Digital Therapeutics And Changing Future Of Healthcare

The acceleration of change for healthcare delivery systems is unprecedented. All previous projections are being shattered every day. Amidst this, a subset of Digital Health - Digital therapeutics (DTx) is taking centre stage, largely because they are evidence-based solutions that fill the healthcare delivery need gap in the current scenario worldwide.

Digital therapeutics are software-based solutions and help prevent, manage or even reverse some chronic conditions like Diabetes, which may be poorly addressed by the healthcare system today. For many of these conditions, though lifestyle therapy is the recommended first-line therapy, adoption is low due to a lack of data to prove its efficacy. Though DTx has been around in the west for almost a decade, now the evidence is emerging from India to demonstrate its value in clinical terms. The Diabefly digital therapeutics program for Diabetes has shown excellent outcomes often surpassing the outcomes shown with only medical therapy. 90% of the patients had better blood sugar control often lowering the HbA1c (a marker of 3month average blood sugar) by 1 point and 30% of the patients achieved partial or complete diabetes reversal.

How Digital therapeutics is helping patients, doctors and employers

1. Improving outcomes

2. Helping the patient make behaviour and lifestyle changes

3. Ensuring compliance and adherence

4. Improving access to holistic care

5. Saving money & time

6. Data for research and publication

Investments in DTx prove its adoption

As per the research done by UnivDatos Market Insights, the Global Digital Therapeutics Market is expected to grow at a CAGR of 24.5 per cent from 2021-2027 to reach US$ 13 billion by 2027. The Mckinsey White Paper says that Investments in digital-therapeutics companies in the United States have grown by an average of 40 per cent a year over the past seven years to reach more than $1 billion in 2018.

As per Forbes, the Biggest Digital Health Deal of All Time: Teladoc and Livongo, Teladoc acquires Livongo for 18.5 billion USD in Aug 2020

Fitterfly, an Indian Digital therapeutics company, raised 3.1 million USD pre-series A round led by Fireside Ventures in March 2021. Wellthy Therapeutics had raised 4 million USD in March 2020.

US payers are now covering DTx in their health plans

A big switch in the reimbursement landscape has been observed after two major Pharmacy benefits management (PBMs) - CVS Caremark and Express Scripts with a market share of 53 per cent in the United States now support DTx in health plans.

This coverage has been welcomed by the US pharmacy and therapeutics industry at large. Findings of Decision Resources Group (DRG) survey conducted on 157 US P&T (United States Pharmacy and Therapeutics) committee members showed that around 50 per cent of the members agreed that 'Digital therapeutics is the future healthcare approach.' On the whole, 70 per cent of formulary decision-makers covered or intended to cover DTx in health plans.

According to the study conducted by the decision resources group in January 2021, overall, 44 per cent of physicians showed interest in prescribing medical apps for patients. The proportion increased to 52 per cent among physicians who are active P&T committee members.

The Bain.com insights indicated that more than 60 per cent of insurance customers expressed interest in having their insurers offer healthcare services beyond their standard insurance offerings - Survey of 172,000 customers in 20 countries.

While we are still working on proving our cost savings model at Fitterfly, there have been several proven models internationally.

Well doc, a DTx company - Economic analysis conducted in partnership with IBM Watson Health - Average cost savings of $254-$271 per user per month. 

Omada- A USA based DTx company showed savings in medical costs of about 500$ per participant per year for diabetes. Employers time to recoup their investment - 6-24 months. 

Better Therapeutics showed estimated cost savings of $145 per patient per month (PPPM) in diabetes, and $97 PPPM in hypertension, a reduction of 22-29 per cent in total medical costs.

Conclusion

We believe that Digital therapeutics will be the innovation in Healthtech and healthcare and will cause real disruption in the next decade. DTx will be the patient’s closest buddy to help with behaviour change for sustainable health outcomes. Digital therapeutics will also win the trust of the doctors who often struggle with time and provide overall support to their patients on lifestyle therapy.

For Pharma companies, the DTx programs can win them loyalty from doctors and better therapy adherence from patients. For employers, the age of discounts will transition over to the outcome-driven approach which DTx offers while increasing productivity, engagement and decreasing the spending on healthcare.

DTx is emerging as the first port of call for many health conditions and in future, we would see three types of models:

- DTx as first-line therapy or monotherapy: Conditions like obesity, diabetes, PCOS, hypertension, depression, anxiety, addictions.

- DTx as a therapeutic adjunct to pharma drugs: Neurological conditions, progressive diabetes, late-stage hypertension, heart disease, asthma, COPD.

- DTx as supportive therapy to other therapies: Cancers, dermatology, immunological disorders.

Dr Arbinder Singal

Guest Author CEO & Co-Founder, of Fitterfly