Digital Sleep Therapeutic Would Save Costs for Payers, Employers, Analyses Find

Two new reports suggest that the use of prescription digital therapeutics (PDTs) for the treatment of chronic insomnia could lead to significant cost savings for both insurers and employers.

Both reports, presented at the Academy of Managed Care Pharmacy’s 2021 Virtual Meeting, pertain to Somryst, a digital application designed to improve symptoms of chronic insomnia by providing a version of cognitive behavioral therapy for insomnia (CBT-I). The program uses 6 lessons to teach patients exercises designed to address behaviors such as dysfunctional thought patterns and problematic nighttime routines, thereby improving the patient’s ability to sleep with limited disruption. The therapy has already been authorized by the FDA.

The first study looked at the cost-effectiveness of PDT versus existing treatment, such as CBT-I sessions with a therapist or taking prescription insomnia medications like suvorexant (Belsomra), zolpidem tartrate (Ambien), and available generic forms of common sleep medications.¹

The investigators found that Somryst was significantly more cost-effective than branded sleep medications, both from a health care payer perspective and from an employer perspective. Using a 3-year Markov model, the investigators determined the cost of PDT would be slightly more than that of CBT-I, but they said both methods were equally successful in treating patients’ insomnia. On the other hand, CBT-I was far more cost-effective than branded drugs, the investigators said. In some scenarios, PDT was also cost-effective compared to certain generics, depending on the willingness-to-pay threshold applied.

The second study was specifically focused on the budget impact of PDT, again analyzing budget both from the perspective of a health care payer and from an employer perspective.² Budget impacts were derived by calculating the estimated difference between the costs of caring for patients with chronic insomnia in a scenario where PDT were available and a scenario where it was not.

The investigators looked at total costs for a health care plan with 1 million members over a 3-year period. They found the 3-year cost impact of PDT was negative for both health care payers and employers when PDT were an available option for therapy. In other words, it led to budget savings of about $2.4 million for payers, while employers would save $2.5 million.

The budget impact on employers included indirect costs like rates of absenteeism. Per-member-per-month costs in the analysis were –$0.01, –$0.09, and –$0.19 over each of the 3 years (respectively) for payers and –$0.03, –$0.10, and –$0.21 for employers. On a per-patient-per-month basis, costs reached –$5.29 for payers and -$5.67 for employers, again translating to savings.

“The most influential variables were market share of the PDT, and cost and number of CBT-I sessions, with both high and low inputs showing net cost reductions,” wrote Fulton Velez, MD, MS, MBA, of Pear Therapeutics, the first author of both studies. Pear Therapeutics is the developer of Somryst.

Conversely, in a scenario where PDT took no market share from prescription insomnia medications, payers would end up paying $435,105 and employers would pay $321,167. Those costs translated to $0.04 per member per month for payers and $0.03 per member per month for employers.

References

1. Velez FF, Smith NJ, Morin CM, Malone D. Cost-effectiveness analysis of the first FDA-authorized prescription digital therapeutic (PDT) for the treatment of chronic insomnia. Presented at: AMCP 2021; April 12-16, 2021. Abstract F26.
2. Velez FF, Smith NJ, Morin CM, Malone D. Budget impact analysis of the first FDA-authorized, non-drug, prescription digital therapeutic for the treatment of chronic insomnia. Presented at: AMCP 2021; April 12-16, 2021. Abstract F27.