Recent findings present two key data points that could shape how insurers and policymakers approach payment for digital therapeutics aimed at treating anxiety and depression.
A new report estimates that prescription digital therapeutics developed by Big Health and Otsuka Precision Health could significantly decrease healthcare costs. Specifically, these therapies may reduce expenses by $363 per user for those with commercial insurance and $78 per user for Medicare recipients. These calculations assume a reimbursement rate of $200 for the apps. For Medicare to break even, the reimbursement would need to be set at $270. Some companies may see this figure as inadequate, yet the apps still yield savings, with commercial insurance maintaining cost reductions even at $400.
This report comes from the Peterson Health Technology Institute, with contributions from Caroline Pearson, Yael Berman, and Sanket Shah.
In addition, lobbyists are gearing up to inform lawmakers about findings from Germany, where broader coverage for digital treatments led to 861,000 app activations at a total cost of €234 million over four years. Advocacy groups like ATA Action are hopeful that this data will influence the Congressional Budget Office as it considers legislation to expand coverage for digital therapeutics within Medicare. Insights from Andy Molnar and Ariel Dora Stern contributed to this analysis.
With mental health issues on the rise, these findings underscore the financial advantages of incorporating digital therapeutics into healthcare systems. As more evidence emerges, the push for expanded coverage continues to gain momentum.
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