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We need more cost effectiveness data as a collective to strengthen the case for health tech. Sleepio, a digital therapeutic that helps people with poor sleep, recently released its health economic outcomes assessment. The study was conducted at a self-insured Fortune 500 company, in collaboration with IBM Watson Health, and health economic consultant Dr. Laurence Baker.

Why this is notable:

• These results, combined with those from Livongo and Omada's, confirms that evidence-based digital therapeutics can lower healthcare costs.
• This type of assessment including the generation of pragmatic, real-world evidence is essential to demonstrate that digital therapeutics are linked to healthcare cost savings.
• It is unclear if we can fully attribute the reduction in costs to Sleepio alone as there may have been confounding factors: 1,102 employees (551 Sleepio users and 551 controls) during an initial 12-month timeframe, before Sleepio was accessed, and then compared annualized healthcare costs after an 18 month follow-up period. At follow-up, the Fortune 500 company spent on average $1,677 less, or 28% lower annualized per-employee costs for those using Sleepio compared to the control group.

Industry Implications:

• There have been huge advances in the generation of evidence proving  efficacy and efficiency of digital health solutions in employer and consumer settings -  but we still have a long way to go.
• Rapid adoption: Sleepio and Daylight digital therapeutics from Big Health have seen large scale, rapid adoption during COVID-19 with hundreds of companies signing up, representing more than 5.5 million lives.

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‍Omada Health recently raised a $57 million round of growth capital from the life sciences investment firm Perceptive Advisors. Omada subsequently used $30 million of that fundraise to acquire the musculoskeletal solutions company Physera. 

‍Why this is notable:

• ‍‍Physera and Omada Health both already work with health plans, employers and individuals. So, the offering of the combination of the two may be fairly simple given they have both nailed down the business model.
• This acquisition expands Omada's suite of solutions. They started off with pre-diabetes and hypertension, and then added the mental health application Lantern through an acquisition last year. Now Physera for musculoskeletal indications, thus making Omada a pretty holistic lifestyle digital therapeutic.
  

Industry Implications:

• This investment in Omada comes as a bit of a surprise as investment gurus had forecasted a reduction in deal flow as investors are focused on managing their existing portfolio.
• The digital musculoskeletal space, in particular, seems to be gaining traction lately, and perhaps rightly so - how many of us are experiencing aches and pains working from home (or even on-site, in a hospital)? Just over a year ago Physera brought in an $8 million Series A while, Hinge Health announced a $90 million Series C raise just a few months ago.
• Omada and Livongo are lapping up more offerings and their competition is gaining momentum.

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Two of the worlds’ leading medical journals Lancet and NEJM, have expressed concern about the accuracy of a few studies that have been published, in haste, over recent months - these papers have been retracted since. We are all living in the fast track lane, trying to get ahead and without the barriers that delay research, regulation, and market entry for our healthcare products and services. While Covid-19 has been a major driver to accelerating market pathways and diminishing market-entry barriers, we must continue to proceed with caution. While the pandemic presents certain opportunities there is not a more important time to ensure that whatever is marketed and accessible to patients is evidence-informed, safe, ethical, etc.

Why this is notable:

• The Lancet found that the antimalarial drugs chloroquine and hydroxychloroquine, which had been explored as potential therapies for Covid-19, did not correspond with improved outcomes for patients, but were in fact associated with higher mortality rates. 
• The NEJM reported that anti-hypertensives were not associated with worse outcomes in Covid-19 patients.
• The disparity between real-world studies and Randomized Control Trials call efficacy into question: The difficulty with observational (“real-world”) studies is that, often, the patients whom doctors choose to treat with a drug are different in this case. Most likely these patients are more ill than those who go untreated. On the other hand one RCT in China actually demonstrated some benefit of the antimalarials in Covid-19. Results are contradictory.
  
  

Industry Implications:

• Question the data: A number of companies' claim to fame is their access to EMR/ claims datasets to run analytics on. Their reliability has been exposed.
• Transparency: The study’s authors did not release the full data underlying the study and did not say which countries or hospitals contributed data.