5 Takeaways: The Rise Of Digital Therapeutics (DTx) In 2022

The COVID-19 pandemic has reshaped many aspects of our lives. One particular field that has flourished on a larger scale is that of digital therapeutics (DTx) and digital health in general.?

For years, countries all over the world have struggled to keep pace with digital healthcare innovation when it comes to regulation and reimbursement. But more recently, the US is finding solutions that are opening the door to digital therapeutics as they gradually find their place in the healthcare ecosystem.

At the BIOMEDevice Conference last month, Scott Thielman moderated a panel titled Is There an App for That? The Rise of Prescription Digital Therapeutics. Below are five takeaways from the experts’ discussion.?

5 Insights from the Rise of Digital Therapeutics BIOMEDevice Panel

PDTs Can Treat the Root Cause, an Area Traditional Medicine has Largely Ignored

“We are at a unique moment in history where there is a possibility for the technology on our smartphones to address these in a way that traditional pharma technology cannot.”

Kristin Wynholds, Chief Product Officer for Better Therapeutics

“The latest numbers we’ve seen are 35 million adults in the United States have type 2 diabetes, 70 million have hypertension, and another 40 million adults have hyperlipidemia or high cholesterol. This is a big space and it’s costing upwards of $450 billion dollars a year to treat symptoms of these diseases,” Kirstin Wynholds, Chief Product Officer for Better Therapeutics, cited in the panel interview.

What do these cardiometabolic diseases have in common? They share the same root causes which include behaviors around poor diet, sedentary lifestyle, poor sleep, and stress.?

“We also know there is a pretty effective treatment for these types of behaviors, and that is Cognitive Behavioral Therapy (CBT),” she mentions. “But CBT is expensive and usually done in 1-1 settings. Therefore, it’s not something that is scalable.”

“We’re at the perfect time in history to use technology with CBT on a large scale to specifically treat the behaviors causing these diseases,” Kristen says in the interview.

A Patient-first Strategy Drives Product Engagement

“Co-design is one of the most important strategies available for driving engagement in digital health interventions.”

Gabe Strauss, Product Manager, Limbix

A digital therapeutic for the treatment of adolescent depression, Limbix is dedicated to a patient-first approach when it comes to product strategy and design.?

During the interview, Gabe Strauss, Product Manager for Limbix, shares how and why they’re taking a co-design approach to product engagement.?

“We’re focusing [our design] on adolescents because we want to deeply understand our user base,” Gabe explains. “We’re adults and for the most part, we aren’t dealing with depression in the same way. So we have to find ways to motivate and engage a patient population that is specific to them. This is one of our biggest challenges because we, ourselves, are not the target audience.”

Gabe goes on to mention there are two main keys to the patient-first strategy at Limbix:

1. User experience testing/formative testing. Limbix has a dedicated UX researcher embedded into the product team that can talk to the users on a weekly basis to keep the pulse.
2. Co-design. Limbix utilizes a patient panel they call the Teen Advisory Council which includes a lineup of teens and adolescents who struggle with depression. The Limbix product team regularly tests new ideas with the council and works with them to generate potential solutions through critiques and brainstorming.?

“While there is no ‘magic bullet’ engagement strategy,” Gabe continues, “it really is hard to overstate its importance to our product.”

Data can Lead to Better Patient Outcomes and Payer Support

“Data day over day, and week over week, allows [physicians] to make much more informed decisions when it comes to their patient’s health.”

Gordon Kass, Vice President of Engineering, Pear Therapeutics

With the technology and healthcare spaces merging, many people question where patient data goes, who uses it, and what security issues are we facing. According to Gordon Kass, Vice President of Engineering for Pear Therapeutics, their product emphasizes data security and data intelligence.?

“The data we collect, we make the aggregate information available to clinicians but we hold real tightly to security standards,” he mentions in the video. “We have software in place that allows the physicians to see only what they’re allowed to see.”

So, if the data isn’t going to the physicians directly, who does it go to?

“We have internal people that look at the data as a whole and then we communicate that information to our payers about what is going on with our products,” Gordon explains. “We collect engagement data. How long [users] use the product, where they drop off is, and more. We then use this to communicate with insurance partners about how patients are using the product.”

In the current healthcare models, physicians only see their patients maybe every three months. Digital health provides the opportunity to collect data on patient behavior day over day and week over week. “This allows [physicians] to make much more informed decisions when it comes to their patient’s health,” says Gordon.?

“This is one of the most important things that will come out of this space,” Kristin Wynholds from Better Therapeutics adds.

Consider Physician Workflows for Successful Integration

“… helping them gain confidence with how to use, integrate and prescribe it can go a long way. “

Mike Rosenbluth, PhD at Swing Therapeutics

While considerable progress has been made in the last two years with technology, the question remains whether digital therapeutics can be successfully integrated into the U.S. healthcare system. To do that, physician adoption is a crucial, yet often overlooked, piece of the puzzle when it comes to DTx.?

“Sometimes one of the hardest behavior changes is the physician’s behavior and the way in which they treat their patients,” said Mike Rosenbluth, Ph.D. of Swing Therapeutics.? “When you’re giving them a new technology they’re not entirely familiar with, helping them gain confidence with how to use, integrate, and prescribe it can go a long way. “

Include a Strategy for Payer Reimbursement

Under FDA public health emergence, we are able to go to market early. [This way,] providers can begin offering it to their patients in order to gain physician/patient traction. Once we get started there, then we can take that to payers to get reimbursement.”

Gabe Strauss, Product Manager, Limbix

Attaining reimbursement often has the greatest impact on patient access and can progress a new treatment toward widespread adoption. In the panel video, Gabe Strauss, Product Manager for Limbix, covers the four dimensions you need to consider to get payer support.

1. Clinical efficacy and evidence to show that your mobile health application can treat the intended diagnosis.
2. What are the health economic outcomes? Is there a hard ROI impact on the bottom line for these payers? Can your program treat patients in a more cost-effective way than traditional treatments?
3. Provider adoption and demand. Once the technology is integrated with the physician’s workflow and standard of care, there is more pressure and incentive for the payer to support and reimburse it. You will also have more key opinion leaders asking for it.
4. Patient adoption. Do they want to use it? Are they using it? Are they reporting favorably on it? If insurance members and employers are asking for digital health options, payers will pay attention.

It’s a bit like a chicken and egg issue. How do you show physician adoption if payers aren’t paying for it? And physicians may be less likely to prescribe if payers won’t pay for it. How incentivized are patients to use it if it’s not being prescribed?

“At Limbix, we also take the physician into consideration when it comes to our product strategy,” Gabe mentions. “Under the FDA’s public health emergency authorization, we were able to go to market early. [This way,] providers can begin offering our therapy in order to gain physician/patient traction. Once we get this going, then we can take that to payers to get reimbursement.”

Digital Therapeutics is Next-Gen Healthcare

Spurred by the pandemic, digital therapeutics have gone from largely hypothetical to FDA-approved treatments in just the last few years. As treatments are approved for a broader range of illnesses and diseases, DTx are poised to become a popular treatment option for patients and a fast-growing market for medical device companies and investors.?

Watch the full interview below: Is There an App for That? The Rise of Prescription Digital Therapeutics (PDTs).