OBJECTIVES: Digital health applications (DiGA) in Germany, introduced in 2019, have been gaining physician and patient acceptance with prescriptions tripling to ~125,000 between 2021 and 2022. Purpose of this analysis was to evaluate pricing trends of all available DiGAs in Germany since inception and identify differences in initial manufacturer price vs final negotiated price.

METHODS: All the assessments listed on DiGA directory were reviewed individually to extract relevant information such as the DiGA name, indication, therapy area, technology platform, manufacturer’s price and negotiated price as on 15 June 2023. Price differential calculations were conducted where both manufacturer and negotiated prices are available to identify discount percentages.

RESULTS: As of June 2023, a total of 47 DiGAs are available for prescription and listed on the DiGA directory. 18 DiGAs are permanently listed while 29 are provisionally listed. Six DiGAs have been removed from the directory to date predominantly due to no positive health benefit. Out of 47 DiGAs listed, negotiated prices are available for 20 applications. For the majority (80%) of DiGAs, negotiated price was lower than initial manufacturer price with an exception of 4 DiGAs (20%). An average of ~47% decrease in negotiated price was observed compared to manufacturer’s initial price. Despite provisional listing of DiGAs in the directory, payer organizations, are critical of the high initial free price set by manufacturers.

CONCLUSIONS: Germany, although being a pioneer in the reimbursement of digital health applications, is increasingly not accepting the higher free price of DiGAs. Manufacturers of these technologies need to have early dialogue with payers to evaluate and align on the evidence requirements and appropriate price comparator for their DiGA to avoid lengthy negotiations and significant price cuts.