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Digital health applications complement medical care and rehabilitation in several European countries

Health apps are used as part of medical care. In Germany a doctor can prescribe an app for a patient in the same way as a medicine. Sitra has studied the use of digital therapeutics in Germany, France, Belgium, England and Catalonia in Spain.


Kirsi Suomalainen

Specialist, Communications and Public Affairs


Digital health applications are already used in some European countries in treating, managing and preventing diseases. Digital therapeutics are digital forms of care based on clinical evidence.

New digital therapeutics support such things as lifestyle changes. They may also be offered alongside medical treatment, for example for cancer. They often target under-treated or totally untreated conditions like diabetes, anxiety and insomnia. Many applications use gamification techniques.

Sitra has looked at how digital therapeutics are being used in Germany, France, Belgium, England and Catalonia in Spain. Germany is the most advanced, having developed a model in which more than 20 applications have already been approved for national reimbursement. In other countries, only a few or none have yet been approved for medical use.

In Germany, a doctor can prescribe a digital health app for a patient, and this will be reimbursed in the same way as medicines. What makes the model progressive is its clarity, speed and the direct link between approval and reimbursement. It also offers the possibility to gather evidence of the effectiveness of the solution in real patients. In autumn 2021, France announced that it would adopt the German model.

“At their best, digital therapeutics play an important role in patient care and rehabilitation. Healthcare professionals receive up-to-date information on the status of the patient so that they can react to any deterioration in the patient’s condition in a timely manner. For health services, digital therapeutics bring savings by supporting people’s wellbeing proactively, thus avoiding more expensive treatments,” says Johannes Ahlqvist an expert at Sitra.

Their uptake of digital therapeutics requires changes to be adopted both on the country and across Europe.

The use of digital therapeutics requires an assessment of applications before they are approved for use as part of care. Health apps need to be safe, easy to use, clinically proven, effective and integrated into existing healthcare systems.

Digital therapeutics offer new tools for the future of healthcare that will have an impact at all stages of healthcare path from health maintenance to disease treatment and rehabilitation. Their uptake requires changes to be adopted both on the country and across Europe. Sitra’s study proposes, among other things, the following measures:

  • Digital therapies should be taken into account in national healthcare reforms to become a seamless part of healthcare.
  • A transparent and clear process should be built for evaluating digital therapeutics. The evaluation should also allow for the granting of a temporary licence when there is a need to gather more data on the effectiveness of a new digital therapy.
  • The introduction of digital therapeutics is a major cultural change for healthcare and will affect the job description of care professions. This is an aspect that should be taken into consideration as the use of digital therapeutics increases.
  • Europe must enable the use of clinical evidence across national borders and build a common register of approved digital therapeutics.

Sitra’s working paper How can digital therapeutics help Europe? was published as part of the Health Data 2030 project, which aims to build solutions, fair rules and a bridge for cross-border use of health data in Europe, and to support the development of Finland’s competitiveness in the health sector.

From a Finnish perspective, digital therapeutics will be examined in more detail in a working paper to be published in early 2022. Sitra will also open a call for funding for digital therapeutics pilots in early 2022.

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