The Value Of Digital Therapeutics: Personalized, Cost-Effective Care

The novel entrant of digital therapeutics (DTx), particularly a subset called prescription digital therapeutics (aka DPT or PDTx), offers value to healthcare organizations beyond their intended use: clinical interventions delivered directly to patients via software to treat, manage, or prevent a disease or disorder.

As software that has been cleared by the FDA and validated through real-world evidence, PDTx provides a gateway to benefits critical to value-based care, population health, personalized medicine, health equity, as well as treating rare and hard-to-remedy disorders.

PDTx provides an alternative or a complement to improve treatment for more patients

A recent PsychU webinar explored the value of digital therapeutics. Madhukar Trivedi, MD, a professor of psychiatry at the University of Texas Southwestern Medical Center, shared his view from a behavioral health perspective. He said that over the past 30 years, his profession has spent so much time debating which is better – medication or therapy. Now, PDTx provides a new way of delivering treatment for behavioral health and other specialties.

Dr. Trivedi's example highlights the need for new treatment options. He shared that 50% of mental disorders go undiagnosed. And, for the other half that have a diagnosis, 50% of patients don't receive treatment. And, for those who do receive treatment, it can be limited or not always effective. For him, digital therapeutics offers an alternative or complement to existing, traditional treatment pathways.

According to a May 2020 article in the Journal of Family Medicine and Primary Care, “DTx often targets conditions that are poorly addressed by the healthcare system," and they are making progress where other treatments haven't. For example, a mobile application to treat alcohol, marijuana, and cocaine addiction demonstrated abstinence in 40% of patients using a DTx application for three months compared with just 17.6% for patients who received standard therapy alone. Outcomes from research are proving efficacy and value as well.

PDTx can reduce healthcare costs

Dr. Trivedi pointed to several research outcomes within behavioral health as examples of how PDTx has been shown to reduce cost. Studies showed that PDTx “improved effectiveness and reduced medical costs compared with standard-of-care treatment in substance use disorders." Other studies demonstrated that using PDTx “reduced utilization of health care resources including decreased inpatient stays, emergency department visits, and lab tests."

And, in the time of price transparency regulations, total cost of care is becoming a more frequent topic of negotiation and value-based care arrangements. According to the Digital Therapeutics Alliance's (DTA) DTx Value Assessment & Integration Guide, DTx can have a direct economic impact by lowering the cost compared to traditional treatment avenues and accelerating progress through continuous treatment. Costs may be avoided by using a DTx product or in addition to a traditional or comparator approach.

PDTx breaks down barriers of time and geography

The beauty of clinically-validated software is that it expands access beyond the “appointment." Care can be extended geographically and meet a patient at the time of need with greater convenience. Plus, engagement can go beyond personal exchanges: it can foster discussion around positive habits and behaviors, treatment adherence, engagement and intervention.

In a time when consumerism is compelling new business models, partnerships, and technologies, PDTx provides a host of value-adds. Here's a sampling from the DTA's value guide:

• Deliver high quality therapies to underserved populations.
• Easily scale and add accessibility through patient-owned devices.
• Offer at-home convenience and privacy
• Transform how patients understand, manage, and engage in their healthcare.
• Extend clinicians' ability to care for patients.
• Support healthcare teams in settings with varying degrees of healthcare infrastructure.

PDTx enables personalized care and scales for population health

Dr. Trivedi pointed out that payers historically have not focused on whole person care. However, with increased vertical integration between providers, pharma, outpatient services, whole person care is becoming more important for payers. PDTx could give payers and providers better, more intimate engagement with patients. One important benefit of PDTx is personalized care.

The care delivered is not only more personal from an engagement perspective but can deliver a personalized therapeutic intervention based on the patient's needs and tailored to their outcomes and abilities. PDTx product TALi® provides tailored treatment to attention impairments. Its clinical research found that “neurodiverse children exhibit not only significant gains in attention after completing the 5-week training program, but gains are sustained 3 months later with additional numeracy improvements also observed."

Another attention impairment PDTx called EndeavorRx “demonstrated improvements in ADHD impairment with responder rates ranging 40–55% after 1-month treatment and 68% following a second month of treatment." Therapeutics like these are using personalized DTx to achieve significant clinical outcomes and showing the value as a complement to physical and pharmaceutical treatments.

PDTx makes care measurement and monitoring easier and offers a rich data source

The richness of data collected through digital therapeutics makes them a valuable complement to care, as well as a device for improved outcomes tracking and reporting for patients, clinicians, and health plans. DTx products can provide patients with real-time results and insights to help reinforce healthy behaviors, provide timely interventions, and celebrate progress.

The patient-generated health data (PGHD) that's created and shared from PDTx add a new level of value. That data can be used as part of population-health analytics, to track health disparities, as part of quality improvement initiatives, or social risk research, for example. Because the data is passively collected, or collected directly in real-time, it provides a more accurate source.

Proving the value of digital therapeutics

Digital therapeutics provides a robust modality that is evidence-based and approved by the FDA for safety and efficacy. As an industry, the goal is to improve health outcomes, reach people, and address diseases in a way that traditional care isn't or could do better. Key to DTx adoption and success is proving efficacy and demonstrating the value-added clinical, economic, and patient experience benefits that treatment software can deliver.

RTI Health Advance brings all the disciplines together to help payers and providers evaluate DTx solutions and to support digital therapeutic developers take their solution from concept to launch. Contact us.