The path to reimbursement of digital health applications – and four challenges on the horizon
The pandemic triggered an acceleration of digital transformation within healthcare and pharma. Technology will continue to playing an increasingly prominent role in patient and healthcare professional interactions and experiences.
A strong post-COVID recovery is likely to depend on accelerating, expanding and refining digital engagement strategies. The way we interface with critical stakeholders must continue to improve. This aligns closely with Santen’s long-term vision, which we have already begun to realise through partnerships with the likes of the International Telecommunications Union and Verily. But what role will digital health play, and what does the path to reimbursement look like?
But first – what actually is digital health?
Digital health is an overarching term that refers to the use of connected technologies that collect, document and share health information. The goal is generally to promote wellbeing by encouraging behaviour changes or enabling improvements in healthcare decision making and delivery.
Currently, there are two main areas in digital health: mobile health (mHealth) and electronic health (eHealth). These broad areas can of course be further categorised into mobile applications, wearables, digital health systems, tele-healthcare and health analytics.
As this space evolves, so too will the term ‘digital’. To uncover the specifics of what this term means right now, the Santen EMEA Pricing & Market Access (P&MA) team, will published a systematic literature review to define the term ‘digital health’, as part of a working group with the Professional Society for Health Economics and Outcomes Research (better known as ISPOR). Watch this space for more on this..!
“At the moment, many different terminologies and definitions regarding digital health are being used. A good overview of definitions and terminology is lacking. This lack of clarity complicates solid research on the topic, which could hamper advancements in the field of digital health, which in turn could impact patients. With this research, we aimed to provide a comprehensive overview of the available digital health definitions to gain clarity on this and help advance research in the field of digital health. We are now in the process of getting the results published to show our commitment as a company to improving patients’ lives through digital health.” – Cécile Van Steen, Manager, Market Access EMEA
What role could digital health play in ophthalmology?
There is a multitude of uses for digital interventions in healthcare that are already in use. Sensor-based blood glucose monitoring systems are in widespread use to support people with diabetes. Wearables to track activity levels and demonstrate the impact of medical rehabilitation for people with cerebral-palsy also show promise.
In ophthalmology, the potential to improve patient care is staggering. Digital health could be used to promote better adherence, align treatment with recognised guidelines and to raise health literacy, to name but a few.
For ophthalmologists and healthcare systems these technologies could be deployed to reduce inefficiencies and increase patient access and engagement with the healthcare continuum. In the future, deep learning techniques could set the scene for more accurate diagnoses and personalised treatment pathways.
Four reimbursement challenges to be met before bringing digital health to the market
- Reimbursement pathways for digital health solutions are evolving at different speeds in Europe. Relatively mature markets where governments are implementing and promoting the digitalisation of care already have standardised reimbursement pathways. Elsewhere, pathways are either not yet established or far from clear. Advances made by front-runners such as Germany, UK and France could help to light the way for other countries to follow.
- There are varying levels of complexity within different healthcare systems, funding models and regulations. This means that to have a chance of reimbursement at scale, manufacturers will need to demonstrate the need for and benefit of digital tools in the management of health conditions, such as glaucoma and dry eye disease.
- Although digital health may secure more accessible healthcare for a larger pool of patients, it raises concerns about individual/personal data protection. Patient data is of course governed by the General Data Protection Regulation (GDPR), which requires strict management of data and must be protected sufficiently to allow for use in analytics. Involvement of legal, data privacy and security experts will be critical in securing a successful and trusted product.
- Digital health data used for scientific purposes could reveal the potential for selection bias. This is due in part to the level of digitalisation in different healthcare systems, which varies significantly. In such cases, the use of m- and e-health applications could be limited to a subgroup of patients with a high level of technological literacy. Equal availability and accessibility of digital health services will need to be provided to all users.
It’s clear that a growing number of patients will seek digital health solutions thanks to government-supported reimbursements. Pharma companies can support patients in gaining access to these valued tools but to do so, it is critical to support the reimbursement process to build a thriving market.
– Frederic Ernst, Vice President, Pricing & Market Access, Santen EMEA
NP-No product-EMEA-0157
Date of preparation: February 2022
