OBJECTIVES: The broad scope of Digital Health Technologies (DHTs) comprises a range of products including apps and online platforms. Evaluating DHTs and their potential benefits is challenging because they are rapidly developed and updated; consequently, there is generally less or lower quality evidence available. Since 2008, the National Institute for Health and Care Excellence (NICE) has worked with NHS England to assess digital therapies that follow NICE recommendations and address conditions managed by the Improving Access to Psychological Therapies (IAPT) programme. Here we review decisions for DHTs under the IAPT programme in England and consider strategies to overcome barriers to patient access.

METHODS: A pragmatic search of the NICE website was conducted to identify DHTs assessed under the IAPT up to June 2020. Recommendations and comments on the evidence presented were extracted.

RESULTS: In total, 14 DHTs were assessed; nine were not recommended, five were recommended for evaluation in practice and one had already been evaluated in practice. All were online programmes, with one available as an app. Levels of evidence varied, with most DHTs investigated by a small number of randomised controlled trials and observational studies. Few DHTs had robust economic evidence, with only one DHT presenting cost-effectiveness data. Challenges arose regarding quality of evidence with criticisms that some trials failed to reflect use of the DHT in clinical practice in England, in addition to a highlighted lack of comparative evidence (versus standard of care), and an absence of relevant economic data.

CONCLUSIONS: DHTs have the potential to reach patients for whom face-to-face therapies are inaccessible. Despite implementation of NICE’s Evidence Framework for DHTs in 2018, established HTA processes remain a barrier for patient access to DHTs. NICE could accelerate patient access by introducing managed access agreements pending submission of real-world data relevant to IAPT patients in England.