Which digital health technologies are exciting payers?
How and where can digital health technology improve patient outcomes and save payers money? Across the digital health field there are hundreds of applications available but how many really meet a clinical need, lead to a positive and provable outcome, and can practically fit into a physician's workload or a patient's life? For pharma, key digital technologies can be a valuable component in a product's value proposition to payers, but clear outcome objectives, provable results, funding and user convenience will be central to gaining their support.
In this new September 2019 report, Paying for Digital Health: Payer Insights (2019), expert payers reveal their insights on the practical issues and challenges of developing digital health applications and technologies that align with payers' ambitions and outlook.
Payers tackle key questions
- What are the key drivers and barriers for digital health adoption?
- What evidence do payers need to understand the benefits of new digital technologies in terms of improved patient engagement, compliance, outcomes or quality of life enhancement?
- In what circumstances could payers provide funding for devices that are designed to engage patients in their health and care?
- What do payers see as the key investment areas for digital health developers and which disease areas are most likely to benefit?
- What are the opportunities for payers to collaborate with pharma to develop digital health technologies that will improve outcomes and/or lower overall health costs?
- What advances do payers expect in digital health adoption over the next five years?
What our experts say…
"I think a lot of it is being driven by consumerism – anytime, anywhere, the need to know. A lot of these wearables are member self-pay – Fitbits and so forth. But we have been paying for telemedicine under very select circumstances, heart failure, for example. I think you'll also see the next generation of devices for asthma and COPD may incorporate some of these tracking tools to help understand if the patient is taking the medication using the correct technique. Also, it helps a clinician understand the frequency of administration and tracks adherence. So, these smart devices hopefully give meaningful and actionable information to a clinician to improve outcomes."
US payer 3
"The manufacturers would have to demonstrate to me that use of that product improves the management of that patient or improves outcomes. That would need to be demonstrated to me as a payer because if it's just another fancy way of the physician getting information, but it doesn't really change anything, I'm not sure that I would find a lot of value in that. Just because you have an app, it doesn't necessarily provide any value unless you can show that patients are using the app, and as a result they are improving their outcomes and improving their health. We just haven't seen that."
US payer 1
"The Apple Watch Series 4 was the first time that they crossed the line between fitness, wellness and healthcare. The problem is that 99% of that Apple Watch is fitness and wellness, and maybe just one percent now is really caring for a disease or prevention. And that's why I think it's not enough to get reimbursed. But a new device or app, which really concentrates on disease, not just on fitness, could get reimbursed. The validity of the alerts is key. That needs to be proven, and as far that Apple Watch is concerned, I have not seen any validation study. We would basically ask for two things: number one, the sensitivity, and number two, the specificity. Both could be an issue. So, if the sensitivity is, let's say, just 50%, then I would say, forget it, it doesn't help you. If 50% of your heart attacks would be overlooked – that's not helpful. The same would go for specificity. If it's just 50% or lower, then I would say, whoa, you can't always go to a doctor's office when it turns out to be a false alarm. That's not helpful. So, these two figures would be crucial in Germany."
"I think it's important that pharma companies are trying to add value developing these health apps, but what I really think is that one pharma company doesn't have the complete treatment that the patient needs – usually it's a combination. So, if pharma companies develop health technologies without a standard, you may need one system for one of your treatments and another system for the other one. So, I think here it is really a complex approach. We try to work with pharma companies developing apps, but I think it has to be more open because the problem is we have as many different apps as treatments. As a patient, you only need one app."
What to expect
- A detailed report based on recent drug launches and withdrawals which analyses the commercial strategies companies are using to drive biosimilar usage
- A detailed report revealing US and European payer insights into the rapidly expanding digital health sector and the technologies they see as beneficial to improving outcomes and lowering health costs
- An examination of 11 key issues which pharma can learn from and respond to
- 25 targeted questions put to payers
- Their perceptive responses that provide 71 insights supported by 72 directly quoted comments
Expert payer contributorsAll the experts who contributed to this report meet the following screening criteria:
- Have over 5 years of experience as a drug-budget manager, pricing and reimbursement (P&R) expert or health economics expert
- Are aware of the current and evolving trends in digital health
- Have experience as a primary decision maker, key influencer or voting/contributing member on a P&R committee or a drug and therapeutics committee with direct involvement in formulary decisions that involve digital health technologies
The identity of the payers has been kept anonymous to ensure full and frank disclosure of opinion.
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