RIO DE JANEIRO, BRAZIL – Health in Brazil has never been this digital. With the pandemic, Brazilian medicine has embraced apps and tele-consultations to continue serving the population. One of the companies benefited by this change in behavior was startup Klivo. Founded in late 2019, the company started its operations specializing in a public that demands periodic monitoring: diabetics.
One of the Covid-19 comorbidities, diabetes is among the most common chronic diseases in Brazil: about 12.3 million people were diagnosed with the disease in 2019, according to the Brazilian Institute of Geography and Statistics (IBGE). With diet adjustments and use of medication or insulin injections, a patient with diabetes can live a peaceful life. But the key to success is maintaining adequate control of the disease.
To help with this monitoring, Klivo has developed a method that combines technology with personalized patient care. In a proprietary app, the company periodically offers a series of contents about the disease and dietary tips. The goal is for users to focus on their health every day, not only in moments of crisis. But when a patients is unwell, the startup provides remote assistance with its own team of health professionals.
With about a year and a half of operation, Klivo has conquered a base of 14,000 patients. Those who pay the bill for the service are not individuals, but large health companies, such as Prevent Senior and Unimed, which see the advantage of investing in monitoring to save on medical expenses. The company currently charges an average of R$50 (US$9.77) per month per person attended.
The business, founded in late 2019, was idealized by partners André Sá (former partner at BTG Pactual) and Marcelo Toledo (former director of engineering at Nubank), both with no prior experience in the health market, but passionate about the topic. To boost the first years of operation, they raised US$2.5 million in January 2020 in a round with the participation of Canary and some angel investors, including Bruno Nardon, ex-CEO of Rappi in Brazil.
The entrepreneurial duo behind Klivo was inspired by the model of American startup Livongo, which also helps monitor patients with chronic diseases. Founded in 2014, the company went public on Nasdaq in 2019, raising US$355 million in the offering, and is valued at around US$12 billion today.
Like its foreign precursor, Klivo is not restricted to diabetes. After realizing that its method helped patients with disease control in the medium term, the company felt confident to expand its model to patients with hypertension, obesity, and high cholesterol.
“Covid-19 has brought more health awareness to everyone. We see that chronic patients are more concerned about staying healthy and averting acute events,” says Sá. The opportunity is tremendous: it is estimated that at least 52% of adults are affected by some chronic disease in Brazil.
To continue growing, Klivo plans to increase the penetration of its services within current customers. “A large network manages more than 30,000 chronic patients, but first passes on a few to us to assess the value of our service,” says Sá. The startup’s expectation is that, with the good results of the first groups, its 12 client companies will begin to pass on more patients to its program.
The partners’ main challenge will be to expand to new companies that have not yet agreed to try their services. To circumvent the problem, the startup is relying on a study with the monitored patients to prove that the startup’s monitoring truly generates health benefits.
Advising the company is endocrinologist Camila Maciel de Oliveira, who has just completed research on population monitoring at Harvard Medical School. “In diabetic patients, we see an important drop in the glycated hemoglobin. We just need to use more sophisticated statistics to refine the test results,” she says.
According to her, the benefits of Klivo monitoring are clear for the healthcare system; her question is how much the solution actually improves the patient’s life. Users’ positive feedbacks in this first one and a half years in operation offers clues to the answer.