Exploring Novel Uses for Prescription Digital Therapeutics in Mental Health

Panelists discuss how negative symptoms of schizophrenia differ from positive and cognitive symptoms, explaining that negative symptoms involve withdrawal, flat affect, and poverty of thought rather than the more visible hallucinations and delusions of positive symptoms.

Panelists discuss how negative symptoms create significant patient burden by appearing during the prodromal period in late adolescence and requiring a comprehensive biopsychosocial treatment approach that addresses biological, psychological, and social aspects of care.

Panelists discuss how the global shortage of psychiatrists contributes to patient burden by necessitating expanded training for other health care professionals, including nurse practitioners, physician assistants, primary care doctors, and law enforcement to recognize and manage schizophrenia symptoms.

Panelists discuss how prescription digital therapeutics can serve the psychological and social components of schizophrenia treatment while potentially improving medication adherence, similar to how digital monitoring tools enhance outcomes in other chronic conditions like diabetes and hypertension.

Panelists discuss how prescription digital therapeutics are currently used in clinical practice, noting that while none are yet approved for schizophrenia, CT-155 shows promise in phase 3 trials, and existing PDTs like Rejoyn for depression demonstrate the potential for technology-based interventions.

Panelists discuss how the CONVOKE clinical trial was designed as a 16-week study focusing specifically on patients with negative symptoms, incorporating patient input in app development and showing improvements in negative symptoms, depression, and cognitive function even in chronically ill patients.

Panelists discuss how prescription digital therapeutics will ideally be used in combination with traditional medications to provide optimal outcomes, particularly for patients hesitant about medication or those in early stages of illness where diagnostic certainty may be evolving.

Panelists discuss how schizophrenia imposes significant economic costs across direct medical expenses, nonmedical expenses, and indirect costs, with negative symptoms particularly amplifying the burden by reducing patient engagement, work capacity, and treatment adherence while increasing relapse risk and total cost of care.

Panelists discuss how prescription digital therapeutics differ from traditional pharmaceuticals by following FDA medical device approval pathways focused on clinical performance and safety rather than chemistry and manufacturing while offering potential economic value by extending behavioral health capacity to underserved populations, especially in rural areas with limited mental health professionals.

Panelists discuss how insurance coverage for prescription digital therapeutics remains uneven due to uncertain reimbursement pathways, lack of awareness among health care leaders, challenges in demonstrating cost-effectiveness, provider workflow concerns, and technical barriers including coding issues and limited electronic health record integration.

Panelists discuss how managed care organizations can leverage prescription digital therapeutics as cost-reduction tools to address quality metrics and offset financial impacts from health care policy changes while identifying education of providers about workflow impacts and value propositions as the biggest unmet need for wider adoption in mental health conditions.

Panelists discuss how physician assistants play an essential role in addressing the critical shortage of psychiatrists, particularly in rural areas, where 55% of US counties lack a single psychiatric provider and 143 million Americans live in psychiatric shortage areas.

Panelists discuss how negative symptoms like lack of motivation, social withdrawal, and impaired expression significantly impact patients’ ability to maintain relationships and employment, representing a challenging aspect of care with limited effective treatment options.