Can you really replace a drug with an app? The answer is yes, if we think of the so-called "digital therapies" that will characterize the "third phase of medicine", according to Andreessen Horowitz , a leading American venture capitalist.
Digital Therapies are clinically validated technological solutions designed to complement or potentially replace traditional therapies, ensuring greater patient involvement while improving the overall quality of healthcare over the long term.
The definition of “digital therapy” measurements into commonly accepted guidelines is among the missions of the Digital Therapeutics Alliance, a working group formed by some of the top digital health companies in the field such as Pear, Akili, Propeller Health, WellDoc, Omada Health and Voluntis. Their mission is to promote and foster the understanding, adoption and integration of digital therapeutic solutions.
Their groundbreaking innovative solutions include videogames designed for the treatment of children with ADHD from Akili, online programs like Omada Health to help lose weight by reducing heart risk, mobile platforms and sensors to support the management of respiratory diseases as those proposed by Propeller Health. These are just some of the most popular digital therapies available in the US, and in most cases they are aimed at patients suffering from chronic diseases or neurological disorders, often not well addressed by the traditional healthcare industry. In addition, these new therapies can offer a very cost-effective option for treatment and at the same time help reduce the workload for doctors by providing individualized support to patients.
If these are the obvious benefits, why haven’t digital therapies yet been fully integrated into the healthcare offer? Why are they not prescribed by doctors and why are pharmaceutical companies not investing in developing new ones? According to McKinsey & Company, there are two obstacles to a real rise of digital therapies: their differentiation in the digital health market and the inefficient distribution of incentives.
The number of health apps has increased greatly, just think that in 2017 over 318,000 health apps and 340 wearable devices were released, but not all of them have demonstrated a therapeutic value. To be considered digital therapies, these solutions should prove to be clinically valid through evidence-based studies and satisfy the standards of safety, efficacy and value which are common benchmarks in the healthcare industry, just like other drugs and OTC supplements. The role of regulators in starting to assess the efficacy of digital solutions is therefore crucial, as their validation will enable consumers to understand what the benefits of a digital therapy really are. It is no surprise that the FDA is now thinking about creating a digital health unit to help oversee this new industry and the health solutions it is bringing to market
For digital therapies to be as widespread as current drugs, changes in the entire health delivery chain are indispensable. The first change needs to be in the approach that doctors take to collecting and sharing data on patients' health status. For example, many digital therapy apps and software platforms are built around monitoring patient symptoms. Making this volume of data available to doctors to conside is often considered by physicians to be more of a nuisance than a help. Therefore, doctors must be tought how to see this data as a very useful information tool when used with analytical software that can help them interpret its meaning.
From the patients' point of view, it is important that the adoption of these new therapies also be reimbursable, but this depends essentially on the type of result that can be achieved by adopting these new therapies. In general, the insurtech sector tends to reimburse those therapies that provide better management of health conditions and/or contribute to better control of the underlying pathology.
Finally, to have a real adoption and widespread distribution of digital therapies requires significant investment from pharmaceutical companies, which traditionally have approached innovation in very different ways than that of the newcomers from outside the industry. Most of the time, innovators and distruptors are new startups using the latest technologies unencumbered by slow internal business processes or internal regulatory constraints.. But something is starting to change in the pharma sector,; one example is that of Roche acquiring mySugr, a support app and platform for diabetic patients. In the near future, more pharmaceutical companies may launch their own digital therapy units, but in the short term, the easiest way for the to catch up to the fast moving field of healthcare innovation is to establish partnerships with promising startups.