Presentation (CTI)

OBJECTIVES: Wearable technologies monitoring physiological data are widely used by the public. However, wearables may not be accessible to individuals of all sociodemographic groups due to high costs and required technological literacy. We aimed to explore the acceptability of wearables, including medical devices, for remote monitoring by Health Technology Assessment (HTA) bodies, and the further potential of wearables.
METHODS: We conducted a focused evidence search of United Kingdom and EU4 HTA websites, clinical trial databases and published literature to identify and summarise the current and potential use of wearables in healthcare, challenges of obtaining reimbursement, and implications to patient access.
RESULTS: Precedents of wearable technologies currently implemented into healthcare systems were identified; continuous glucose monitors are widely utilised by patients with diabetes and transmit data to connected devices (e.g., smartphones). Other wearables have further potential that is not widely implemented in healthcare systems. There is evidence that wearables can predict painful crisis events for patients with sickle cell disease allowing proactive intervention to minimise the crisis event and prevent hospital admission. The HTA evaluation process for wearables differs across Europe with some countries (i.e., Italy and Spain) lacking appropriate reimbursement pathways. Heterogeneity in HTA evaluation processes and reimbursement drivers (e.g., cost-effectiveness) present as challenges for wearable reimbursement, which may restrict access for some patients.The future of wearables is promising, with digital endpoints measured using wearables increasingly being incorporated in clinical trials. Additionally, wearable designs may be tailored to specific to disease characteristics; improved technologies that measure movement disorder symptoms are undergoing investigation.
CONCLUSIONS: Wearables empower patients by promoting personalised healthcare and shared decision making. However, they often face challenges with reimbursement. Limited reimbursement may restrict wearable use for individuals of lower socioeconomic status, expanding health inequalities as only individuals who can pay will benefit from remote health monitoring.