Two stakeholders involved in the investment and development of behavioral care services discuss the potential of digital therapy as a cost-effective alternative to address unmet mental health needs during an AHIP 2022 session.
The growing mental health crisis in the United States has seen a substantial increase increase in demand and spending for behavioral care services, with a Estimate 1 in 4 Americans prescribed medication to help them cope with stress, anxiety, or depression.
Despite market innovations, stakeholders at a session at AHIP 2022 discussed how the fragmented mental health care system continues to perpetuate barriers to care (cost, accessibility, stigma, etc.) and prevents patients in across the country get the care they need. The role of prescription digital therapies (PDT) was further discussed as a cost-effective alternative to standard care options of psychotherapy and prescription medication, the latter of which has significant adverse effects and overdose risks
“Payers and health systems trying to solve the [access] gap, build more networks, and yet the supply challenge still exists. We also know that payers and health systems are taking risks, going out of network, and that cost becomes incredibly high. The challenges for the patient: that’s great, I have access to a therapist, but there’s a 3-month waiting list. Or worse, I have social determinants of health, so how would I get there? said Gabriella Pérez, commercial director of Big Health.
As a former managing partner of Kaiser Permanente Ventures, Liz Rockett, MBA, MPH, venture partner at Unseen Capital, noted that hedging strategies to address mental health have changed dramatically in the United States over the last two decades, but there remains a substantial bottleneck. in the demand and supply of mental health providers.
“Anyone within health plans or systems knows that a lot of our providers’ time in behavioral health has been identifying which drug to focus on and then weighing that drug. And there’s a large part of our patient population who would rather not take medication or may have been on medication for so long that it’s not really safe for them to continue medication,” Rockett said. “We need to think more creatively about what kinds of approaches people can access.”
Described as a safe and effective drug-free alternative for the most common mental health conditions, Perez said that PDTs are a new category of clinical grade that have produced superior results compared to any other mental health treatment on the market today. His organization, Big Health, has designed 2 PDTs for insomnia and anxiety called Sleepio and Daylight, respectively.
“How does it work [is] we retrain your brain through personalized programs that tailor and implement precision formulary treatment for the unique individual, and this interactive treatment enables you to achieve remission and is delivered through an application at scale,” explained Pérez.
Listed in 4 clinical guidelines in the United States, including the American Psychological Association, as a first-line behavioral health treatment, Big Health’s approach to care addresses the 4 P’s: personalized, participatory, predictive and preventive.
“We are attached to the form,” Pérez explained. “We are a claim, available for individual uses, and we put all our rates at risk.”
Rockett noted that her initial fear as an early investor in the digital therapy space was whether efficiency and outcomes would be prioritized in the marketing and distribution of care services, particularly in the mental health industry, which remains at a crossroads regarding the need for evidence-based metrics. .
“As buyers, we should demand that because it will bring the entire industry to the level that we want to see and deliver to our members and patients. Thinking about accessibility, thinking about what is going to attract people and what is going to engage our patients or members. But also, does it fit into your operations?”
Specifically for mental health care advocacy and outreach, Rockett said more attention is being paid to integrating care services into provider contracting and drug channels. The availability of these metrics reduces the burden for health plans and employers to determine who needs these interventions and where they should go, and instead allows for the natural interest of provider populations seeking to prescribe these services, he added.
“As we set our standards for what we’re looking for to help us act on the mental health access challenge, these are some of the things we can really demand right now, and again, get the entire industry to step up. for that challenge,” he said.
As an industry leader in research and randomized controlled trials, Big Health’s research on Sleepio led to its recommendation by the National Institute for Health and Care Excellence as an alternative to sleeping pills for patients with insomnia. Additional research is underway to determine the effectiveness of Sleepio and Daylight in patients with comorbidities such as cancer and stroke.
“We know that a mother and child who are not treated for perinatal depression cost $30,000 more than those mothers who receive anxiety support. Follow the money, follow the claims to see long-term savings and impact on claims. What matters? We are in the risky business of managing dollars; we should not be in the business of caring for the sick, but in the prevention of well-being and doing the right thing,” Pérez said.
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