PNS85 Economic Evaluations of Digital Therapeutics (DTX) from a US Perspective

Abstract

DTx represent a potentially transformative approach to support self-management of chronic conditions and to complement conventional disease monitoring and treatment. While DTx have not yet notably impacted patient care or service delivery in the US, these technologies have the potential to increase efficiency, improve outcomes, and expand access to care while reducing costs. In the absence of a large body of published research or consensus guidelines on DTx, US payers have posed questions about how to determine whether the effectiveness of a DTx merits the time, effort, and costs of utilizing the technology. We therefore sought to identify economic evaluations of DTx from the US perspective. A strategic literature review was conducted using the pearl growing/snowball method, wherein core publications were identified using an initial PubMed search strategy with the MeSH term “mobile applications/economics*”. Of 46 publications identified, two core publications were used to establish keywords and for bibliographic and prospective citation searches to identify additional relevant publications. ISPOR and AMCP congress abstracts also were searched from 2018 to 2020. Our search identified ten US-focused economic evaluations of DTx. Therapeutic areas included general mental health (1), depression (1), opioid use disorder (2), eating disorders (1), and diabetes (5, including 1 with hypertension). Five studies were claims analyses (one also included a cost-effectiveness (CEA) and budget impact model), and the remaining 5 studies included 3 CEAs and 2 cost-consequence models. Model horizons ranged from 3 months to 10 years, with longer-term models demonstrating higher quality-adjusted life year gains and cost savings. DTx represent an emerging opportunity to reduce healthcare expenditures while empowering patients and improving outcomes, but the existing evidence base is sparse. There are relatively few economic evaluations of DTx from the US perspective, presenting a challenge to payers seeking to develop coverage policies for this novel treatment modality.