Optimizing Benefit Design and Implementation for Improved PDT Access

Author(s):

Robert O'Brien, RPh,Diana Brixner, PhD

Panelists explore how payers choose between pharmacy and medical benefit designs for covering prescription digital therapeutics (PDTs), optimizing patient access and adoption, and discussing why the selected pathway was considered optimal for a specific PDT.

EP: 1.Differentiating PDTs from Wellness Apps and Evaluating Efficacy

EP: 2.Payer Needs and Strategies for Evaluating and Covering PDTs

EP: 3.Payers Review Process and Effective Strategies for PDT Coverage

EP: 4.Stakeholder Involvement and Evidence Requirements for PDT Coverage Decisions

EP: 5.Dawn of the Age of Adopting PDTs

EP: 6.Identifying the Most Impactful Disease Areas and Patient Populations for PDTs

EP: 7.Evolving Commercialization and Distribution Models for PDTs

EP: 8.Promoting Appropriate PDT Prescribing Through Provider Education and Support

EP: 9.Optimizing Provider Education, Utilization Monitoring, and Value-Based Contracts for PDTs

Now Viewing

EP: 10.Optimizing Benefit Design and Implementation for Improved PDT Access

EP: 11.PDTs' Role in Addressing Health Care Disparities and Priorities for Improving PDT Access

Video content above is prompted by the following questions:

How do payers determine the optimal pharmacy vs. medical benefit design to cover prescription digital therapeutics (PDTs) to enhance patient access and adoption?
- What factors and considerations went into the decision to cover a particular PDT through the pharmacy benefit versus the medical benefit, and why was that pathway determined to be optimal for that specific PDT?
What characteristics and factors did Mass Health consider when selecting clinics to prescribe and implement the use of prescription digital therapeutics?