Maximising Economic Value in Digital Therapeutics

Digital therapeutics (DTx), a category of software-driven medical interventions, offer significant promise in addressing chronic and mental health conditions. Yet despite their clinical potential, questions surrounding their economic value remain a barrier to widespread adoption. A recent group concept mapping (GCM) study involving diverse stakeholders—researchers, industry, healthcare professionals and public sector representatives—identified 59 factors across eight clusters that influence the economic value of DTx. While clusters such as patient outcomes and implementation ranked highest in importance, others, like associated costs and monetisation models, were consistently underconsidered in practice. This misalignment reveals critical opportunities to strengthen the economic foundations of DTx and support broader health system integration. 

Stakeholder Perspectives and Lifecycle Phases 
The development and deployment of DTx span multiple lifecycle phases, each shaped by different stakeholder roles. The GCM study identified three temporal themes across the eight clusters: early development, preimplementation and deployment. Each phase encompasses factors ranging from clinical validation to market fit and system integration. Researchers, often active in early development, tend to focus more on clinical validation methods, while public and industry stakeholders are more involved in deployment and monetisation. 

Differences in perspective emerge clearly in the prioritisation of clusters. Public stakeholders rated technology considerations and healthcare system impact highly, reflecting their concern for regulatory compliance, data security and systemic cost implications. In contrast, industry stakeholders ranked these lower, indicating a stronger focus on market alignment and commercial viability. Meanwhile, researchers—despite acknowledging the importance of costs and monetisation—rated them as significantly underconsidered in their practice, perhaps due to their early-stage focus and separation from financial planning processes. 

These discrepancies illustrate how each group’s roles and responsibilities shape their perception of DTx value. However, the lack of convergence on certain critical economic factors may impede successful adoption, as it limits the holistic integration of DTx into healthcare ecosystems.

Unpacking the Underconsidered Priority Clusters 
Among the most striking findings of the study is the presence of several high-importance but underconsidered clusters: DTx Implementation, Monetisation Models and Associated Costs. Despite being widely acknowledged as crucial to DTx success, these areas receive insufficient attention in practice, particularly from researchers. This gap suggests that while stakeholders recognise their importance in theory, operationalisation remains a challenge. 

For example, implementation factors—such as healthcare workforce readiness, patient education and integration into care pathways—are central to ensuring real-world uptake and sustained use. Yet these factors often fall outside the direct remit of product developers or early-stage researchers. Similarly, monetisation strategies, including pricing models and reimbursement pathways, are critical for sustainability but are rarely embedded in the early stages of DTx design. Without early consideration, developers risk misalignment with payer expectations and reduced commercial viability. 

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The cluster on associated costs, including ongoing maintenance, indirect costs and out-of-pocket expenses for patients, revealed the highest divergence in ratings. Researchers scored this cluster particularly low, even though failing to address these costs upfront could compromise reimbursement decisions and long-term adoption. This highlights a disconnect between the generation of evidence and the real-world conditions under which DTx are evaluated and deployed. 

Towards a Shared Framework for Economic Value 
To address these misalignments, the study proposed a conceptual framework that maps the perceived importance of each factor against the extent of its practical consideration. Using a quadrant analysis, the framework helps visualise priority areas where stakeholder focus should be realigned. Of particular interest is Quadrant II, which identifies clusters that are perceived as important but receive low attention in practice. This quadrant contains actionable insights: if stakeholders collectively prioritise these overlooked factors, they can enhance the economic case for DTx. 

A deeper analysis of the individual factors within this quadrant points to systemic issues. Factors such as the cost of patient education, indirect financial burdens and the local healthcare context influence the affordability and effectiveness of DTx but are often overshadowed by more tangible clinical concerns. Addressing these areas requires cross-functional collaboration. For instance, researchers could work with commercial teams and policymakers earlier in the lifecycle to ensure their innovations align with reimbursement frameworks and market needs. 

The study further recommends fostering public-private partnerships to integrate commercial expertise into DTx development. By embedding considerations of market fit, pricing and scalability from the outset, innovations from academic or public research institutions may be better positioned for successful commercialisation. This holistic approach would ensure that clinical efficacy is complemented by economic viability, enhancing the chances of DTx achieving broader uptake and sustained use. 

Digital therapeutics are set to transform healthcare delivery, but their long-term success depends on demonstrating not just clinical value but also economic viability. The GCM study reveals that while stakeholders understand the broad contours of what makes a DTx valuable, they often fall short in aligning their actions with this understanding. Priority areas such as implementation logistics, monetisation and cost structures are crucial but consistently underconsidered, especially in the early stages of development. 

Bridging this gap calls for a shared framework that encourages stakeholders to reassess their roles and responsibilities throughout the DTx lifecycle. By prioritising cross-sector collaboration and embedding economic considerations into early development, stakeholders can help ensure that digital therapeutics are both clinically effective and economically sustainable. This shift will be essential in realising the full potential of DTx within increasingly resource-constrained healthcare systems. 

Source: npj digital medicine 

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