Despite potential to improve patient outcomes, adoption of digital therapeutics (DTx) in Europe is still relatively low, even in the most mature markets for digital health. In Germany for example, DiGA prescriptions are currently estimated to have reached 50,000 a year after the first DiGA approval. While this may seem like a large number, it is still limited in the context of a population of 83 million.
Healthcare professionals (HCPs) are recognized as central to DTx adoption, given the role they play in prescription (and/or influencing patient uptake) as well as the role they play in optimizing a patient’s care while using a DTx. To understand potential drivers and barriers to HCP adoption, ZS interviewed general practitioners (GPs) and specialists in the early adoption markets of Belgium, Germany, Sweden and the U.K.
This article is one of two that discuss our findings relating to DTx adoption barriers. In this first article, we will focus on unpacking lack of DTx awareness and exploring ways to overcome this. The second article focuses on the remaining adoption barriers uncovered in our research.
Physicians still don’t know enough about DTx
The majority of HCPs emphasized a lack of awareness regarding the availability and benefits of DTx. In general, there is a lack of knowledge around the efficacy of DTx, and whether these solutions have robust clinical trial data to support their use. This notion is even more prominent in markets that show higher levels of skepticism and conservatist attitudes toward digital technology (e.g., Germany and Belgium). More generally, lack of awareness is also more prominent in older HCPs, potentially reflecting a status-quo effect embedded through the lack of digital therapeutic integration within medical training programs of the past.
“The main barrier is a lack of knowledge of the digital therapeutics itself. Many of them are not known by us.”
What can companies do to increase awareness of DTx? For initial introduction to a new solution, the HCPs we interviewed still preferred in-person channels, such as rep calls or medically oriented meetings or seminars. This route may be most available for pharmaceutical companies that have developed or partnered on a DTx and have pre-established field forces which they can leverage. For these companies, it may be especially relevant to promote via the sales force when DTx are a companion to one of their pharmaceutical products.
Digital channels also have an important role to play, either out of necessity (if it would not be feasible or appropriate to leverage in-person channels) or luxury (to synergize with in-person engagement as part of an omnichannel approach). More mature digital health companies and pharmaceutical digital health teams are pursuing broader partnerships with health systems and companion organizations to further raise awareness. In the U.K., Boehringer Ingelheim has partnered with ORCHA to establish “The Digital Health Academy” offering courses to educate HCPs on the use of digital tools at both a foundational and disease-specific level.
Finally, some companies are adopting more direct-to-consumer approaches to create direct demand or indirectly raise awareness. Prescription DTx companies have leveraged digital front doors through telemedicine channels to create novel routes to patient-initiated prescription. For example, DocMorris Obesity Care is a digital hub in Germany that provides integrated care for people living with obesity. Patients are directed from the DocMorris digital hub to HCPs through Teleclinic, Germany’s largest telehealth providers, who in turn can prescribe digital therapies in obesity care and mental health (prescription of approved DiGA’s Selfapy and zanadio are provided during teleclinic consults).
Other companies (such as Kaia Health) have gone so far as to launch non-prescription consumer versions of their products, leveraging the user base, experience and data from the non-prescription product to gain broad brand awareness and capture a halo effect on their prescription digital therapeutic product.
The awareness barrier is likely to persist for some time, but our study has shown that it is not insurmountable. Pioneers need to be prepared to invest in promotion and education both at a product-specific but also at a product-agnostic level. The right strategy is likely to be dependent on the company, product and situation, but ideally involves an omnichannel approach to engage the breadth of the HCP universe and accommodate different beliefs and educational needs across HCP segments.
The barriers to broad digital therapeutics survey was internally commissioned and took place in Oct. 2021. The survey consisted of qualitative interviews conducted with 29 GPs and psychiatrists from four countries (Belgium: 6, Germany: 8, Sweden: 8, U.K.: 7).
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