The ongoing COVID-19 pandemic has widened existing disparities across social determinants of health. For patients who require prescription medications, such as those experiencing depression and anxiety, the pandemic has reduced opportunities to be seen in-person. A startup called Cerebral sought to fill this need when the federal government expanded access for healthcare providers to prescribe certain medications via telehealth, ones that would typically require an in-person visit. However, Cerebral appears to have been plagued by potentially exploitative practices, issues with affiliated providers, and more. Rolfe Winkler, Khadeeja Safdar, and Andrea Fuller report in The Wall Street Journal.

"Online mental-health startup Cerebral Inc. was just getting off the ground in early 2020 when it detected a potential problem in its business model. The company was focused on treating people experiencing depression and anxiety, charging a monthly fee to see a nurse practitioner online for prescription antidepressants. But patients tended to cancel their subscriptions after only a few months, making it more difficult for the company to recoup advertising and other costs, according to documents reviewed by The Wall Street Journal and people familiar with the matter.

Hope came from the federal government, which was concerned that people wouldn't be able to see their physicians during COVID-19 lockdowns. It had just granted online providers the ability to prescribe so-called schedule 2 controlled substances, drugs such as OxyContin and Vicodin, which are often abused and would normally require an in-person doctor visit.

Cerebral saw an opportunity in one such drug, Adderall, a powerful stimulant used to treat attention-deficit hyperactivity disorder, or ADHD. In a February 2021 presentation to attract new investors, Cerebral said a pilot project showed that it was half as costly to advertise for ADHD patients than for those with depression and anxiety because each ad dollar yielded more customers. Treating ADHD could expand its market by 30%, the presentation suggested."

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