u/Capable-Mark-7554

Reposted on linkedin by CMPS

If anyone has acess and can copy in the comments :)

I dug a bit and I think this is something that has not yet been discussed enough nor brought to attention much on this sub.

this might be bigger than people realize and it's probably the source of the "clamoring demand" and “Patient waiting list” that we heard in recent cmps communicaitons.

 A lot of the demand-side info Compass has put out  the inbound waitlist, day-1 readiness, "centers are clamoring"almost certainly traces back to Greenbrook. And once you look at who Greenbrook is, that info gets a lot more credible.

Who they are:

Greenbrook is the largest interventional psychiatry network in the country (TMS + Spravato).

Greenbrook is now a subsidiary of Neuronetics, the TMS device maker. Neuronetics/Greenbrook combines a device maker + a clinic network. That's a vertically integrated interventional psychiatry play. they make the TMS machines and run the rooms. COMP360 slots into that as a third modality.

COMP360 and TMS both target TRD , this means they are competing for the same conditions. not sure if good or bad for cmps.

Who runs green brook:

Greenbrook's CMO, Dr. Geoffrey Grammer, is not a typical clinic exec:

• Retired Army colonel
• Two Iraq deployments and one in Afghanistan as a combat psychiatrist
• Eight years as Chief of Inpatient Psychiatry at Walter Reed, where he built their TMS program
• Created one of the first TMS centers in the US (with Steve Levine having founded the first Spravato center, this is great experience)

Two things jump out. First, he runs the exact infrastructure COMP360 needs (spravato room = comp360 room S.L)

Second, his military/VA background is 100% relevant to the PTSD program  which could matters given where the VA channel could go.

quick parenthesis : I would add that the argument about room economics made by A Borecky completely disappears if VA becomes a customer and uses comp360 for its veterans. Since they operate with a congressional budget allowance, room economics do not matter, they will use their own personel and infrastructure I assume.

What the 2024 collaboration was actually for

they signed a three-year research collaboration back in 2024, specifically to research scalable commercial COMP360 delivery.

That relationship has been building for two years now. I insist on the words scalable and commercial which is the key bearish argument when it comes to long duration drugs

It was scoped to research "models for the delivery of scalable, commercial COMP360"  delivery at Greenbrook's centers, improving the patient experience, understanding staffing needs, integrating digital tools.

i undersrand that basically, Greenbrook has been Compass's real-world lab for figuring out how to actually run these sessions in a working clinic network. Three years (2024–2027) also lines up almost perfectly with launch.

it is not an exclusive commercial one. So Greenbrook could work with other psychedelic developers, and Compass will certainly certify sites beyond Greenbrook.

What could come out of it going forward :

i see 3 options but could be more, feel free to comment / add .

1. launch-partner / early-adopter arrangement
2. Greenbrook becomes one of the first certified networks to offer COMP360 at approval. Day-1 readiness, protocols already built, staff already trained through the collaboration. The B. Riley "reaffirmed day-1 readiness" language essentially confirms this point. Greenbrook is the anchor site network.
3. a validated operational playbook / consultant option:
4. The tangible deliverable of a three-year research collaboration is a proven delivery model  staffing ratios, room config, scheduling, digital tools, patient flow. Compass then uses Greenbrook's data to show other clinics "here's how you run this profitably." That's worth more than one network's rooms — it's the template that supports adoption in other centers.

3.preferred economics or volume commitment :
Greenbrook could commit to converting a defined number of rooms/sites in exchange for early access, training, or favorable terms.

These scenarios could come in the form of :

• A formal commercial/launch agreement (upgrade from "research collaboration" to "Greenbrook will offer COMP360 at X sites")
• Published delivery-economics data from the collaboration showing per-session profitability
• A specific site/room conversion number with a timeline
• Greenbrook naming COMP360 in its own (Neuronetics') investor materials as a growth driver

i conclude that the infrastructure is already there, so a smoother-than-Spravato launch isn't news. What's more interesting is that Greenbrook's willingness to lean in is mild evidence the economics actually work .

this cuts against a lot of the bear takes on room economics. An operator running Spravato buy-and-bill today, who knows exactly what reimbursement friction looks like, doesn't build day-1 readiness for something they expect to lose money on. Not proof, but not nothing. Don’t you think ?

Worth adding: at one point Steve Levine said the economics of a COMP360 room are actually better than a Spravato room. I'd imagine that's based on real modeling, not a talking point. it fits with the "time in chair, not throughput" framing (one full-day patient, no turnover, no no-show leakage across four staggered slots).

The one honest caveat: a delivery partner proves operational feasibility, not reimbursement rates. This is still the big unknwon although I remember CMPS saying initial talk with payers supported that payment to annual spravato cost level would work.

additionally, i think it is important to mention Greenbrook TMS was financially distressed before Neuronetics acquired it. It had going-concern warnings, mounting losses, and heavy debt. they might have more incentive to chase a new high-margin service . A struggling network needs a growth story, and COMP360 is one. this devalues the greenbrook approval stamp read i mentioned.

perhaps listening to the STIM's earnings calls could provide good data since they own greenbrook and decide capital allocation ect.

EDIT : STIM management explicitly names "potential future revenue if Compass Pathways' psilocybin therapy is approved" as an upside catalyst in their own earnings guidance

I am not sure I understand well the topics of the monitoring codes and what they actually pay.

Please comment, correct where needed

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Kyle LaHucik Biotech Correspondent

Johnson & Johnson and AbbVie, the two pharma giants already in the psychedelic space, also eyed AtaiBeckley, according to a source familiar with the situation, but didn't make an offer before Eli Lilly sealed its $2.8 billion upfront acquisition last week.

The source, who was well-positioned to have insider information but spoke to End- points News on the condition of anonymity, said J&J and AbbVie had been in the data room looking at AtaiBeckley during the sale process that ultimately led to a deal with Lilly.

https://youtu.be/t8FNmVNVu3c?si=SE0o0FriG-Tdd8AS

Dftx up another 20% after dilution with 5m volume. Cmps not moving as much yet part B around the corner. Help up after public offering.

Am i missing something ?

Anyone planning on joining and can debrief. Would love to hear what former fda staff say

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The key efficacy numbers:

COMP005: "25% of participants receiving the 25 mg dose had a clinically meaningful benefit at the Week 6 primary endpoint after a single administration, and 40% of those who received a second administration went into remission."

COMP006: "Nearly 40% of participants had a clinically meaningful benefit after receiving two 25 mg doses."

On durability

"For some patients, one or two treatments may have an almost immediate, meaningful and durable benefit out to at least six months."

(Specific percentage at Week 26 not disclosed.)

On functional unblinding :

"A lot of attention has been paid to this issue of unblinding... But it's actually true of all antidepressants and all psychiatric drugs."

On regulatory expectations :

"The regulatory standards for demonstrating evidence of safety, efficacy and quality are no different than for any other psychiatric compounds."

"The usual standards of evidence apply."

On Patient-Reported Outcomes :

"MADRS... doesn't necessarily measure what we've heard from patients is most important, which is quality of life and level of function as opposed to the symptom reduction."

Good watch.