Digital Therapeutics: The Future of Health Care Will Be App-Based


https://www.forbes.com/sites/eladnatanson/2017/07/24/digital-therapeutics-the-future-of-health-care-will-be-app-based/#797cc5b37637

Image result for clinical mobile applications

Last month, healthcare startup Omada Health secured a $50 million C round led by major insurer Cigna, which brings the 5-year-old company’s total funding to over $127 million.  That kind of nine-figure investment isn’t unusual for a company with the next blockbuster drug or game changing medical device, but Omada’s core product is a diabetes-preventing mobile app!  Omada is a leader in one of the hottest new sectors of the app economy: Digital Therapeutics.

Digital therapeutics are a new category of apps that help treat diseases by modifying patient behavior and providing remote monitoring to improve long-term health outcomes.  Depending on the disease, they can encourage patients to stick to diet and exercise programs or help them adhere to drug intake regimes.  Wait a minute, doesn’t that sound a lot like wellness apps?  There are already hundreds of apps that help us manage our workouts or meditate more effectively!

The key difference is that digital therapeutics implement treatment programs tailored to specific ailments, especially major chronic diseases like diabetes, heart disease, high blood pressure, and pulmonary diseases like COPD.  Because patient behavior is so crucial in preventing and limiting the severity of these life-threatening illnesses, the early evidence is that these digital health programs, often combined with human coaching/interaction, can make a significant difference in health outcomes.

To provide hard data of their efficacy (and differentiate themselves from wellness apps), newcomers like Omada have taken a page from the pharma industry and have performed clinical trials with major healthcare networks like Humana.  In recently published research, prediabetic patients that participated in a year-long  Omada-based program lost 7.5% of their initial body weight and showed improved glucose control and decreased cholesterol.

These results are one reason why health insurance firms are among the big investors in the leading startups.  Mobile app-based digital treatment programs can be delivered at massive scale and low cost, and by helping to prevent disease progression, can potentially save insurers billions of dollars.  On the other side of the equation, the prospect of health insurance covered recurring subscription revenues has VC’s salivating.   Omada proved early validation of this prospect when last year it got Medicare to agree to reimburse the cost of its digital diabetes prevention program.

Another reason the insurers are excited about the potential of mobile-delivered health programs is data.  Once clinical trials are complete, most pharmaceutical companies don’t track real-world results for their drugs.  With precise regimes and daily monitoring, digital therapeutics can offer mountains of data that can potentially provide doctors unprecedented insights into patient behavior and create feedback/optimization loops for individual patients.   Enabling patients to take greater control over managing their chronic illnesses and preventing disease progression could yield huge cost savings throughout the entire healthcare system.

Some digital therapeutics is meant to entirely replace medication with behavioral-based treatment, such as apps that use visualization exercises to help insomnia sufferers as an alternative to sleeping pills like Ambien.  Others are designed to work in conjunction with medications by helping patients better manage their treatment regimes.  A company that has taken this approach is Propeller Health, which makes a sensor that attaches to inhalers used by people who suffer from chronic asthma and COPD.  The sensor monitors inhaler usage and provides feedback via a mobile app.  Propeller has partnered with GlaxoSmithKline to create a digital therapy platform to guide patients in using its asthma medications.

Another innovative digital drug adherence platform is the one created by startup Proteus Digital Health.  Proteus has built an ingestible radio tag the size of a grain of sand.  It can be put inside a pill and can send data to a wearable patch on the patient’s torso.  For elder patients managing multiple chronic conditions with an array of daily medications, Proteus’ sensors and the app can send alerts to patients as well as family and primary care providers when a key dose has been missed.  Trials have shown that Proteus’ system has shown reductions in blood pressure among patients taking medication for hypertension.

From these examples, it becomes clearer to see how digital health programs, which can be tailored and optimized for individual patients and delivered at scale via mobile, represent a transformational development in healthcare.  As Andreessen Horowitz partner Vijay Pande calls it, digital therapeutics, by enabling the kind of behavioral meditation which is the only effective way of managing chronic illness, represent a true “third phase” of medicine, after small-molecule drugs and protein biologics.  I predict that someday, apps that help people manage illness and prevent long-term disease will no longer have a special name.  They will just be another form of software on our phones.  More than anything else, the rise of digital therapeutics demonstrates once again the power of mobile computing as the most transformational technology platform the world has ever seen.

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