Prescription Digital Therapeutics in Behavior-Driven Conditions - Episode 3

Potential Impact of Prescription Digital Therapeutics

January 6, 2021

Payer and provider insight regarding the potential impact prescription digital therapeutics could have on addressing challenges surrounding the management of behavior-driven conditions.

Megan Coder, PharmD, MBA: Dr Peskin, what unmet needs have you seen that digital therapeutics could address for health care payers?

Steven Peskin, MD, MBA, FACP: Certainly, around the area of access. Specifically, how digital therapeutics can supplement and augment the great work that our clinical partners do, whether she be a family physician, psychiatrist, or a general internist like me. So, the ability to supplement, augment, or complement the work of the clinical team. I should mention that the care team as well is much bigger than the MDs [medical doctors] and DOs [doctors of osteopathic medicine]. It includes the MSWs, [master’s in social work], and clinical counselors. We’ve certainly embraced community health workers. There are many individuals within primary care and behavioral health, which is very much a team-based effort where digital therapeutics can enhance that interaction.

I did have a physician I was talking to earlier today who, and again, this was not something that we were paying for directly, although indirectly as we pay our clinical partners on a value-based construct. He was disappointed that the particular digital intervention they were using to try to avert people with generalized anxiety disorder, depression, or bipolar from going in to seek emergency department care did not end up having a positive effect on the number of people who had received a digital therapeutic text-based message. It’s certainly not a panacea, but it holds a tremendous amount of promise.

Clearly, people have their smartphones clutched. As one person said to me in the technology arena, [a smartphone is] more intimate than jewelry. I don’t even have any jewelry, so definitely my smartphone is more intimate for me than jewelry. Smartphones are a part of a part of us, for better or for worse. Sometimes, for the worse. The opportunity is there for digital therapeutics to be very meaningful and have impact, and then augment and supplement. Additionally, the relative low cost of digital therapeutics can have a positive impact on what we look at, which is total medical expense.

Megan Coder, PharmD, MBA: I think it’s a good point you bring up. It is also interesting to point out that oftentimes what people will think of as a digital therapeutic might not actually be one. The text-based messaging therapeutic may not have been one, but that notion of using digital and having it scalable and accessible to patients is critical to what this industry can provide. Dr Luo, from your perspective addressing the same question but focusing on health care providers, what types of unmet needs do you think digital therapeutics provide to a provider type of community?

John Luo, MD: I think providers are looking for a way to help their patients, especially when you’re very busy and have a huge panel of outpatients. When there’s a crisis, how do you squeeze in the time to go see the patient? If there is a digital therapeutic that can serve as a bridge until the next time that you can interact with the patient, whether in person or via these videoconferencing solutions, I think digital therapeutics pose a great adjunct. As Dr Moukaddam mentioned, the idea is you want this to be a tool that the provider has confidence in and helps the provider with their style or method versus the patient going off on their own. I still remember when the internet was in its infancy and patients came in reading about medication [adverse] effects from a patient forum they read and decided not to take the medication.

I wish they’d have had a conversation with me. However, I learned quickly that I must accept that patients will bring things in, and I need to have a discussion with them so that we can understand what will be potentially beneficial for them specifically, because they’re not as well-trained to know what the strategy is for the digital therapeutic or whether their condition is appropriate.