In 10 years, healthcare providers will prescribe digital medicine more often than they prescribe pharmaceuticals or biologics for some chronic conditions. Here’s why:
The growing field of Digital Medicine and specifically Digital Therapeutics, or the use of digital health technologies to support behavior change that positively impacts health outcomes, is poised to take off. Today, patients interact with their healthcare providers for a small percentage of their lives. But what happens during the majority of time, when patients aren’t sitting in an exam room? Digital therapies, as well as digital prophylactics and digital diagnostics, promise to support and track behavior outside of clinical settings, helping enact lasting behavior change, while capturing the data required to create informed shared decision moments between patients and their health care professionals. Early data has shown that these therapies, when targeting the right patients, can work.
Today, the perfect storm of need and capability has digital therapeutics positioned to earn more attention, investment, and become more prolific.
The unprecedented continuance of Moore’s law - lower cost and higher capacity storage and computing power, combined with advancements in sensor technology and their integration into smartphones and other consumer products, has created amazing potential for digital health innovation. Add to that Eroom’s law which shows that drug discovery is becoming slower and more expensive over time, despite improvements in technology, you’ve got a recipe for prime market disruption.
Large life science companies have seen this coming, and as a result many have created innovation groups within their organizations to take advantage of the market indicators.
Experts are calling this the era of “Bio 2.0,” and it’s sure to offer significant funding opportunities, too (Andreessen Horowitz just put $200 million toward funding Bio 2.0, for example). I envision that this boom of funding and focus will enable organizations to invest in the digital tools and repeatable clinical development processes necessary to finally make an impact therapeutically on consumers in a predictable and sustainable manner.
There are several companies worth calling out here, as they’re making huge strides in the digital therapeutics field already, providing great models for others in the space.
Pear Therapeutics just this month closed $20 million in financing, which will support their development of digital therapies, called eFormulations. Their digital therapies work to treat disease and also enhance pharmaceuticals at the same time. They’ve focused specifically so far on Substance Use Disorder, Bipolar Disorder, Chronic Pain, PTSD, General Anxiety Disorder, Insomnia, and Schizophrenia. Pear also appears to have a strong handle on obtaining FDA approval for their solutions, which will keep them out of harm's way in the future.
Welldoc’s Blue Star diabetes app also caught my attention when it launched, as it’s the first FDA cleared, mobile prescription therapy developed for adults living with type 2 diabetes. Their digital therapy allows patients to manage their diabetes with real time coaching from an app. It also helps patients adhere to a treatment plan that can be set, seen, and managed by their healthcare provider.
Alivecor is a mobile electrocardiogram (ECG) solution that can be attached to a mobile phone or tablet. It’s FDA approved, and provides instant feedback to consumers about whether or not atrial fibrillation has been detected, especially for patients with histories of adverse cardiac events.
Lively is a passive activity wristband aimed at seniors. It’s smart because it allows older adults to maintain independence, but it also alerts family members to potentially dangerous situations within a mobile app.
Omada Health have piloted their 16-week digital therapy program, Prevent, aimed at folks with chronic illnesses. It incorporates connected devices and sensors with app-based health coaching and gamification. On February 17th, they announced a 12-month clinical trial tailored to the underinsured population. This solution stands out to me as having a particularly strong user experience, and ROI-driven business model, and a clinical nature of their outcomes validation - use of clinical trial protocols including peer reviewed outcome data.
Evidation Health is doing what I think might be the most important piece of all of this: validating the science behind digital therapies. As you may know, there was a flood of applications in this arena in 2010, and they had very little validation to back them up. Did they actually work? Consumers used them, but there was no evidence that the therapy would actually benefit patients in a scientific manner. With players like Evidation Health finally in the space, though, the system of checks and balances will finally come into play.
Digital therapeutics offer the opportunity for significant behavior change that not only treats a health problem, but aims to build long-term healthy habits as well.
By supporting patients more effectively outside of clinical settings and capturing the data required to enable valuable patient-provider dialog, digital therapeutics will gain prevalence as the most effective treatment to some of the world’s rare and most common diseases. We will see the benefit of these therapies published in respected medical journals and other clinically validated channels, and regulatory bodies will continue to evolve their thinking, to embrace the change and strike a balance between establishing guidelines to prevent adverse events, while not stifling the great potential it sees.
For more posts on the potential impact of digital therapeutics, read:
by Jonathan H. Chen
by Todd Greenwood and Benjamin Dean