CVS Health kicks off digital health-friendly service for PBM clients with Big Health’s Sleepio

The announcement is yet another milestone on the road to adoption and reimbursement of digital therapies, Big Health CEO Peter Hames said.
By Dave Muoio
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Yesterday, CVS Health unveiled Vendor Benefit Management, a new service that will help CVS Caremark pharmacy benefit management (PBM) clients roll out and manage third-party health products.

As the service is applicable to both digital and non-digital health and wellness products, the company has decided to inaugurate its initiative by announcing Big Health — maker of the CBT-based sleep app Sleepio — as the first vendor participating in the service.

"Given that poor-quality sleep and insomnia affect approximately 30 percent of adults, and is a condition that can impact a wide variety of mental health conditions, we are pleased to be working with Big Health to help make their digital therapeutic product, Sleepio, more accessible," Dr. Troyen A. Brennan, chief medical officer at CVS Health, said in a statement. "Big Health's commitment to clinical evaluation and research aligns with our focus on applying evidence-based medicine to provide our clients and their members with access to appropriate health solutions and services, and many of our clients are interested in adopting this platform to help increase member access to these types of solutions, including Sleepio."

According to the announcement, Vendor Benefit Management will help PBM clients access negotiated pricing, real-time and standardized member eligibility verification, easy billing and payment processing, and standardized result reports for supported vendors and products. Designed as an open platform that will support a range of vendors and products, CVS Health said it will be looking to smoking cessation and substance abuse support, medication adherence, care management and benefit navigation products as potential additions to the service down the road.

WHY IT MATTERS

For Big Health CEO Peter Hames, the inclusion of his company’s digital product is another stepping stone on the way to broader adoption and reimbursement of digital therapeutics.

“The challenge is not just in developing [digital] products — we now have very effective products — but how do we distribute and gain reimbursements for those products in a very, very scalable way, in a way that allows not just the really early adopters to buy and then offer to their populations?” Hames asked MobiHealthNews. “What this partnership with CVS offers, specifically in the context of digital therapeutics, is a new pathway to facilitate that mainstream adoption of a digital therapeutic.”

Sleepio, Hames explained, has been deployed for several years and has a clear body of evidence supporting its effectiveness. This was a major factor toward winning the support of a healthcare company with the clout of CVS Health, and provides an incentive for other digital health companies seeking major support to spend the time and effort validating their products.

“If we are serious as an industry about really fulfilling our potential to offer a real mainstream modality of healthcare, we have to be held and hold ourselves accountable to exactly the same high bar that any other domain of therapeutic would be held to,” he said. “In my view, that’s absolutely critical. The prospect is that in three to five years time they’re not digital therapeutics, they’re just therapeutics.”

THE LARGER TREND

It was less than a month ago that digital therapeutics earned a vote of confidence from another PBM when Express Scripts announced the release of a stand-alone digital health formulary. This tool requires digital health devices or software to undergo review by physicians, pharmacists and other experts to prove their outcomes, value, usability and security.

Meanwhile, the calls for digital therapeutic validation have been growing louder and louder, with providers and industry members alike looking to establish accountability across the heterogeneous landscape of digital health. New partnerships with established pharma players has earned some of these novel treatments recognition and a path to market, although such collaborations are not always without their challenges.