Results could help build case for insurance coverage for prescription digital therapeutics
“In a new report, the Peterson Health Technology Institute (PHTI) finds that Rejoyn, an app for depression from Otsuka Precision Health, and DaylightRx, an app for anxiety from Big Health, warrant further adoption because their clinical trials show strong evidence of benefits. Both apps are intended to be used alongside ongoing mental health treatment, and in most cases, the institute found the apps will save money. PHTI was founded in 2023 with $50 million to conduct independent evaluations of health technology. Its findings, both positive and negative, have ruffled feathers in the industry, and have been cited by lobbyists, investors, and marketers.
The report’s economic analysis includes the price of the products and the cost savings from any improvement in symptoms. For example, because the evidence suggests that a person’s anxiety symptoms will improve after using DaylightRx, the report takes into account how much less that person’s health care will cost as a result. The report estimates that DaylightRx and Rejoyn will save $363 per user with commercial insurance and $78 per user on Medicare. The report concludes the treatments will increase Medicaid costs by $33 per user. Because the report is designed for purchasers, like insurers, it goes on to estimate the savings per population of 1 million users, assuming only a fraction enroll in the apps. For example, it arrives at $8.7 million in savings per 1 million commercial members. [..]
The economics vary depending on how much the apps actually cost. Using recently created Medicare reimbursement for mental health apps as a guide, PHTI assumes providers will be reimbursed $200 for supplying the apps to their patients and $80 for reviewing data and other services related to the apps. The model assumes that people will not receive multiple prescriptions for the same app and that clinical benefits will last for a year.
According to PHTI’s calculations, Medicare breaks even when it pays providers $270 to offer an app. For users on commercial insurance, the apps still save money at a price of $400, which PHTI determined was the high end of prices.”
From the PTHI report: “[..] for people not otherwise receiving psychotherapy, virtual solutions that
incorporate digital content make it more likely that patients will achieve clinically meaningful improvements in depression—and to a more limited extent anxiety—compared with control arms. On average, users improved depression scores by approximately 7 points relative to baseline, which is 3.9 points more than controls. Given the significant barriers to accessing traditional psychotherapy—including cost, provider shortages, geographic limitations, and stigma—such digital content may help address a critical gap in mental healthcare delivery.
For patients receiving usual care (typically including a mix of medication and therapy) for their mental health needs, adding digital content produces only small incremental improvements in depression symptoms that do not achieve MCID [minimal clinically important difference] in most studies. On average, users improved depression scores by 4.9 points over baseline, which is only 2.1 points more than controls. The depression benefits appear more pronounced for patients with more severe baseline symptoms, suggesting that targeting these solutions to appropriate patient populations may enhance their clinical impact. For anxiety, digital content performs comparably to usual care.”
Full article, M Aguilar, STAT+, 2025.5.20