Health Tech, Payers

In claims analysis, Pear finds digital therapeutic for opioid use disorder decreased medical costs  

In a review of real-world claims data, Pear Therapeutics found that its digital therapeutic for opioid use disorder resulted in a reduction in spending $2,150 per patient over six months.

Digital health startup Pear Therapeutics released the first real-world data showing its digital therapeutic for opioid use disorder decreased medical costs. The company received FDA clearance for its reSET-O product in 2018 to be used as a treatment for opioid use disorder in conjunction with medication.

Until now, the company had estimated the digital therapeutic’s cost effectiveness using modeled data.

“This is the first data looking at actual claims and real-world use,” Pear CEO Dr. Corey McCann said in a phone interview. “I think that establishing the cost effectiveness is an important part of the value proposition for any therapeutic — in particular, a digital therapeutic. “

The results were published in peer-reviewed journal Expert Review of Pharmacoeconomics & Outcomes Research on Wednesday. Pear funded and conducted the retrospective study, which evaluated 351 patients’ healthcare utilization up to six months before and after using reSET-O.  The majority, 82.6%, were covered through Medicaid.

Patients used reSET-O in conjunction with medication-assisted therapy, specifically, buprenorphine. They would interact with the app for about 40 to 50 minutes per week, which features modules focused on helping them understand their reasons for use and motivations for sobriety, as well as skills for managing triggers and harm reduction.

In total, researchers saw 1,181 fewer claims after using reSET-O, resulting in a savings of about $2,150 per patient. They saw 45 fewer inpatient visits, a significant decline, and 27 fewer emergency department visits, a less significant decrease. Patients used case management and rehabilitative services more frequently.

McCann said Pear has seen “a good deal of payer interest” in its programs, and was also in advanced conversations with state Medicaid organizations. Earlier this year, a bill was also introduced into the U.S. Senate to establish a benefit category for digital therapeutics under Medicare and Medicaid.

“We absolutely are using this data for conversations with employers, payers, and also state payers like Medicaid,” he said.

In the meantime, states are grappling with the “epidemic within the pandemic,” as opioid use has increased in recent months. As of late October, more than 40 states had reported increases in opioid-related deaths, according to the American Medical Association.

For many patients, what would have been face-to-face visits has shifted to telemedicine encounters. In some states, patients still face prior authorization hurdles to accessing care.

“The pandemic has really impacted them from both sides. While they’ve experienced a decrease in access to care, they also experience an increase in depression, anxiety and other triggering events,” McCann said. “I think that’s something that has gotten worse during the Covid era.”

Photo credit: Getty Images, photo_chaz

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