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Having had a few weeks to reflect on our discussions at the HealthXL Global Gathering in Barcelona this past May, we’re delighted to share our event recap with you. We hosted over 60 leaders of the HealthXL community at the DFactory in Barcelona to break down one of the most discussed issues in digital health: the future of Digital Therapeutics (DTx) in Europe.
As DTx play an increasing role in patient care, our healthcare systems are evolving. We brought together stakeholders from across tech and healthcare to look at how to shape this evolution. We split up into several roundtables, with each tackling one of the following topics: 1) what can we learn from DiGA and 2) what’s next for the patient experience in virtual and brick and mortar settings
Here is what we learned.
Reimbursement - what has worked and what hasn’t worked?
Following its launch in 2019 the German framework - known as DiGA - was lauded as a leader in digital health reimbursement globally. The program created a fast-track pathway and is considered to be a role model in terms of a 3-month evaluation process and the centralization of reimbursement.
While DiGA is seen as the ‘gold standard’ we explored what has worked and what could be improved:
- The need for real-world evidence. While real-world evidence (RWE) is supposedly accepted, no DiGA approvals have been based on it so far.
- Recognizing international evidence. All listed products to date have completed German trials. While the program will technically accept trials from elsewhere, we have not seen any examples so far. This needs to be addressed to allow scalability across countries.
- Lack of transparency on pricing. It is unclear how pricing decisions are made and what the right standard of care models are to set a ‘fair’ price.
- The lack of a centralized European model. As health budgets are fiercely held at a national level, there is unlikely to be a path to a pan-European model for reimbursement as each country will want to retain some control.
- Restrictions on data usage. As part of the process, companies give up the right to resell even anonymous data which can be a significant opportunity.
- Physician awareness and education. It is not only about reimbursement schemes, physician education is critical. On top of that, there also needs to be policies that incentivize adoption, like the recent news about Sleepio and the NICE.
Beyond reimbursement - Patient and clinician engagement
Reimbursement is an important component of adoption, but without understanding the people who use the product, their journeys, and the way individuals and institutions interact, it can be difficult to make real progress.
- Awareness, education and integration into health systems. These are seen as some of the key factors to build solutions that improve patient and clinician experience. Business-to-consumer (B2C) commercialization models can be used as a validation phase to ensure the solution delivers what patients need. After this validation, business to business (B2B) is crucial to scale sustainably. Service and product providers, need to put themselves into the shoes of the payer, the physician, and the patient in all phases of product development and commercialization.
- Without trust, it will be very difficult for the industry to go to the next level. There is an opportunity to connect the dots and help the industry become a more data-driven sector. A major challenge the healthcare industry faces though, especially pharma, is the patient reluctance to share data. Empowering the patient with the ability to share their data based on specific use cases might be a good start - allowing users to share discrete items for specific purposes could help build trust.
- Not all physicians are the same. It is unlikely that the traditional key opinion leaders will be early adopters of digital solutions. Understanding the personas of those more open to novel approaches is important.
- Beyond doctors. While the industry recognizes physicians as a core piece of the DTx industry's success, the whole care system can’t be forgotten. DTx companies and their partners also need to engage the broader care teams, not just the physicians.
- Not just virtual. Clinical studies are a good example that shows mixing virtual and in-person approaches are extremely promising in healthcare. Less than 5% could be fully virtual clinical trials, however, more than 70% of site visits could be removed. But what does the interplay between virtual and brick and mortar look like in practice and how can it work holistically for the patient?
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