Utilization of Digital Health Applications (DiGAs) in Cancer Treatment in Germany

OBJECTIVES: Globally, there has been an increasing use of digital health technologies in cancer care aspects such as screening, patient education, decision-making, symptom monitoring and psychological support. As Germany has been a frontrunner in bringing access to digitized healthcare to its citizens, we aimed to systematically evaluate the current range and accessibility of DiGA designed for cancer support in the country.

METHODS: The DiGA directory was searched for cancer-support apps that have been listed after Federal Institute for Drugs and Medical Devices (BfArM) assessment and were reviewed. Parameters related to the scope of the DiGA, the evidence submitted, and unmet needs were analyzed.

RESULTS: Among the plethora of DiGAs available to support chronic illnesses, very few cater to patients suffering from cancer. A total of five DiGAs were listed in the BfArM directory, of which four apps were indicated for breast cancer support. Only one of the five apps, PINK! Coach®, was permanently recorded, while two, optimune® and Untire®, received provisional admission. The core premise of these cancer care apps is to provide psychosomatic care and cognitive behavioral therapy (CBT) for breast cancer patients and survivors. All three apps submitted clinical evidence from randomized controlled trials. Demonstrating a statistically significant advantage over the control arm was the key factor for permanent recording as a DiGA, while demonstrating a certain advantage resulted in provisional admission.

CONCLUSIONS: Despite significant advancements in the digitization of healthcare in Germany, there was a limited range of approved DiGA specifically designed for cancer support. With the available DiGA primarily focused on psychosomatic care and CBT in breast cancer, the scarcity of options highlights a gap in the digital healthcare landscape for a broader spectrum of cancer-related needs.