Fractional CFO for digital therapeutics companies
Digital therapeutics carry a hybrid economic profile: software product, drug-style economics, gated by FDA or EMA clearance and only viable once payers add it to formulary. Pear and Better both wound down post-clearance because covered lives never converted to prescription volume.
The CFO seat here is about defending runway across the gap between authorisation and reimbursement. That means tracking authorised prescriptions against actual claim adjudication and copay leakage, accruing chargebacks and rebates like a small specialty pharma, capitalising clinical and real-world evidence costs, and reconciling the gross-to-net spread PBMs apply to software. Board reporting centres on lives under coverage by payer type and cash burn between milestones.
Flow provides financial modelling, FP&A and fractional CFO advisory to digital therapeutics companies across prescription DTx operators, SaMD platforms, cardiometabolic and respiratory programmes, neurology and substance use therapeutics and OTC wellness adjuncts. Our startup CFO team brings the financial modelling discipline a DTx board needs across clearance, payer contracting and reimbursement.
KPIs to track for "digital therapeutics" startups
We're very 'KPI-driven' fractional CFOs, and we make sure to monitor the right metrics for your startup.
Covered lives
Prescriptions written
Prescription fill rate
Net revenue per Rx
Payer contracts signed
Patient engagement rate
Clinical outcome delta
Adherence at 12 weeks
Gross margin
Cash runway
Financial modelling for "digital therapeutics" startups
As fractional CFOs, we build KPI-driven financial models that are insightful and easy to maintain.
Financial modelling is both art and science - models must be robust, but also understandable, and useful for both internal planning and VC fundraising purposes. Hire a fractional CFO who knows how to handle both sides of the equation.
Covered lives to net revenue funnel
Covered lives walked to prescriptions written, fills adjudicated and net revenue per Rx, with payer-by-payer conversion rates surfaced. The funnel that distinguishes formulary wins that monetise from formulary wins that stall.
Gross-to-net spread
List price stepped down through PBM rebates, payer-specific chargebacks, copay assistance and patient out-of-pocket to net revenue per fill. Accrued period by period rather than trued-up at year end, since DTx gross-to-net behaves like specialty pharma.
Clinical and RWE cost capitalisation
Clinical trial spend, real-world evidence studies and post-market commitments assessed against capitalisation criteria, with the rest expensed and tied to the runway model. The largest single judgement on the P&L between clearance and breakeven.
Payer contracting milestone model
Cash flow modelled against signed PBM contracts, formulary tier wins and J-code or NDC issuance, with the volume ramp each contract is expected to deliver. Ties commercial milestones to the runway envelope rather than treating them as commentary.
Runway and milestone-financed plan
Cash burn against the next clinical, regulatory and commercial milestone, with the financing requirement to reach each one explicit. The DTx category dies in the gap between clearance and reimbursement, and only a milestone-financed plan survives it.
Patient engagement to outcome economics
Engagement, adherence at 12 weeks and clinical outcome delta modelled against contract pricing tiers where outcome-based payment applies. Tells the board which payer deals genuinely pay for performance and which are de facto fee-for-prescription.
Founders and investors we've worked with
We've supported winning builders across digital therapeutics and beyond.
BiomX
As a fractional CFO we performed a confidential valuation of BiomX, a Tel Aviv-based clinical-stage microbiome therapeutics company, supporting Elevator Fund's portfolio management.
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Cannadorf
As a fractional CFO we helped Cannadorf, an Israel-based pharma-grade medical cannabis leader applying tissue culture technologies, build out its financial plan ahead of scaling production.
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Cannabis Innovation Center
We acted as fractional CFO to Cannabis Innovation Center, a Tel Aviv-based medical cannabis group developing multiple cannabis-based therapies, providing internal valuation guidance.
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TBô
We acted as fractional CFO to TBô, a Zurich-based tech-enabled DTC male underwear brand, building a bottom-up financial / operating model with cohort-level KPIs and positioning the company for its next venture round.
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Onlogist
We acted as fractional CFO to Onlogist, a Hamburg-based online marketplace for last-mile vehicle transfer, providing confidential valuation guidance and operating model support.
See moreRecent fractional CFO track record
See our fractional CFO and financial modelling experience across digital therapeutics and beyond.
Simple pricing
No hidden costs, no complicated long-term contracts. We understand how important flexibility is for digital therapeutics startups.
Per month
- Accounting / FP&A tech stack implementation
- Monthly financial statements and reporting pack
- Quarterly board pack with detailed financial analysis (with variance analysis vs. budget, relevant KPI observations etc.)
- Investor-friendly output
Per month
- Everything in Core, plus
- Operating model (via an online platform like Runway or Excel-based)
- Ongoing model maintenance, refining projections, burn/runway management
- Customer cohorts modelling, churn and retention analysis
- LTV / CAC, unit economics analysis
- Cap table management
Per month
- Everything in Grow, plus
- M&A / fundraising support; review of business plan
- Pitch deck preparation
- Investor approach strategy / list building
- Due diligence support and deal negotiation
- Valuation as required and free access to Multiples Pro
Packages shown are illustrative, final pricing is tailored to client requirements.
Explore our fractional CFO offering for similar verticals
We're a specialized fractional CFO to digital health companies.
Our fractional CFO experience spans across all digital health verticals.
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We know tech inside & out.
We provide fractional CFO services to companies operating across the entire tech.
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We help you scale by providing fractional CFO advice, through fundraising and a successful M&A exit.
VC fundraising for digital therapeutics companies
We help you prepare materials, reach out to investors in our extensive network, negotiate fair term sheets and structure the VC round.
Learn moreM&A for digital therapeutics companies
We advise winning tech companies on M&A exits, and over the years successfully executed numerous transactions with both financial and strategic buyers.
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