Sunday, May 16

Global lessons learned about DTx implementation, reimbursement

All around the world the coronavirus pandemic has led to an uptick in digital healthcare delivery models. While telemedicine is often touted as the poster child of digital success in 2020, digital therapeutics (DTx) also emerged as a player on the global stage.

“What we are seeing is digital therapeutics, while they won’t directly treat COVID, they are really an integral component of this healthcare going forward. I think policymakers and payers increasingly over the year have understood that,” Megan Coder, executive director of the Digital Therapeutics Alliance, said during a panel discussion at DTx West this morning.

Coder noted that in the United States, she saw policymakers go from barely understanding the field in February and March of 2020 to actively seeking out these technologies just a few months later.

Within DTx circles, Germany has emerged as a frontrunner for not only implementing digital tools, but also blazing the trail for reimbursement models.

“Germany really got out ahead of how they thought about reimbursement and making clear pathways for digital therapeutics,” Brent Vaughan, CEO of Cognito Therapeutics, said at the DTx event.

In 2019, Germany passed a provision called the Digital Supply Law that allows doctors to prescribe digital health apps to patients, which can be reimbursed by the country’s statutory health insurance.

Jan Hensmann, head of unit for e-health intelligence for the German Ministry of Health, said Germany’s approach to digital is holistic.

“At the German Ministry of Health, we have a very broad approach of digitalization of health,” he said during the panel discussion. “We’ve been really pushing this topic over the last three or four years in different areas. Let me make this point. I think with digitalization of healthcare you have to take an overall perspective. It all has to come together—it’s the industry, it’s healthcare, it’s professionals, it’s patients.”

Coder said that over the years she’s seen the DTx regulatory spotlight shift from country to country.

“I think it is interesting we’ve definitely seen leadership evolve in different areas. When we first started, Pre-Cert was the topic of the day and everyone had all eyes on what was going on,” she said. “There’s still high interest in that of course, but then UK came out with their evidence for effectiveness guideline, and all eyes were there in terms of it was the first time we saw a government saying these are exactly the types of trials and health economic outcomes you need to achieve if you are at these categorizations. Now Germany, you are at the front of all these conversations to what do we start to adapt certain aspects of our system to what is going on in our own country.”

However, Coder noted that, while different countries are coming up with attractive models, it’ll never be a one-size-fits-all situation. Instead, she said the success and innovations countries have had can help the world learn about the industry.

While there may not be one universal model for rolling out digital therapeutics, the technology itself is promising to tackle global issues exacerbated by COVID-19, including mental health.

“Clearly our primary focus is psychiatry, serious mental illness. What we see there is, there is still very significant unmet medical need,” Kabir Nath, CEO of Otsuka North America, said during the panel. “Many patients do not get to good outcomes, there are still huge problems of supply in terms of therapists, access to psychologists and so on. There are other problems in access to care and coordination of care. What we see clearly is that digital potentially has a role to play in helping solve many of those problems.”

Nath explained that in the future we could see more digital tools that can affect brain placidity, which could fundamentally change how mental illness is treated.

“We’re on a journey. We’re doing a lot of learning from the things we’ve done well and the failures we’ve had and so on. We also recognize we are still relatively early on that journey,” Nath said.

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