Why digital therapeutics are flourishing under COVID-19

Efficient distribution, dissipating stigma and an emphasis on decentralized trials are all working in favor of digital treatments, according to a panel of digital therapeutics executives and industry stakeholders.
By Dave Muoio
03:35 pm

The increased adoption of virtual care technologies during the COVID-19 public health emergency is fairly well documented by this point, but a widespread embrace of health technologies is providing a similar upswell on individual niches within the digital health landscape.

One such group of beneficiaries are the companies working to develop, validate and distribute digital therapeutics. Speaking in a virtual panel at the DTx East 2020 web conference, digital therapeutics executives and other industry stakeholders reaffirmed the increased demand for efficient and scalable treatments as providers find their services stretched thin, and patients find themselves cut off from in-person care.

"There's this open moment because of COVID where everyone is aligned. Patients are desperate and want solutions. Providers see that these walls are broken down, and they want to respond," Eddie Martucci, CEO of Akili Interactive, said this morning during a panel discussion. "Everyone understands that we have this taste of efficiency and rapid ability to serve the patient, and we're seeing it happen in real time. I certainly hope that pace cements itself and doesn't recede."

Many of the sector's old hands have been "fighting this kind of good battle" to prove to convince the healthcare industry – providers, payers and pharmas alike – that effective treatments can be delivered through a digital screen, Click Therapeutics CEO David Klein said. As such, the onset of COVID-19 has been "bittersweet" for digital therapeutics advocates in that the emergency health crisis has yielded a near-perfect environment for these treatments to win over industry stakeholders.

"Six months ago, with COVID hitting, what's really happened is that the stigma around being able to treat people digitally has almost been completely removed," he said. "Outside of everything else, people's thought processes around 'Can you treat people digitally?' have been much more favorable in our space than in the past."

A key part of this shift has been made up by the needs of the consumer, Dr. Liz Kwo, medical director of digital and staff VP of clinical data analytics at Anthem, said. Similar to telehealth, these patients will increasingly view digital health tools as a convenient and timely resource when traditional options are limited.

"Improvement of self-care with isolated patients using digital therapeutics is bound to come," she said. "Home healthcare is going to be a big thing."

Peter Hames, CEO of Big Health, said that his company has already been seeing these trends among U.S. and U.K. consumers alike. In many cases, these consumers aren't looking for tools that strictly resemble traditional care, but for those that are appealing and have a low barrier to entry.

"[Patients] just want a solution to their problem. They don't care what it's called. They don't care whether it feels like a white-coat-style experience. They just want help in a way that fits in their life, and I think what COVID has done is made everything have to come to the individual," he said. "Everything is happening in the context of a person's life at home, ... so it's almost a perfect environment for digital therapeutics to draw on different disciplines to come up with ... the ideal solution in that new context."

Aside from the accessibility advantages, Big Health, Click Therapeutics, Akili and several other digital therapeutics companies have also seen new interest as a result of the conditions they've chosen to tackle, Martucci said. Mental health, psychiatric conditions and cognitive impairments have long been subject to stigma, but are more present in the mainstream than ever due to pandemic distress.

"These have been kind of quiet conditions that have needed so much patient advocacy and so much change in our thinking to destigmatize," he said. "What COVID has done is made it front-and-center for all of us. You don't see articles anymore questioning 'Is there a mental health crisis?' You see articles now saying 'There is a mental health issue and we're all experiencing it,' because every one of us is at a new level of anxiety."

While all of these factors are helping digital therapeutics companies get their existing treatments into patients' hands, COVID-19's repercussions could also benefit the development and validation of new digital treatments, the panel noted.

While traditional clinical trial designs are facing enrollment difficulties, decentralized and remote clinical trial designs embraced by many digital health researchers are seeing unprecedented enrollment, Hames said.

"Far from being a problem, we see it as a big, juicy opportunity to accelerate what was already successful," he said. "We were already using social media, digital means to enroll. And now that everyone's focus is on digital, being trapped in their homes and isolated, we're actually seeing much higher enrollment rates through those channels than we had previously."

What's more, successful decentralized trials are no longer exclusive to dedicated platforms or digital therapeutics startups with funding to spare, Martucci said. Rather, he said that he's heard of "three or four" digital therapeutics companies that are, for the first time, initiating remote trials of their products all on their own.

"Investment is always one of the barriers, ... and the second is always rules and logistics, and a little bit of fear, honestly, that you're going to do something wrong and misstep," he said. "A lot of these old antiquated paradigms where you focus on risk aversion, we're kind of breaking down those barriers really quickly, so I think it's allowing entrants to feel comfortable with a small investment jumping into [an] even smaller remote trial. That's a really good thing."

Whether or not these in-house remote trials will be robust enough to meet the FDA's regulatory requirements is still "a question for the future," he noted. However, an opportunity to collect hard clinical evidence and make a case to stakeholders is certain to benefit up-and-coming digital therapeutics players.

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