In digital therapeutics (DTx), it is not the chemical molecule (drug) but coaching, behavioural monitoring, data analysis, and real-time measurement of progress that become part of the therapeutic plan.
DTx are much more than ordinary health apps – they are meticulously designed platforms tested for outcomes and economic benefits for the payer.
A new subcategory of DTx involves those known as PDT – Prescription Digital Therapeutics. Doctors in Germany (and soon France) can prescribe mobile apps and e-health platforms, and the patient is reimbursed by the insurer for their purchase, just as they would if they bought a prescription at a pharmacy. The American health insurance system, Medicare, is also planning to facilitate access to DTx.
The most recent example of DTx as a therapy for patients with atopic dermatitis (AD) was introduced in May by the Icelandic startup, Sidekick, and Pfizer. This solution, which uses gamification to increase patient compliance, will be introduced first in the UK, followed by Belgium, Norway, the Netherlands, Sweden, France, Ireland and Japan.
What are the benefits of using digital therapeutics?
DTx has the advantage of utilizing the therapeutic potential inherent in the patients themselves. This happens by changing people’s habits, motivating them to adhere to treatment recommendations (adherence) and stimulating specific actions. These types of solutions also allow for tracking progress and adjusting treatment parameters to individual needs. DTx and PDT complement traditional therapies and even replace medications; for example, in the case of such conditions as insomnia or treatment of back pain resulting from stress or inappropriate lifestyle.
Sidekick and Pfizer’s e-therapy is primarily motivational. AD is an inflammatory, chronic and relapsing skin disease that affects up to 14% of adults worldwide. People with AD experience constant itching of the skin, leading to sleep problems, increased stress, and avoidance of social interactions, negatively affecting their quality of life.
One of the challenges associated with effective treatment of AD is low patient adherence to treatment recommendations. Sidekick’s digital therapeutics platform aims to increase patient compliance, using gamification and behavioural psychology to guide treatment through an optimal care pathway with the right medication.
Sidekick recently completed an independently funded clinical trial for AD that demonstrated a reduction in the severity and extent of skin lesions by more than 40% and a nearly 50% reduction in overall symptom severity. The study participants also reported a significant improvement in quality of life.
The future is digital-drug therapeutics
Sidekick has previously partnered with Pfizer on therapies for inflammatory bowel disease and rheumatoid arthritis, among others. The startup, which has received EUR 70.8 million in funding in less than two years, is developing gamification-based digital therapeutics for more than 40 medical conditions. Pharmaceutical companies are beginning to recognize the potential of digital therapeutics based on clinical evidence.
For most diseases, treatment success depends on patient engagement and behaviour change. Without these elements, a pill alone is sometimes not enough. The challenge remains in distributing DTx and bringing them into the reimbursement system, just like traditional prescription drugs. There is a lack of universal standards for evaluating DTx efficacy; expensive clinical trials are a barrier for many startups. Therefore, a new pathway is needed to introduce digital therapeutics to the market and to educate health care professionals and patients.