Are Current Reimbursement Options for Opioid Use Disorder DTx Causing a Barrier to Widespread Adoption in the USA?

November 09, 2021

In 2020, Trinity assessed three applications developed to treat Opioid Use Disorders (OUD) (e.g., reSET-O, Connections, DynamiCare) through the lens of ICER conducting a cost-effectiveness evaluation. Only a year later, several more health tech startups have adopted a preventative outlook and seek to address chronic pain with digital health tools (e.g., phone applications). A key focal point is the current public health issue faced by the US with ~2.1 million Americans diagnosed with OUD.

These applications, including Clearing, Curable, Remedee Labs, Swing Therapeutics and AppliedVR, seek to proactively reduce the number of patients using painkillers to address chronic pain through a diverse range of techniques, from biopsychosocial methods to electromagnetic waves. When looking at each tool’s revenue model, they all rely on a long-term subscription, but insurance reimbursement differs significantly between products and their components, potentially posing a barrier to widespread adoption.

As these applications seek insurance reimbursement, we anticipate real-world evidence proving efficacy and downstream cost offsets to be pivotal for success.

By Crystal Zhao and Kate Watkins