Current and future digital therapeutics trends from the payer perspective

ABSTRACT

BACKGROUND: Digital therapeutics (DTx) represent a growing market, accelerated over the last two years by the COVID-19 pandemic. As more DTx emerge, healthcare decision makers (HCDMs) are tasked with navigating a crowded and highly variable market to ensure patients have access to treatment options that can potentially improve outcomes. There is limited evidence evaluating how DTx products are perceived from the payer perspective. OBJECTIVE(S) To assess payer perceptions on the current and future state of DTx global trends and evidence generation needs. METHOD(S) A double-blind web-based survey was fielded from April 2022 to May 2022 to HCDMs to gather insights on existing and anticipated DTx trends. RESULT(S) There were 50 HCDMs who completed the survey. Respondents predicted that DTx will expand to new disease areas outside of mental health, diabetes, and cardiology (70%) and that more prescription DTx products will be covered (56%) over the next 18 months. Considering COVID- 19, respondents were at least somewhat likely to allow virtual assistance (64%) and API transfer (68%) for benefits verification. A MaxDiff trade-off exercise showed from an evidentiary needs perspective, head-to-head comparison studies (81) followed by prospective randomized controlled trials (74) were considered the best evidence options in terms of usefulness for DTx review, and objective clinical effectiveness (81) and total cost of care offset (66) were priorities for health outcomes data. Respondents (78%) noted that evidence demonstrating long-term efficacy and specific disease-state management were absolutely needed to determine coverage for new DTx. 48% considered two years as the best definition of long-term efficacy and most (68%) were at least interested in discussions about piloting a DTx to gather real-world evidence pending more information. CONCLUSION(S) The results indicate that HCDMs expect the market to continue to expand into new therapeutic areas and that more prescription DTx will obtain coverage. Evidence of long-term efficacy demonstrated over at least two years and pilot programs may be instrumental in optimizing DTx HCDM evaluation. Stakeholder alignment across the industry will help shape the future of DTx and facilitate appropriate patient access.