Digital Therapeutics: You will need a prescription to download that app
Somehow, someway, words like digital health, health tech, telehealth, and telemedicine have managed to permeate our everyday lexicon. The expansion and success of digital health solutions have advanced the overall industry, while enticing new populations of the general public (and investors) into the healthcare sector. Through more tangible, patient-centric care models, and innovations that are more consumable by those without an advanced science degree, digital health has more momentum and potential than ever before.
So what’s the next new concept that is going to become a household word discussed at the dinner table? I’m putting my chips on digital therapeutics (Dtx).
…
For the past 20+ years, technology has increasingly found new ways to disrupt traditional healthcare models, benefitting stakeholders across the continuum of care. Beginning with email newsletters, websites, and online communities, to early forms of remote care, all of which have paved the way for the early success of Dtx. As defined by the Dtx alliance, “Digital therapeutics deliver evidence-based therapeutic interventions that are driven by high quality software programs to prevent, manage, or treat a medical disorder or disease”[1].
So, it’s a software program — like an app — that can somehow directly treat a patient? How does that even work?
Kind of a funny concept, I know. For the most part, these are web-based applications that provide virtual treatments for both mental and physical ailments (more on this later). Just as a typical small or large molecule drug is manufactured, a Dtx follows a very similar process. DTx manufacturers must establish clinical endpoints for their treatment, which are tested in clinical trials and used to support safety and efficacy claims. These claims are then validated by a third-party regulatory body, such as the FDA, that allows for market delivery of the product, either via a prescription or over the counter.
Doctors are writing prescriptions for apps?
Yes! Again, it’s no different from the process of a doctor writing a prescription for an antibiotic. But in this case, the prescription will give you access to a digital treatment.
Okay… what exactly are these being used for?
DTx applications span a broad spectrum of therapeutic areas and indications. On the preventative front, solutions exist for diabetes, obesity, nutrition, and lifestyle management. But the majority of Dtx are in the vast array of care-related applications, including chronic respiratory disorders, musculoskeletal disorders, cardiovascular diseases, gastrointestinal disorders, and mental health disorders.
Additionally, the positive impact of DTx extends well beyond delivering an efficacious treatment. From decreasing healthcare utilization and costs, to increasing patient compliance and adherence of a primary treatment, and providing bandwidth relief for overworked care teams, DTx provide clinical, economic, and operational benefits to a wide range of stakeholders, including patients, caregivers, providers, payers, employers, and pharmaceutical companies.
Are these really going to catch on?
Early traction has continued to fuel Dtx investment, increasing manufacturer pipelines and driving market projections of the global market to reach $12.1B by 2026[2] and $32.5B by 2030[3]. This growth has been reflected in Google Books Ngram Viewer, which shows an almost 700% increase from 2017–2019 in usage of the term “digital therapeutics” in books in the Google data base[4].
Anything else that’s helpful to understand?
With the early proliferation of digital therapeutics, it could be extremely overwhelming to differentiate among all the hundreds — if not, thousands — of Dtx options available. While this poses clear challenges, I think this increase in competition will help illuminate some of the most critical success factors for a Dtx that will prevail in the long run. A few standout considerations:
1. The ability to target very specific patient populations
The early entrants in this space had very general indications, but I think the value is going to come from those who can best relate to their patients by having either a therapeutic area specific platform or indication specific assets will see success. For example, Blue Note Therapeutics is a cancer-focused mental healthcare company that is developing tumor-specific mental health therapies
2. Creativity is needed in how care is delivered to effectively engage and retain patients
Developments in the gamification of healthcare (Akili Interactive) and virtual reality (OxfordVR) are prime examples of how technology can enhance care delivery and user/patient experience.
3. Keep an eye out for Dtx and diagnostic solutions being developed together
A creative example here is Cognoa, who develops a diagnostic companion with each of their Dtx, enhancing the continuum of care from diagnosis to treatment.
Final thoughts
In conclusion, I believe that Dtx have been developed at the right time / right place, and are an exemplary example of how technology can be used in creative ways to directly improve care for patients. They represent a rare win for patients, providers, and payers, increasing their likelihood of becoming a normalized part of each of our care plans in the not so distant future.
References
1. https://dtxalliance.org/understanding-dtx/
3. https://www.grandviewresearch.com/press-release/global-digital-therapeutics-market
