Paying for Digital Health: Payer Insights

Paying for Digital Health: Payer Insights


Payers love digital technologies that reduce health costs and deliver patient benefit–but who should pick up the tab?

Digital technology is revolutionising healthcare from advanced electronic medical records and telemedicine to emerging technologies such as smart pills/inhalers and 3D dose printing. Great stuff, but payers are only interested in value. Where there is evidence that digital technology delivers lower costs by minimising hospitalisation, reducing waste and improving patient adherence and outcomes, then payers are on board. Nice to have technology, has no place. What does this mean for pharma? What digital technologies will influence payers? What role and contribution would payers like pharma to make?

To answer these key questions we interviewed eight US and European payer experts to reveal in Paying for Digital Health – Payer Insights the specific technologies, funding strategies and operational drivers that are shaping payer attitudes.

Payers explore the digital landscape

What digital technologies do payers want and why?

How will funding models need to change to make digital health technologies widely available to patients?

What challenges does 3D dose printing technology need to overcome to gain payer support?

How useful do payers think the information collected by smart pills or inhalers will be in terms of improving patient engagement, compliance and outcomes?

What real-world evidence will future digital devices need in order to be adopted and reimbursed in the healthcare setting?

How important will it be for manufacturers to ensure that data collection is fully integrated with existing health systems so that HCPs can easily access data for patient care?

Technology partnering is critical for Pharma, but with whom and for what?

What payers say

Ultimately the payer is the one who says, 'I don't care how. I care what and when'… Whether it's a Proteus pill, a Wi-Fi-enabled injection or a Wi-Fi-enabled inhaler – those are all great things. Will they make a difference in the real world? And the companies want me to pay extra for it [but] I won't until they prove that it's better than what I have now. You're not in a risk-taking game, you're in the cost-reduction game… Maybe those who are paying step back and say, Don't bamboozle me with technology. I'm in the business of buying value and giving value for money. What do you offer? Digital Health Expert US

I'm going to be a big sceptic here and say that 3D remote printing of medicine, robotic dispensing of printed medicine is a solution to a problem that I don't see. Digital Health Expert US

If we have 100 patients that are eligible for a drug, our biggest concern is, how do we know all 100 patients are going to respond? Now, if there was a way with respect to some of these technologies [that] we're able to specifically identify the 20 we know are going to benefit and 80 we know are not, that's very beneficial because... that saves us 80 percent of the cost. I could definitely see where we could provide reimbursement if there was data showing that we were able to [target] utilisation of a product to a specific patient based on the technology. Pharmacy Director US

One of the big things the pharma industry needs to pick up on is waste. We know by looking in anybody's bathroom cabinet, you've got boxes of unused pills, often reaching expiry date, often for people with multiple comorbidities who will have reams and reams of this, and they get their repeat prescriptions. That model can't survive. It's got to be about making sure that people are being compliant with their meds. Smart pills are one of the ways of monitoring that, ensuring that the drugs that are prescribed are actually having value. US Payer

What to expect

A detailed report exploring payer attitudes to digital health funding and the technologies that are helping to drive their value agenda

An examination of six key issues which Pharma needs to understand and respond to

28 targeted questions put to payer experts in Europe and the US

Their responses, which provided 43 current insights supported by 55 directly quoted comments

Expert contributors

The report harnesses critical frontline insights from senior payers who completely understand how digital technology can support them, and presents their views on how it can be funded. To ensure frank and open opinions were expressed we have agreed to keep their identities anonymous.

Clinical Lead, Digital Health Programme, UK

UK Payer

German Payer

Member of Drug Committee, Germany

Hospital Pharmacy Manager, Spain

US Payer

Pharmacy Director, US

Digital Health Expert, US

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1. Subject synopsis
2. Research methodology and objectives
2.1 Methodology
2.2 Objectives
3 Key insights summary
4 Issues and insights
4.1 What is digital health and who should pay for it?
4.1.1 Issue summary
4.1.2 Questions
4.1.3 Key insights Normalisation of digital technology Paying for different types of digital health Technologies that support the healthcare infrastructure
4.1.4 Supporting quotes Digital health benefits Who should pay for digital health? Digital healthcare infrastructure
4.1.5 Intelligence exhibits
4.1.6 Sources
4.2 The potential for smart drug delivery
4.2.1 Issue summary Smart pills Smart inhalers 3D printing technology
4.3 Questions
4.4 Key insight(s)
4.4.1 Payer views on smart pills
4.4.2 Payer views on smart inhalers
4.4.3 Payer views on 3D dose printing technologies
4.5 Supporting quotes
4.5.1 Smart drug delivery
4.5.2 The future for smart inhalers
4.5.3 Payer views on 3D dose printing
4.6 Intelligence exhibits
4.7 Sources
4.8 Medical-grade wearables and smart phones
4.8.1 Issue summary Continuous glucose monitoring in diabetes care
4.8.2 Questions
4.8.3 Key insights
4.8.4 Supporting quotes Diabetes care
4.8.5 Intelligence exhibits
4.8.6 Sources
5. Digital health challenges and opportunities
5.1 Data collection, storage and integration
5.1.1 Issue summary
5.1.2 Questions
5.1.3 Key insights
5.1.4 Supporting quotes
5.1.5 Intelligence exhibits
5.1.6 Sources
5.2 Novel business models and opportunities for collaboration
5.2.1 Issue summary
5.2.2 Question
5.2.3 Key insights
5.2.4 Supporting quotes
5.2.5 Intelligence exhibits Case Study: Pear Therapeutics’ prescription digital therapeutics
5.2.6 Sources
5.3 Managing the pace of digital health innovation
5.3.1 Issue summary
5.3.2 Questions
5.3.3 Key insights
5.3.4 Supporting quotes

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