The Role and Value of Prescription Digital Therapeutics in Behavioral Disorders - Episode 10
Our experts conclude by interpreting ways to better educate both payers and providers on PDTs.
Arwen Podesta, MD: My peers in psychiatry, those in behavioral health, and nurse practitioner PAs [physician assistants] that are prescribers don't have access to knowledge on digital therapeutics at this time. It's not what we have been taught, and it's been minimal at conferences. Only a small subset of folks go to conferences. If they do, they might go to different conferences for various reasons and different locations. There is a marketing strategy to get information about PDTs [prescription digital therapeutics] out there for the prescribers. One way would be to offer not just an in-service because we don't have time for in-services, but how we can relieve this pressure point where we feel stuck. We don't have a therapist that I can refer someone to, but I know my patient needs a therapist. We feel stuck. Why not have some very light in-service [therapy] with information about all PDTs and how to access them? I know my medical students and residents want to know what the experience is. I know some of the companies offer a 4-week demo on-screen, but let's upload it to my phone so I can look at it, process it, and do what the patient is going to do. It gives you a better insight. That's a place to look to, residencies and medical schools, so that we can get the language going. This is a necessary part of our future of treatment. We need the up-and-coming wave of providers to know the language.
Psychiatrists, addiction, depression, attention deficit, even irritable bowel, post-traumatic stress, substance, insomnia—those are such high-need areas, and patients are miserable. Patients are suffering and struggling, and we can only offer so much. Our tools don't fix everything; [our] tools really get to less than 75 to even 60% of treatment successes. We need to add more [and] use everything that we can to make it sustainable. These PDTs that are out there so far [are] FDA authorized, and the ones coming down the pipeline [are] authorized for a reason because they're effective and have few-to-no adverse events. I don't know a single prescriber that wouldn't want durable long-term treatment of these disorders so patients are no longer suffering.
Diana Brixner, RPh, PhD: There's a lot of confusion, myself included, of understanding the difference between a health care patient support app that you can readily access and a prescription digital therapeutic. I'll address the patient education first. Patients need to understand that they're going to access the PDT as they would any type of pharmaceutical therapy through insurance, coverage, the health care system, and that it has been demonstrated and approved by the FDA to help them in a certain area. There's a role for patient education. There's a role similar to that for payer education, to understand that I'm being asked to cover a PDT, and there's a cost associated with a PDT; the reasons for that are because this PDT went through a development process [that is] very similar to a pharmaceutical trial, presenting to the FDA [to get] approval [so] the patient and the provider can feel more confident that there is an expected outcome of utilization of this PDT. Providers in a health care system also need to be aware that the PDT is an option, particularly the gatekeeper or the primary care provider. One of the first providers to see the patient when they're in trouble need an intervention to know that's an option. Yes, they can receive a prescription drug. Yes, they can be referred to a behavioral health therapist, but there is also this new option of a prescription digital therapeutic. There is an unmet need that PDTs could address.
This transcript has been edited for clarity.