As the pandemic unevenly roars on, Emily Melton, founder and managing partner of Threshold VC, is reflecting on a previous public health crisis: the Spanish flu.

She says the response just over a century ago prompted the rise of interventional medicine — treating illness through surgery or medicine only after symptoms manifest. Today, interventional medicine is the dominant mindset in Western healthcare. And, Melton, a lead investor in health tech startups including Livongo, Tia and Calibrate, says the care pathway ages well.

Personalized medicine — the buzzy yet powerful framing growing in popularity among Silicon Valley startups — is a delivery system in which patients receive more holistic care that takes into account multiple symptoms or comorbidities.

“What’s happening in our society? Chronic diseases, chronic pain, diabetes and obesity,” she said. “That doesn’t require a magic pill and there’s not just a surgery. Oftentimes, there’s therapeutic components, behavior changes and movable touch points.”

Enter personalized medicine. The buzzy yet powerful framing is growing in popularity among Silicon Valley startups. It’s a delivery system in which patients receive more holistic care that takes into account multiple symptoms or comorbidities. In hormonal health, for example, personalized medicine could add more data and specificity to which birth control someone takes, instead of the usual process of trial and error. Essentially, it’s the opposite of interventional medicine.

“We’re not just an arm or a leg, we’re not just obese or a diabetic or a pain sufferer,” Melton said. “How do we treat you as a whole person?”

A number of companies are using this approach to reinvent care for patients with musculoskeletal (MSK) medical conditions and chronic pain. These conditions are commonly treated with addictive opioids, a major public health concern. As an estimated 50 million Americans suffer from chronic pain, entrepreneurs are working on solutions that don’t resemble the cookie-cutter status quo. And the money market is certainly there: In 2017, the global MSK medical market was valued at $57.4 billion; the market for chronic pain, which overlaps with MSK medicine, is expected to hit $151.7 billion in value by 2030.

“Oftentimes it’s not new ideas, it’s conflating a number of factors that come together at one moment in time that allow exponential change that makes a startup work,” Melton said, of the boom and recent activity in MSK medicine. Today, we’ll focus on three startups taking different approaches to help people suffering from chronic pain and MSK-related conditions: Clearing, PeerWell and Hinge Health.

Clearing

Avi Dorfman says going direct to consumers is the most effective way to treat chronic pain, so he founded Clearing. The digital health startup worked with a medical advisory board of physicians and researchers from Harvard, Johns Hopkins and NYC’s Hospital for Special Surgery to create an opioid-free solution for people struggling with pain.

Last month, Clearing raised a $20 million seed round led by Bessemer and Founders Fund. Melton also invested in the round on behalf of Threshold.

Clearing offers four products: prescription compound cream that includes FDA-approved ingredients, CBD cream for topical discomfort, nutraceuticals to supplement joint health, and a directory of prerecorded, at-home exercises. It currently is available to patients in California, Florida, Georgia, Illinois, New York, North Carolina, Ohio, Pennsylvania, Tennessee and Texas.

Originally published at techcrunch.com

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