OBJECTIVES: This analysis examined the impact of a prescription digital therapeutic (PDT) for treating chronic insomnia (Somryst^®) on healthcare resource use (HCRU) by comparing patients treated with digital cognitive behavioral therapy for insomnia (dCBTi) to patients not treated with dCBTi, but with insomnia medications.

METHODS: A retrospective health claims data analysis was conducted in two cohorts across the United States: patients registered for dCBTi between 1 June 2016 and 31 October 2018 vs. patients not registered for dCBTi who received medication for insomnia (controls). Observation period was 16-24 months. Incidence rates for HCRU encounter type were calculated using a negative binomial model for both cohorts. Costs were estimated by multiplying HCRU by published average costs.

RESULTS: Evaluated were 248 dCBTi patients (median age 56.5 years, 57.3% female, 52.4% treated with sleep-related medications) and 248 matched controls (median age 55.0 years, 56.0% female, 100.0% treated with sleep-related medications). 24 months post-initiation, dCBTi patients had significantly lower incidence of hospitalizations (55% lower, IRR: 0.45; 95% CI: 0.28-0.73; P=0.001), emergency department (ED) visits (59% lower; IRR: 0.41; 95% CI: 0.27-0.63; P<0.001); and hospital outpatient visits (36% lower; IRR: 0.64; 95% CI: 0.49-0.82; P<0.001). Use of sleep medications was more than four times greater in controls vs. dCBTi patients, with 9.6 (95% CI: 7.88-11.76) and 2.4 (95% CI: 1.91-2.95) prescriptions/patient, respectively (P<0.001). All-cause per-patient HCRU costs were $8,202 lower over 24 months for dCBTi patients vs. controls. Number needed to treat (NNT) with dCBTi (instead of the control) for one additional patient to not have a hospitalization or an ED visit was 6.

CONCLUSIONS: Patients with chronic insomnia treated with a PDT delivering CBTi had durable real-world reductions in health care resource use compared to matched controls, with per-patient cost savings over 24 months of $8,202.