Payers say they'll cover pharma's beyond-the-pill offerings. They just want proof first

Pharma companies are discovering that developing apps and digital health technologies is just like developing drugs--at least when it comes to persuading payers to cover them.

Payers say they're willing to reimburse for digital health technologies, the health economics consultancy Xcenda found in a recent survey. But they need proof first. “Payers want to see the clinical effectiveness of these digital health technologies and they want to understand the cost effectiveness,” Xcenda President Tommy Bramley told FiercePharmaMarketing in an interview.

That may be why many payers are evaluating technologies, but few of those surveyed are currently covering them. Digital health purveyors, including pharma, need to better demonstrate the clinical and economic value to payers, Bramley said.

Take an example presented at the annual American Society of Clinical Oncology meeting in June. Lung cancer patients who used a particular app improved overall survival by seven months compared to average standard follow up care. The app triggered a call to the patient’s doctor when anomalies were noted in the data stream. Providers who attended the meeting were quick to spread the word.

Such tangible benefits--better patient outcomes, fewer unnecessary office visits and in this case, fewer CT scans--are exactly what payers want.

“We’re at the very front of pharma interest in digital health to better manage patients," Bramley said. "Everyone is interested in wearable tech, monitoring systems and even ways to measure compliance. Pharma companies want to provide solutions behind the pill and I think this is one area where you’ll see much more activity."

In a competitive market, digital health technology can also be a market advantage.

“If you have a product that doesn’t have digital health support and one that does that’s similar, you can probably show improved outcomes and you can probably show more cost effectiveness, so I think there’s a lot of value in pursuing this. All else being equal, if you have a digital solution, you’re going to win out over the competition, I believe,” he said.

It's also why a host of respiratory companies have teamed up with device makers on smart inhalers, and are testing those devices in clinical trials to see whether they improve adherence. It's also why Eli Lilly teamed up with Companion Medical to develop a Bluetooth insulin pen that pairs with a smartphone app. The idea is to help patients better track and control their blood sugar, and communicate stats to doctors.

"The best therapies of the future will marry breakthrough scientific discovery with customer-friendly devices," Lilly EVP Jan Lundberg said of the partnership, and such therapies "will give Lilly a true competitive edge."

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