OBJECTIVES: Digital therapeutics which are primarily used to prevent, manage, and treat disease, offer new ways to deliver and receive health care and represent a growing range of potential products. An FDA-authorized medical device EndeavorRx (EndRx) is an ADHD Treatment for children 8 to 12 years old, delivered through a video game on mobile devices. A simulation model was developed to estimate the expected cost of EndRx when incorporated into standard care which includes stimulants (Stim) and CBT.

METHODS: A decision tree model was developed with a 1-year time horizon from the payer perspective. Six treatment arms were included: EndRx, Stim, EndRx+Stim, Stim+CBT, Stim with the addition of EndRx, Stim and switch to a branded Stim. Billed charge data was taken from the New Hampshire All-Payer Claims database. Rates for Stim success and switching was based on the literature. Generic pricing for Stim was used unless there was a switch to a branded Stim.

RESULTS: A probabilistic sensitivity analysis of 10,000 iterations resulted in the following expected cost means and [95% CI] for each arm: EndRx $2050 [$2042, $2058], Stim $2878 [$2857, $2901], EndRx + Stim $4387 [$4363, $4411], Stim+ CBT $5507 [$5471, $5543], generic stim add EndRx $2869 [$2855, $2883], generic stim switch to branded stim$2862 [$2840, $2885].

CONCLUSIONS: In all scenarios evaluated, EndRx resulted in either cost savings or similar costs as was the case when comparing a generic stimulant switch to a branded stimulant ($2862) or adding EndRx to a generic stimulant ($2869). EndRx provides patients, prescribers and payers another option for treating ADHD in children without increasing costs or concern of side effects as with stimulants.