Neurostimulation for Mental Health Disorders with Christopher von Jako, PhD, President, and CEO at BrainsWay: Audio automatically transcribed by Sonix

Neurostimulation for Mental Health Disorders with Christopher von Jako, PhD, President, and CEO at BrainsWay: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
Hey, everybody. Welcome back to the Outcomes Rocket, Saul Marquez here, and today I have the privilege of hosting the outstanding Dr. Chris Von Jako. He is the President and Chief Executive Officer at BrainsWay, just serving since January of 2020. Chris is a technology-driven executive who brings over twenty-five years of leadership and experience in the global medical device market. He’s passionate about the development and commercialization of minimally invasive techniques to improve health and transform lives. During his career Chris led organizations to improve profitability, performance, and value in early-stage expansion, turnout, and Fortune 500 environments with five entities that he’s worked with resulting either in merger or acquisition. Most recently, Chris served as CEO of Dynatronics, a publicly-traded medical device company. They design and manufacture high-quality restorative products and prior to that, several of their hats have, as mentioned, led to acquisition or merger with companies like Covidien, Medtronic, Radionics and et cetera. Chris has a Ph.D. in biomedical science from the University of Pecs Medical School and really just excited to have him here on the podcast to expand on the work being done on BrainsWay and really what’s going on in the industry overall. So, such a pleasure to have you here, Chris. Thanks for joining us.

Dr. Chris von Jako:
Thanks, Saul. It’s really great to be here. I really am excited about having a conversation with you today and kind of sharing with everyone my thoughts around issues around mental health and how BrainsWay is really making an impact.

Saul Marquez:
Yeah, for sure. And we’re excited to learn about it. Mental health is it’s one of those things. It’s on the radar now. And that’s a great thing. COVID has certainly pressed on some of the strains and stresses to create more need for this so definitely excited to dive into how you guys are doing things differently. Chris, before we do that, though, I love to hear more about what inspires your long life’s work and health care.

Dr. Chris von Jako:
Oh, well, that’s a great question. So I come from a family. I’m a first-generation in the US. My family is originally from Hungary. Yeah. And my father was the, I think, fourth-generation physician in the family. My brother happens to be the fifth generation, but I ended up deciding to go into engineering and in that kind of direction, but that I was always very interested in health care itself. I did a Master’s at MIT and there I kind of got involved in doing things, minimally invasive technology, really focused on the brain using MRI, and think just because of my dad. It was sort of the way we grew up. My dad pioneered a lot of things in medicine. He was an ear, nose, and throat physician or head neck physician, and he pioneered laser surgery here in Boston back yeah, back in the late 60s and early 70s. And yeah, Cirlot, grandfather of laser surgery. So it was sort of in my blood, so to speak. And after I got to grad school, I joined my first company, which was focused on minimally invasive techniques for brain surgery. And sort of the rest is history. And I’ve been going on since then.

Saul Marquez:
Amazing, amazing. Such a cool history there with your family physicians for a long time, the innovation gene from your dad and the legacy continue. I think you and your brother are gonna take in half and half the medicine and the innovation Right.

Dr. Chris von Jako:
Is actually interesting because my brother was heading down a path of research in the spine and then he ended up becoming a Chief Medical Officer of GE Health care. So he’s also in the industry.

Saul Marquez:
Interesting.

Dr. Chris von Jako:
So it’s kind of cool. I once had a conversation when I was joining a new company about ten years ago with my older son. He was probably about 10 at the time. And he was saying, like, it’s pretty cool, dad, what you’re doing. Papa, who we referred to as my dad, he’s helping one person at a time. And you’re helping many physicians. And so you’re helping many people at one time. And he got it at ten.

Saul Marquez:
Awesome man.

Dr. Chris von Jako:
But then I kind of rethought it a little bit and I was like, but my dad also helped many, many people with all the inventions.

Saul Marquez:
That’s true.

Dr. Chris von Jako:
But it’s still pretty cool. It was really cool for a ten-year-old guy to do that.

Saul Marquez:
So he’s connecting the dots early on, man. That’s cool. So, Chris, talk to us about the work you guys are doing at BrainsWay. And really, I want to hone into how the business is adding value to the health care ecosystem. Talk to us about that.

Dr. Chris von Jako:
Yeah, well, I think in general, obviously, mental health, as you said, there was a crisis already prior to the pandemic that we’ve had. The pandemic has been sort of a silver lining for our company, and for a lot of people because it’s put more focus on mental illnesses. My entire career has been focused specifically on mainly cancer, cancer-related things and did some other things like Parkinson’s disease, obviously in the brain as well. But most people think about when they think about health care, think about physical illnesses and not and really not mental illnesses. This is a big problem with our mental illnesses and the stigma that has been a huge issue because people don’t want to especially men don’t want to kind of look weak in a way. So most people, when they think about having let’s talk about depression because we’re focused on a number of different areas that’s we’ll probably talk about at some point. But our technology is differentiated and it allows us to kind of focus on a bunch of different brain disorders. So let’s just take depression.

Saul Marquez:
OK.

Dr. Chris von Jako:
That’s a huge market. And it’s been a lot of focus on depression and anxiety during COVID. But a lot of people, when they think about depression, they think about going to a psychiatrist or a therapist to talk about their problems, but also take medication. And I think a lot of people understand the side effects of medication because, you know, if you’ve seen advertisements for antidepressants on TV, the end of the thing talks about all the unfortunate side effects that you have. But what people may not know is that if you have 10 people that are actually taking an antidepressant, their first antidepressants, they take only five out of ten will get help from it. So you have another five people that are not helped from that problem. And then when they go to try a different antidepressant, it’s even less likely it’s going to help them. So overall, somewhere on the order of about three to four people out of 10 will not get help from anything. And it’s those particular people that we focus on. It’s called treatment-resistant depression. That’s where our technology is really kind of focused on. We also have the technology for OCD, obsessive-compulsive disorder, which is probably, you know, everybody thinks they have a little bit of OCD in them. But for people that have clinical OCD, it’s really preventing them from actually having a good lifestyle. And that is, again, there are only five medications that are approved by the FDA for OCD. And it’s a lifelong disorder. You’re hoping with depression you can actually get somebody out of that episode of depression and get them back normal and healthy again, even though they may relapse. But OCD is a lifelong struggle for people. So we’re helping there. And the third thing that we just got FDA clearance on last year was people that are struggling with certain types of addictions that we focused on. So the first addiction that we did was smoking. It’s interesting to know. But there are thirty-four million people in the United States who smoke a still smoke and there is a huge portion of them somewhere on the order of 20 million each year that try to quit smoking. And they just don’t have success. And there are medications out there, there’s hypnosis. And it is all different things to trying to do, but it’s really, really difficult. So that’s what we’re focused on. We’re focused on the toughest of toughest patients, specific brain disorders, and mental health.

Saul Marquez:
Thank you. Yeah, that’s fascinating, Chris. And you highlighted the segment that goes through the normal pathway of care to see a psychologist, psychiatrist, and they get their medication, 50 percent don’t get the results. And then maybe a few others get results. And now you’re dealing with those three or four out of ten patients that haven’t gotten the results. What is it about BrainsWay and what do you guys do that helps that segment? That’s not getting relief. That’s not getting the results. What makes you guys different? How does it work? What do you guys do?

Dr. Chris von Jako:
Yeah, so that’s an excellent question. So at a high level, what our technologies call it is called transcranial magnetic stimulation.

Saul Marquez:
Ok.

Dr. Chris von Jako:
What we do is we put a coil on a portion of the head. In this case, let’s take depression. It’s on the front left side of the brain. And you put a coil on the head. Like what it does is it creates a magnetic field and you stimulate that magnetic field into the brain. And what it does is it creates an electrical field in the brain and it’s trying to jump-start the neurons in the brain where they stop working. And that’s particularly for depression.

Saul Marquez:
Fascinating.

Dr. Chris von Jako:
Now, this technology transcranial magnetic stimulation was originally invented back in 1985. And then there were a few companies that started popping up in sort of the mid to late 2000s, I was very familiar with the technology. I’ll be honest, at first, I was really extremely skeptical about the technology, whether it was really working or not. But the data shows that it does work and it works incredibly. We have a new advanced form of this. We call it TMS Transcranial Magnetic Stimulation, or TMS. Our version from BrainsWay is called Deep TMS. And it’s exactly what it sounds like. We go deeper and broader into the brain than the previous technologies that are out there. And that’s what really differentiates us. And it gives us two things. And this is why I was really excited about joining the company. It shows that we’re more efficacious without, by the way, the safety profile for both TMS and DTMS is extremely good. So they’re really essentially no side effects from the technology. But our technology goes deeper and broader. We ensure a couple of things. That we’re treating more neurons and we also ensure that we’re not missing the target that we’re trying to go after in the brain. And we have studies that show that our technology is more efficacious as well, which is great. Now, the other benefit to our technology, since it goes deeper and broader, OCD, for instance, is a deeper portion of the brain. It’s in the center of the brain towards the front, but it’s deeper. Our technology platform can do just more than just depression. So that’s really the exciting thing about what we can do. And people are really benefiting from it. I mean, if you go to our website, www.brainsway.com, you’ll see articles on there from patients that talk about somebody who talked to a lot of patients over the last year and a half since I’ve joined. And there’s one particular woman, for example, she’s in her 60s. She remembers really from a young age being depressed ever since she was, I think, early teens like 12, 13 years old. She remembers her entire life being depressed. Then last year, this woman, in particular, ends up having our treatment, which is about thirty-six daily treatments that anywhere between three to twenty minutes. And they go every day for about thirty-six sessions. And she the result is it’s she said to me, it’s like you’re in a dark room for your entire life with the lights out. And then one day the light turns back on and I mean it’s so, it’s so powerful.

Saul Marquez:
Now that’s very powerful. Chris, thanks for highlighting some of these things. A couple of questions for you. One, on access, and then the other one is about health care economics. So let’s touch on transcranial magnetic. What was it? Magnetic.

Dr. Chris von Jako:
Stimulation.

Saul Marquez:
Stimulation?

Dr. Chris von Jako:
Yeah, just call IT TMS. Most people call it TMS. Yeah, our flavor. Our flavor is deep TMS.

Saul Marquez:
Ok, so deep TMS. I know that the listeners are probably wondering transcranial. So is it trance cutaneous. Is it through the skin or is it on top of the skin?

Dr. Chris von Jako:
On top of the skin. So OK, one hundred percent noninvasive. our particular thing people go to our website, they’ll see it looks like an old fashioned hairdryer. It’s a helmet that they put on and it’s non-invasive and it’s like going into an MRI. But you don’t have that claustrophobic feeling of generally in an MRI It’s basically magnets. It’s what it’s doing. It’s pulsing a magnetic field into the brain.

Saul Marquez:
Beautiful. Thank you for that. And then the other one is where does it take place? Is it in the clinic? Is it at home? Talk to us about where it takes place.

Dr. Chris von Jako:
Yeah, that’s a really good point. So we are generally three different types of setups. So we’re either in the outpatient portion of a hospital or we’re in a psychiatrist’s office or because the technology is actually blown up quite well, is it’s basically there are centers that may have a specific name to it, Right. like a TMS center that has our technology in it where there is a psychiatrist there. But it’s kind of like the kind of growing up and it’s kind of like Lasic. There are these centers that are popping up. So those are the kind of three different places that have our technology. So you have to go to the facility itself. And the beauty is, is that people that are depressed, sometimes they don’t even want to leave their home. Once they start going and start doing the procedure, they start feeling a kind of a benefit out sort of in the second week, maybe early into the third week. And then they want to keep going, which is great to get them out of the house. That’s also part of the benefit in the same thing with the OCD patients as well.

Saul Marquez:
Yeah, that’s super interesting. Thank you, Chris. Is this a prescribed treatment then? You get to get a prescription from who usually describes it.

Dr. Chris von Jako:
Yeah, so that’s a very good question. So you talked a little bit about access. So traditionally what happens if someone, let’s just talk about depression for a minute so someone’s depressed. They end up hopefully at some point talking to their primary care physician and their primary care physician will typically prescribe to them an SSRI medication, hoping that will get them better. And then they’ll tell them, you know, go see a therapist. You want to do some talk therapy as well in combination with taking the medication. I like I said, 50 percent of the time, that doesn’t work. So maybe the physician will end up trying another SSRI, another antidepressant, but maybe they’ll end is sending the patient to a psychiatrist who will make a more improved diagnosis on them. But from an access standpoint, our technology is basically reimbursed in the United States by, I would say, almost every private payer and all of Medicare, which is nice. However, there are certain limitations to that. Some private payers, need you to fail for medications before they allow it. But yeah, but on the other hand, there are some that only need you to fail one patient. Yeah. Which is much better. Right? Because the problem is the more and more medications that you end up doing and if you don’t get better, the more and more depressed you lose hope. Right. And it just doesn’t make sense not to try something alternative. So with technology allows you’ll end up going to see a psychiatrist and the psychiatrist hopefully will have a deep team system and they’ll try this. You know, basically, for a patient that’s treatment-resistant to medications, they’ll try this alternative and, you know, hopefully, the patient will get better.

Saul Marquez:
Yeah, awesome. Chris, thank you for this. You’ve made it very clear the pathway to get this sort of thing. And I ask those questions because the audience is an awesome mix of health care leaders that could point people in and groups and populations and the right direction. So I appreciate you highlighting the reimbursement pathway, the access point. All that stuff is super, supercritical. I mean, it’s clear how what you do is better than what’s available today. Talk to us about some of those outcomes that have improved with your tech. Maybe highlight a white paper or some of the work that you guys have done, whatever you want to focus on outcomes, Chris.

Dr. Chris von Jako:
Yeah, sure. So, again, let’s focus again on depression for a minute. So our technology, it’s really amazing the way it works. So I mentioned it’s like a helmet going on to the patient’s head. When we did clinical trials, this is really what sold me on the company when I was looking at the company in particular because it hit all of the other boundaries, non-invasive, focused on the brain, mental health, huge impact. But I want to make sure that the technology really was working. Our technology the way the helmet is set up is in the clinical trials. You would do what, active treatments, right? So patients would undergo an active treatment and also some patients and the randomized trial would go under placebo treatment. That was pretty easy when you’re doing like a pill. So you’re giving someone a red pill or a blue pill. They don’t know which one is active, which was not. With our technology, because the helmet goes on their head, we have the coils that are producing the magnetic field up in the helmet. We actually have in our helmet for the clinical trials two different versions of the coil, one that sets up a little bit higher. That’s the placebo version that makes noise just like the active wood doesn’t give a therapeutic effect, makes a little sensation on the patient’s scalp so that they think they’re getting the active treatment. But nobody knows. The doctor doesn’t know. The patient doesn’t know. The technician that’s performing it doesn’t know. And in this, we saw very specifically a difference between the response rate and the remission rate for these patients in clinical practice. Now, we’ve shown over a 50 percent remission rate for our technology and a response rate of upwards of about 80 percent. So, again, you have to remember, these are the hardest of the hardest patients. And then a head to head with the previous technology, we showed a statistical difference in their response rate, which is really important, and also a better rate on the remission rate, because, in the end, we’re trying to get these patients to remission That’s the goal. Try to get them out of their depressed state.

Saul Marquez:
Well, it works. And the side effects. I mean, we talk about the long list of side effects of drugs and it’s always a joke. Like that commercial that you see and your friends from Europe come over and think, we’re all crazy in this country. That just happens. I had a buddy come in from Greece and he’s like, was that like a joke or something? I’m like, No, man, that’s actually what happens here. So that was a bad side effect, things that people should be thinking about here.

Dr. Chris von Jako:
Well, the side effects are there when you’re taking medications. There’s a long list of them, whether it’s weight gain or, you know, actually suicidal ideations that people get. First of all, you’re trying to get a depressant and then you have suicidal ideation. I think it’s good that when the commercials go there, they tell you about the side effects. I think it’s important. I also don’t want to minimize what the pharmaceuticals have done. They’ve actually helped a lot of people, a lot of people. Unfortunately, people are going to have different side effects on it. When people use our technology, sometimes they’re on medication already and some people believe it’s actually helping the medication work better. And some people get off the medications, which is also great. But I don’t want to minimize what you know. It’s amazing what these pharmaceutical companies have done with these antidepressants. They’ve helped many, many, many, many, many people. Unfortunately, they just can’t help everyone because people are individualized at some level. What helps one person may not help another. And that’s sort of it for us. It was beachfront for us was looking at this group that wasn’t helped by this medication. What can we do to further help them enhance that? And that’s what I’m really proud about with our technology, is that we’re sort of an adjunct. But we also could be a first-line treatment. But right now we’re a second-line treatment right now. Yes, in general, pharmaceuticals are going to be less expensive if they’re easier to administer than someone coming in every day to get our technology done. But, you know, for that woman that I talked about a few minutes ago, it’s completely changed her life. Imagine trying all sorts of medications for 50 years and then finally one day finding out our technology. I mean, that’s why Saul I’m so happy to do this podcast because, for us, it’s building awareness of this technology. I’ve said it a number of times, deep TMS is one of the best-kept secrets in medicine. And we’re doing our best really to get the word out about this technology. You asked about the side effects of our technology. In general, there are very minimal side effects. Some people tend to get headaches in the beginning because you give this sort of tapping on the head and that would give anybody a headache. If they if you continue to tap on someone’s head like that. And it’s again for depression treatments, 19 minutes, 18 minutes for OCD treatment, and for smoking addiction in seventeen minutes. But recently we just got FDA clearance for our depression treatment. We now have a three-minute treatment which is kind of nice. And so somebody can’t tolerate this tapping on the head because you don’t feel anything when your we talked about the magnetic field going into the brain and creating an electrical field, you don’t feel that in the brain. Right? So what they feel is a little bit of tapping on the head.

Saul Marquez:
Yeah, that’s interesting. Well, minimal, minimal stuff there for the upside. As you think about the company and the potential setback you guys have had. We learn most from those setbacks. What would you say, Chris, is one of those key challenges you guys have faced and what you’ve learned from that?

Dr. Chris von Jako:
Well, that’s easy to talk about right now. I started in January 2020. A brand new company, very excited to be part of the organization. And then literally two months later, we get hit with COVID. Right. Insane. I can’t tell you how many people I spoke to there. Like, we can’t believe this happened. It is what it is. I’m really happy to be a part of the company and lead the company. And even for us, it was a difficult time because our revenues only went down by about four to five percent versus the prior year and we grew at forty percent the prior year. So we’re trying to grow. Our mission is really boldly advancing neuroscience to improve health and transform lives. That’s our mission. That’s why we wake up every day. But unfortunately, during that period of isolation, nobody was leaving their homes. So nobody was going to get their heart checked. Nobody was going to get whatever as their blood checked. They weren’t going to the physicians. They weren’t they weren’t even handling their mental health at that time. Nobody was leaving their homes. And the isolation caused a huge increase in mental health that we’re going to live on for, I think, decades from this. Nobody knows the long-lasting effects. I didn’t talk about it, but seventeen million people each year get an episode of depression, clinical depression. Six million of those 17 million will not benefit from medication. That’s six million people. It’s a huge market. Dwarfs everything like before, but in general, what they saw during covid. There are reports now that have showed that the incidence of depression is tripled. So take that 17 million number and multiply it by three. That’s very, very scary when you think about it. But from a setback standpoint, I need to make sure that I was doing the right thing for the company. I was really proud we didn’t let anybody go into the company. We really tightened down our budgets. We worked really closely with our customers to make sure things worked out. We really focused on education. We really focused on a new level of how we work. I can tell you we did a lot of zoom calls and that also affects people’s mental health. So so, I mean, I think just like everybody, we all had setbacks. And I think that I think as a company, I was thinking I was talking to a friend of mine and he asked me, do you know about NASCAR, NASCAR racing? I said I’m a big football fan, big Patriots fan. I don’t know much about NASCAR. But he said, what do you think that you win the race? Is it in the straightaways or it’s in the turns? And I said it’s in the turns, right? And said, yes, and we’re in the biggest turn that will probably ever be and ever. And what I was trying to make sure I was doing is strategically making sure that we were going to be much better coming out of that turn. So we upgraded a lot of our talent. We did a lot of education. And so I think right now we’re coming out of that turn and we’re on the straight away and we just have great things happening for the company. So I think a lot of lessons were learned during COVID.

Saul Marquez:
Yeah, Chris, great analogy there of the turn. And certainly, this has been one of the most challenging turns for not only our industry but really our world. And so I really appreciate your perspective, your excitement for the future. What would be your call to action, Chris? What do we leave our listeners with today? Who do you want to benefit from this message and what’s the best way for them to connect with you or your company?

Dr. Chris von Jako:
So I would say I mean, it’s amazing because I spent many years in neurosurgery focused on the brain and people would always come to me for suggestions, you know, brain tumor or Parkinson’s disease or epilepsy. People are coming to me. And it’s been amazing how over this last year and a half since I’ve joined BrainsWay, that there are so many more people coming to me about mental health whether it’s about themselves, their spouse, their child, knowing about our technology, brain switches deep TMS technology is important. And I think sharing that message is important. So I have never been I would say a big social media person, but I’m extremely active now on LinkedIn. People could find me on LinkedIn. They can also find our technology on www.brainsway.com. People can email me directly. chris.vonjako@brainsway.com. I think you can find me anywhere or from that. It’s public information. But anyhow, my company can kind of help people. People are struggling out there and anyhow we can help and get further word out. In general is my goal to make sure that everybody who needs access to our technology, can get access to our technology. It’s so needed. I’m also excited about what I told you about our OCD treatment. We just started gaining reimbursement, our OCD treatment with three payers that have now stepped up to the plate.

Saul Marquez:
Congratulations.

Dr. Chris von Jako:
It’s going to be, yeah, which is huge. We still have a long way to go but I think this is great. It’s a good alternative. And right now, to control marker release for our smoking addiction product. Smoking is still a big problem. People want to quit and we’re trying to learn and try to better understand how we can get this technology out there. So I think spreading the word and letting people know about it because I can guarantee everybody knows somebody that is going through a mental health issue right now. People are not admitting to it, but we have to be willing to talk about it, which I think is important.

Saul Marquez:
Yeah. Wow, that’s awesome. Well, Chris, thank you. It’s great to learn all these things about TMS. Certainly new to me. Deep TMS in particular, different ways to get it. There are centers you’re prescribed by your physician outpatient and the many pathways to actually pay for it. There are already there. It’s like nothing crazy that you have to do to get access to this. So including Medicare, which is phenomenal, Chris, and a testament to what you and your team are doing to not only innovate but to create access for these types of technologies that are going to make a difference. Thank you. Thank you so much for what you do and for sharing it with us today.

Dr. Chris von Jako:
Thanks, Saul. I really appreciate it. Thank you very much for taking the time. And to your listeners, I really appreciate everyone for taking the time to listen as well. Thanks.

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