News /
min read /
February 3, 2024

For many with mental health conditions, medication is the only option. That has to change.


Let’s bring clinically proven, non-drug digital treatments front and center to help millions in need.

Right now, hundreds of millions of people around the world are stuck in an ongoing struggle with their mental health. They’re overwhelmed in their daily lives and underserved in their options for care. This issue is near to my heart. It has become my life’s mission. We can and must do better. And I’m proud to lead our company, Big Health, in bringing millions back to good mental health.

Case in point: In the US and UK, more than 130 million adults suffer from insomnia, anxiety or both1-6. And, the sad truth is that the current default approaches are just not working. Nearly 70% of anxiety and insomnia patients are treated with prescription drugs only7. More than three quarters of so-called “rescue” prescriptions exceed the recommended duration of 30 days, despite concerns about abuse and physical dependence7. Regrettably, less than 10% of those treated receive the widely recommended first-line treatment, cognitive behavioral therapy7. This may well be the most glaring case within our medical system where the widespread, ongoing practice is so divergent from what’s indicated by the data and clinical guidelines.

Mobilizing to Deliver a Better Approach

Amid this unfortunate reality, advances in digital therapeutics (DTx) are delivering a promising path forward. Mental health is emerging as the first large-scale use case for digital therapeutics because it 1) encompasses a number of highly prevalent conditions such as insomnia, anxiety, depression, PTSD, and chronic pain that, taken together, impact one in three human beings; 2) has woefully inadequate treatments including most typically prescribed medications that show mixed results and carry significant side-effect profiles; and 3) has emerged through the pandemic as a top three issue for employers, health systems, and governments to address more effectively. Adding to these factors and market dynamics are patient preferences, which indicate that 75% of individuals would prefer a non-drug treatment8.

The Case for DTx

Distinct and different from the growing range of wellness apps, digital therapeutics are real medical treatments that include a number of defining characteristics:

  • Evidence-based — Based on proven models of care, such as cognitive behavioral therapy (CBT)
  • Clinically Validated — Outcomes have been extensively validated in both peer-reviewed research and real-world studies
  • Reimbursed — Typically covered by payors, and therefore operate with the approval of financing systems that define them as healthcare (versus discretionary consumer spending)
  • Scalable — Driven largely by automation, and not dependent on a large-scale provider network
  • Regulated —Typically as a drug, medical device, or clinical service
  • Practitioner Driven — Usually recommended, authorized, and/or directly furnished by a healthcare practitioner

Rising to the Challenge

Over the next decade, a small number of digital therapeutics businesses are likely to reach the scale of big pharma, while defining a new treatment category in the process. Toward that end, Big Health is leveraging its decade-long commitment to building clinical-grade digital treatments that are deeply science-based and research-validated.

In 2019, Big Health’s founders – Peter Hames and Colin Espie – invited me to join the company’s board of directors to draw on my past experience scaling big visions. Their remarkable, pioneering work developing clinical-grade, non-drug digital treatments for the most common mental health conditions had resulted in two industry leading products, Sleepio for insomnia and Daylight for generalized anxiety disorder. These are evidence-based, research-validated, fully automated digital treatments that provide a clear pathway to meaningfully scale and accelerate access to guideline-recommended care. I was both humbled and energized last year when Peter, Colin, and Big Health’s leading investors, including Softbank, Octopus, Gilde, and Morningside Ventures, came together and asked me to lead the company’s scale-up as CEO.

Springing Forward

Underlying our products is an industry-leading body of peer-reviewed research and randomized controlled trials. Our guideline-recommended digital treatments have the most evidence in the industry, supported by more than 80 peer-reviewed publications and 14 randomized controlled trials. Our products are proven to drive significant clinical improvement with 71-76% of participants having been shown to achieve remission9,10. Importantly, we do this while also enabling meaningful cost reduction of $6,400 annualized decrease in per patient spend11.

The evidence shows us that the world is moving in our direction. Indeed, Big Health has already been approved for reimbursement by numerous employers, large prescription benefit managers (PBMs), the National Health Service (NHS) in Scotland, and multiple payers. We concluded 2022 as the most successful year since our founding, achieving significant business milestones including:

  • Series C Funding round for $75 million with SoftBank
  • Daylight and Sleepio products added to a second national digital formulary
  • National Institute for Health and Care Excellence (NICE) approval of Sleepio as first line treatment for insomnia ahead of medication
  • Strategic partnership with major payer for medication targeting
  • Our 300,000th patient enrolling in treatment

The Time is Now

Our momentum is strong as we drive forward in 2023. We continue to build out a diverse and talented team with a number of recently named senior executives focused on finance, product, people, sales and marketing joining many long-standing Big Health employees expert in digital treatment development. We’re already on pace to add more covered lives this year than any in recent years, including several strategic relationships. Our products, already leading the industry in their efficacy and usability, are making further jumps in efficacy and adherence. We will treat a record number of patients this year, all on a fully reimbursed basis and through fully automated digital experiences. And our industry as a whole is maturing to understand the role that evidence-based, digital treatments will play as the first-line mental health treatment of any modern health system. We look forward to sharing more progress and inviting your collaboration on the road ahead.

About the Author:

Arun Gupta is Chief Executive Officer and Executive Chairman of Big Health, the leading provider of clinical grade, non-drug treatments for the most common mental health conditions. Big Health’s two products – Sleepio for insomnia and Daylight for generalized anxiety disorder – are proven in over 80 peer-reviewed papers to deliver clinical outcomes without serious side effects. Previously, Arun founded Quartet Health, a technology and clinical services company scaling effective mental health access in partnership with insurers and health systems. He led Quartet through a significant scale-up serving as CEO for Quartet’s first five years and then Executive Chairman of the Board. Earlier, Arun built and scaled several industry-defining companies as a General Partner at Accretive. The firm’s launches created over $5B of equity value including several IPOs with successes like Accolade, R1, Fandango, and others. Arun earned a Master’s Degree from the Harvard Kennedy School where he was a Reynolds Fellow for Social Entrepreneurship and graduated with honors from Duke University.

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  1. United States Census Bureau 2020-2021
  2. United Kingdom Census 2021, Office of National Statistics
  3. NICE clinical guideline 22 (2004): ‘Anxiety: management of generalised anxiety disorder and panic disorder’
  4. Vargas et al., 2020. Brain Sciences.
  5. Roth et al., 2011. Biological Psychiatry.
  6. National Institute of Mental Health (2023). Any Anxiety Disorder.
  7. C Bazell et al. (pending publication) Treatment patterns for generalized anxiety disorder and insomnia in Medicare fee-for-service
  8. McHugh RK et al. (2013) Journal of Clinical Psychiatry
  9. Espie et al. (2012). Online cognitive behavioral therapy for chronic insomnia disorder.
  10. Carl et al. (2020). Depression & Anxiety.
  11. Anderson et al 2014 (

During the COVID-19 public health emergency, Sleepio and Daylight are being made available as treatments for insomnia disorder and generalized anxiety disorder (GAD), respectively, without a prescription. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia disorder and GAD, respectively.

1. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125-133.2. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., … & Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700.3. Wilson, S., Anderson, K., Baldwin, D., Dijk, D. J., Espie, A., Espie, C., … & Sharpley, A. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update. Journal of Psychopharmacology, 33(8), 923-947.4. King’s Technology Evaluation Centre. (2017, November 9). Overview: Health app: SLEEPIO for adults with poor Sleep: Advice. NICE. Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. (2012). A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep, 35(6), 769-781.6. Carl, J. R., Miller, C. B., Henry, A. L., Davis, M. L., Stott, R., Smits, J. A., … & Espie, C. A. (2020). Efficacy of digital cognitive behavioral therapy for moderate‐to‐severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and Anxiety, 37(12), 1168-1178.

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