OBJECTIVES

To outline a value framework for the contribution of digital health to overall disease management from multiple perspectives.

METHODS

A targeted literature review (TLR) explored the emergence of value frameworks in the context of key trends in digital health and disease management. Selection criteria: value frameworks, digital, connected, wearable(s), monitoring, intervention, prediction/predictive, analytics, outcomes, HRQOL.

A survey of payers (EU5. N=5 per market) was undertaken to externally validate hypotheses generated on the basis of the TLR, and to explore the implications of the insights for improving health outcomes and reducing burden of illness.

RESULTS

The TLR indicated:

• Healthcare is becoming more “connected” with multiple components - digital patient-level, real-world/real-time monitoring; software, algorithms, and apps informing interventions; and analytics predicting outcomes.
• Value Frameworks are becoming increasingly useful and important for structuring the value of holistic disease management

The payer survey confirmed:

• There is a perception of a disconnect between the health outcomes reported in randomized clinical trials and the outcomes seen in a “connected health” environment that embraces real-time monitoring, data informed intervention, and outcomes prediction
• Value contribution may be segmented in different ways:
  • Segmentation 1 based on 3 elements: MONITORING, INTERVENTION, and PREDICTION
  • Segmentation 2 based 3 outcomes: ECONOMIC, CLINICAL, and HUMANISTIC
  • Segmentation 3 based on 3 stakeholder groups: PATIENT, PAYER, and PHYSICIAN
• Payers see value in all 3 elements of the MIP paradigm but see potential ethical, legal, and regulatory challenges emerging from the intervention element

CONCLUSIONS

The MIP Value Framework resonated well with payers in this exploratory research. Further exploratory research is recommended with patients and physicians. For the framework to be used in clinical and health technology assessment consideration needs to be given to methodological and clinical validation.