Overview
Akili built medical treatments delivered through video games, obtained US regulatory authorizations, and raised substantial capital. Its revenue remained small relative to its operating costs. In July 2024, Virtual Therapeutics acquired the company at $0.434 per common share. Akili survived as a subsidiary, and its US products remain available. Shionogi launched a related licensed product in Japan in June 2026.[2][4][10][12]
The useful lesson concerns the distance between clinical validation and a repeatable sales model. A treatment can meet a defined regulatory standard while still struggling to reach enough paying users. The continuing products also prevent a simple conclusion that the technology failed or disappeared.
Founding Story
Akili began in 2011. Eddie Martucci, then at PureTech, connected with neuroscientist Adam Gazzaley's research. Matt Omernick and Adam Piper contributed game-design and engineering experience from LucasArts. The founding team combined disciplines because the product needed both a therapeutic mechanism and an experience patients would use repeatedly.[1]
The company pursued software whose activity constituted treatment, rather than an app that merely delivered existing educational material. This choice required clinical research, device controls, and regulatory work alongside ordinary game development. The attractive distribution properties of software did not remove those obligations.[1][3]
In 2021, Martucci described future digital treatments that would “adapt to the unique needs and preferences of each user.” The ambition combined personalized treatment with an engaging product experience.[4]
Timeline
- 2011: Akili was founded by Martucci, Gazzaley, Omernick, and Piper.[1]
- 2019: Shionogi partnered on development and commercialization in Japan and Taiwan.[11]
- 2020: FDA granted the EndeavorRx De Novo request for a prescription attention treatment.[2]
- 2021: A $110 million Series D brought disclosed equity funding to $230 million; a credit facility of up to $50 million was separate.[4]
- 2022: The public-listing transaction closed with more than $163 million in gross proceeds before transaction expenses.[5]
- 2023: Akili launched EndeavorOTC under pandemic-era FDA policy, then shifted its business toward consumer subscriptions.[7]
- 2024: It restructured, amended its Shionogi economics, obtained adult OTC clearance, and became a Virtual Therapeutics subsidiary.[8][9][10]
- 2026: Shionogi launched ENDEAVORRIDE in Japan; EndeavorRx and EndeavorOTC were still marketed in the US.[12][13][14]
What They Built
EndeavorRx uses adaptive challenges in a game environment. FDA's original review described a 348-child randomized trial against a digital control, with improvement on the primary computer-based attention measure. Its secondary clinical and parent ratings did not all show significant differences. The result supports the defined indication; it does not establish that ordinary video games treat ADHD or that every symptom improves.[3]
EndeavorOTC extended the platform to adults. FDA cleared it on June 14, 2024 for improving attention measured through computer testing in adults with specified ADHD presentations and a demonstrated attention issue. The label says benefits may not extend to typical behavioral symptoms such as hyperactivity and that it should form part of a broader therapeutic program. The supporting adult study lacked a sham control group.[9]
The current pediatric product remains prescription-only for ages 8–17 and has a separate parent progress app, EndeavorRx Insight. Its published use is part of a therapeutic program, rather than a replacement for medication. A new adherence dashboard would therefore overlap an existing part of the product.[13]
Market Position
Target Customers
Akili initially needed clinicians to prescribe, caregivers to obtain access, and children to complete treatment. Its later adult subscription strategy addressed consumers more directly. That removed the prescription step for the adult product while increasing the importance of consumer awareness, acquisition, and retention.[7]
Market Size
A large ADHD population is not a measured market for one paid digital treatment. Relevant limits include the authorized population, willingness to pay, clinical fit, access, and continued use. This research does not establish a reliable serviceable-market estimate or current customer acquisition cost. The historical financial results provide a firmer view of realized demand than a prevalence-based revenue forecast.[6][7]
Competition
The closest benchmark for rebuilding Akili's proposition is Akili itself. Its products remain sold separately: EndeavorRx lists $99 for a 30-day prescription, while EndeavorOTC lists $24.99 monthly, $99.99 per six months, or $129.99 annually. The adult plans renew automatically. These prices were checked in October 2026; product access was not purchased or tested.[13][14]
A nonclinical focus service faces a different comparison. Focusmate offers three free sessions weekly and unlimited sessions at $8 monthly with annual billing or $12 with monthly billing, before applicable taxes. A study-session business cannot justify its price by relabeling generic coworking or implying medical benefits.[15]
Business Model
At the August 2022 listing, Martucci looked ahead to “as we begin to scale and serve patients in need.” The financing supported a commercial launch; it did not establish that the sales model already worked.[5]
The original prescription strategy required a commercial process around the authorized device. In September 2023, Akili moved its main investment toward a consumer subscription model and eliminated field-sales and market-access teams. This was an attempt to improve distribution economics, not an expansion of what its clinical evidence proved.[7]
Licensing offered another route. The original Shionogi agreement included upfront payments, milestones, and royalties. In April 2024, Akili exchanged all future royalties and certain milestone rights for $10.5 million, alongside cancellation of a $5 million bond. Other service payments and possible milestones remained. Japan's later product launch therefore cannot be read as preserving the original royalty stream.[11][8]
Traction
For full-year 2023, Akili reported $1.7 million in total revenue, comprising approximately $1.2 million from EndeavorOTC and $0.5 million from EndeavorRx. GAAP operating expenses were $65.3 million. Fourth-quarter gross margin was 66%, but a positive quarterly gross margin did not mean the company covered its operating costs.[6]
The gap was commercial as well as financial: a medically validated product still needed a scalable path to payment and repeat use. These figures do not identify which individual distribution barrier mattered most. The subsequent pivot and restructuring show management changing its approach, rather than establish that one cause explains the entire outcome.
Outcome and evolution
Virtual Therapeutics completed its acquisition on July 2, 2024. The public filing confirms that Akili continued as a wholly owned subsidiary. The common-share tender price describes that security's consideration; it is not a complete return calculation for every historical financing or employee award.[10]
The regional partnership also continued. Shionogi's June 2026 launch announcement describes ENDEAVORRIDE as an adjunctive pediatric ADHD treatment in Japan, following a local Phase 3 trial and domestic approval. This is a later commercial milestone with a separate indication and commercial agreement. Current subsidiary revenue and profitability remain unverified.[12]
Key Lessons
- Measure the commercial path separately. Regulatory authorization answers a defined device question. It does not establish affordable acquisition or repeat revenue.
- Keep the evidence attached to the claim. Improvement on a computer-based attention measure does not justify promises about every ADHD symptom.
- Read amended deal terms. A licensed product can launch after royalties were exchanged for earlier cash and other concessions.
- A small rebuild needs a smaller promise. A nonclinical service can test demand cheaply, but it cannot borrow Akili's therapeutic claims or ignore existing free alternatives.
Sources
- Akili / SEC — Company origins (2022-08-19).
- FDA — EndeavorRx De Novo record (2020-06-15).
- FDA — EndeavorRx decision summary (2020).
- PureTech / Akili — Financing (2021-05-26).
- Akili — SPAC closing (2022-08-19).
- Akili / SEC — 2023 results (2024-02-29).
- Akili / SEC — 2023 annual report (2024).
- Akili / SEC — Q1 filing and Shionogi amendment (2024-05-14).
- FDA — EndeavorOTC clearance (2024-06-14).
- Akili / SEC — Acquisition completion (2024-07-02).
- Shionogi — Original regional partnership (2019-03-07).
- Shionogi — ENDEAVORRIDE launch (2026-06-05).
- Akili — Current EndeavorRx access (checked October 23, 2026).
- Akili — Current EndeavorOTC access and screenshot (checked October 23, 2026).
- Focusmate — Current nonclinical baseline (checked October 23, 2026).