The Evolving German DiGA Market: Insights From a Claims Data Analysis

OBJECTIVES: With the introduction of digital health applications (DiGA), Germany took a pioneering step to implement digital therapeutics in the outpatient sector. This study aims to shed light on the evolving DiGA market in the statutory health insurance (SHI).

METHODS: Based on claims data of the largest German SHI fund, Techniker Krankenkasse (TK), we perform longitudinal analyses of DiGA prescriptions issued between October 2020 and June 2023. The analyses focus on usage patterns, market shares, costs, as well as prescriber and user characteristics.

RESULTS: During the observation period, 53 DiGA were listed in the reimbursement catalogue and considered in our analyses. By June 2023, 68,000 prescriptions were issued to about 69,000 individuals insured by the TK. This is equivalent to 0.6% of the total TK population (approx. 11.1 million). The cumulative market share of the ten most frequently used DiGA exceeds 75%. With a share of 30% of all prescriptions, mental health conditions are the predominant indication area, followed by muskuloskeletal diseases (19%), and endocrine, nutritional and metabolic diseases (16%). The mean growth rate of prescriptions issued per quarter since Q1/2021 is 21%. However, in three of the last five quarters of the observation period, the quarterly growth rates were far below 10%. Mean costs per prescription increased from €298 in Q4/2020 to €357 in Q2/2023. Increasingly available (lower) negotiated prices interrupted this trend only temporarily. Of all German outpatient physicians and psychotherapists, approx. 12% issued a DiGA prescription to TK-insured persons. 20% of these prescribers accounted for over 60% of prescriptions.

CONCLUSIONS: The relatively low reach and the high concentration of prescriptions on few applications and prescribers indicate that DiGA have not yet truly disrupted outpatient care. Despite this still early development stage and a growing number of reimbursable applications, the growth of the DiGA market has recently slowed.