In a healthcare landscape where the continuum of care has become increasingly technology-dependent, digital therapeutics (DTx) extend patient treatment options. DTx are a subset of digital health that deliver medical interventions directly to patients using evidence-based, clinically evaluated software to treat, manage and prevent a broad spectrum of diseases and disorders (1). DTx products are held to the same standards of evidence and regulatory oversight as traditional medical treatments.

DTx approaches can range from the simple, such as communications that send reminders and notifications designed to alter the behavior of patients who are at risk of diabetes or obesity, to the complex, such as ingestible or implantable devices that communicate with a remote, external sensor to monitor medication efficacy.

An expanding area of treatment utilizing DTx is assisting patients with psychological and neurological symptoms. Disorders such as attention-deficit/hyperactivity disorder (ADHD), anxiety and depression can be treated with behavioral therapy through a mobile device, providing the patients with on-demand and recurring self-help treatment.

The Need for DTx

The COVID-19 pandemic has had a profound impact on the ability of patients to access health services. Due to constraints imposed by social distancing and other precautionary measures, the ability to visit a medical professional has been reduced. Further, given the increase in COVID-related conditions, such as pandemic fatigue, posttraumatic stress disorder (PTSD) and general depression, the demand for professional services has exceeded the available supply of practitioners, delaying much-needed care.

Certain geographic areas of the country have typically been underserved from a medical and wellness access perspective. Government initiatives such as Healthy People 2020 provide a construct for setting and tracking public health priorities. From 2007-2017, differences in target outcomes between rural and urban areas were tracked for seven major causes of death. As of 2017, age-adjusted death rates in rural populations were higher in all areas, and disparities compared to non-rural populations had widened for five of these diseases: COPD, suicide, diabetes related, coronary heart disease and cancer (2).

Conventional, office-centric treatment options may pose barriers from a patient logistics perspective, most notably for homebound patients. In areas where professional services are more abundant, the location and available openings could be problematic, especially for patients who don’t have the flexibility to schedule therapy or treatment during traditional office hours.

Benefits of DTx

The benefits from DTx extend to many stakeholders and can include the following:

• Increased patient engagement
• Individualized treatment
• Improved outcomes due to continuous monitoring of patients
• Improved compliance with care
• Reduced cost of care
• Extended reach/accessibility of care
• More rapid access to new medical and therapeutic insights

For patients, the benefits include access to care that was previously not available or difficult to obtain. The potential also exists for this care to be tailored and personalized to better meet the specific needs of the individual, which also has the potential for improved clinical outcomes and higher patient satisfaction. Furthermore, as therapy is customized to the patient, there is a greater likelihood of continued engagement, as patients become self-advocates of their care.

Providers gain easy access to personalized diagnostic data, allowing rapid identification of gaps in care and more timely interventions. Using evidence-based care therapies, providers can improve the efficiency of care delivery. Patients with chronic conditions may require fewer interventions, which can lower the overall cost of care.

The benefits of DTx extend to payors by lowering the cost of care, reducing the progression of medical issues and improving adherence to treatment plans. As patients become more adept at self-managing their conditions through DTx, the volume of claims per patient reduces. Tailored care plans also help reduce the cost of care by eliminating unnecessary consultations, follow-ups and testing.

For manufacturers and distributors, drug and/or device treatment can be tracked, and the effectiveness monitored in near real-time. The demand for specific treatments, drugs and devices can be tracked over different regions more easily, allowing for more effective supply chain management.

The benefits of DTx should also be balanced with the potential disadvantages (3):

By utilizing DTx, the potential for a bright future is on the horizon for portions of the population that are historically underserved by traditional treatments. Additionally, the continuation of care and therapeutic offerings will only expand as the indications for DTx increase, leading to the possibility of lower cost and, most importantly, better outcomes for patients.

Read part two “Challenges Faced by Digital Therapeutics Developers.”

References

1. Digital Therapeutics Alliance. Understanding DTx: A New Category of Medicine. Available from: https://dtxalliance.org/understanding-dtx
2. Yaemsiri S, Alfier JM, Moy E, Rossen LM, Bastian B, Bolin J, et al. Healthy People 2020: Rural Areas Lag In Achieving Targets For Major Causes Of Death. Health Affairs. Vol. 38, No. 12. Available from: https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.00915
3. Khirasaria R, Singh V, Batta A. Exploring digital therapeutics: The next paradigm of modern health-care industry. National Institutes of Health. [Internet]. 2020 May. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342342/