Doctor-prescribed videogame for ADHD
A prescription-only video game for children with ADHD, EndeavorRx, has prompted debate over whether it meaningfully improves attention or mainly leverages FDA “medical device” authorization and U.S. healthcare pricing to justify a $99/month subscription. Commenters scrutinize the cited studies, noting modest gains on narrow computerized tests (like TOVA) that may not translate into real‑world symptom relief, and question if similar benefits could come from ordinary games or non-digital strategies at far lower cost. The product also raises concerns about exploiting ADHD-related executive dysfunction with subscriptions, data privacy around app-based treatments, and the risk that such tools distract from highly effective but stigmatized stimulant medications.
Pricing and Business Model
- $99 for 30 days is widely viewed as excessive, especially versus full-price AAA games or generic ADHD meds.
- Many see the subscription model as exploiting ADHD-related executive dysfunction (harder to cancel than to sign up).
- Some argue cost reflects medical R&D, FDA process, and “digital therapeutic” positioning; others call it pure rent-seeking enabled by insurance/FSA/HSA rules.
FDA Status and Clinical Evidence
- Product is regulated as a medical device and went through the De Novo pathway; posters debate whether this constitutes “approval” vs “authorization.”
- FDA required safety and efficacy data, but not necessarily at the same standard as drugs.
- Key endpoint: improvements on TOVA (a computerized attention test). Some trials show statistically significant differences vs control; others are non-significant or lack proper sham controls.
- Several commenters criticize TOVA as weak or poorly correlated with real-life ADHD symptoms; improvements may mostly reflect “training the test.”
Game Design, Engagement, and Compliance
- First‑hand reports describe the game as boring, frustrating, and hard to stick with—ironically problematic for people whose core issue is doing boring tasks.
- Mean compliance in trials (~72%) suggests many kids did not complete prescribed play time.
- Some speculate the boredom and mild frustration are intentional “attention training”; others suspect this is just low production quality.
Role in ADHD Treatment
- Widely agreed it should not replace stimulants or core therapies; even marketing materials present it as an adjunct.
- Several ADHD-diagnosed commenters emphasize that meds have large, well‑proven benefits; they worry this exists mainly for medication‑averse parents.
- Others note that structured “attention training” (reading, hard games, meditation, biofeedback) can help as part of a broader coping toolkit.
Data Privacy and Platform Concerns
- App requires phones/app stores and shares some data with third parties, including for advertising; some view this as unacceptable for a medical product.
Broader Skepticism about Digital Therapeutics and Healthcare
- Many see this as an example of systemic healthcare profiteering and “games as treatment” hype.
- Some countries (e.g., Germany) have similar reimbursed “digital health apps,” and commenters suspect many are low-value cash grabs.
Unclear / Open Questions
- How its real‑world effectiveness compares to ordinary commercial games or other low‑cost interventions remains unclear.
- No independent head‑to‑head trials vs meds, other games, or non‑digital therapies are discussed in the thread.