our product combines human interaction with digital medicine.

Isn’t there a healthy skepticism from patients and practitioners alike if digital therapy is as effective as meeting face to face?
A few years ago this was definitely the case, but the perception has changed dramatically since. Sympatient is a spin-off from the University Medical Center Schleswig Holstein, one of the largest medical centers in Europe. Our advisory board includes key opinion leaders in the field of psychotherapy that write the guidelines for anxiety therapy. We have successfully treated thousands of patients, and the preliminary results from our clinical trial show that Invirto is as good as the gold standard. Invirto isn’t just an app that replaces doctors or therapists. Our product combines human interaction with digital medicine and allows treatment professionals to treat more people and reduce the shortage of treatment opportunities for the benefit of patients. This supply problem, by the way, has been made significantly worse by Covid. According to the medical journal The Lancet, anxiety disorders have increased by 25%, bringing the number worldwide up to 370 million from around 300 million before the pandemic. Anxiety is now the number one psychological illness, even before depression.

So in a way, the push to adopt digital solutions because of the pandemic has been noticeable in psychotherapy as well?
Yes. We were ready at the right time. After we founded Sympatient in 2017 we had to do a lot of pioneering and difficult work to get our product approved as one of the first digital health apps in Germany. Being one of the first, however, has given us a lot of coverage that has increased our visibility. Sympatient also won many awards that helped us a lot such as “Newcomer of the Year” from the German Startup Awards and internationally, second place in MEDICA’s worldwide startup competition. When the pandemic hit, it affected anxiety patients who struggled badly with human interaction. Therapists were glad that they could help their patients with digital therapy whose quality is guaranteed.

What comes next for Sympatient in terms of product and geographical expansion?
We want to transform our product into the first digital anxiety clinic that will cover the treatment process end-to-end, from diagnosis to treatment to aftercare. The next step toward this goal is adding digital aftercare to our existing product. Some patients relapse after therapy and we want to offer them a way to keep up their mental health, which also includes psychotherapeutic elements. At the same time, we’re analyzing the reimbursement schemes of different markets other than Germany to build the first European player. We can already sell our product across Europe, but reimbursement is important.

Navigating the complexities of different national healthcare systems is a very tall order for a startup.
Indeed, we would never have thought that this might be as complicated as it is. But the good thing is that we have substantially strengthened our management team with Kathrin Pfeiffer, a regulatory expert who has been instrumental in the implementation of DiGA in Germany.

How difficult is hiring the necessary talent for you in Hamburg in general?
There is a very large talent pool of intelligent people that want to work for a startup that is purpose-driven. What Sympatient does, the way we can help patients and have an impact on their lives has a powerful radiance. But Hamburg’s startup scene is less overhyped than others.