OBJECTIVES: To review US payer coverage of approved digital health technologies (DHTs) to better understand the likely evolution of payer evidence needs with continued growth in the space.

METHODS: Coverage information of DHTs by public payers, commercial insurers, pharmacies, and Pharmacy Benefit Managers (PBMs) was obtained in a review of websites, press releases, and public domain sources.

RESULTS: The first example of US payers managing DHTs came when PBM Evernorth announced the introduction of its Digital Health Formulary in 2019. Since its launch, Evernorth has expanded the formulary and updated the selection of preferred products for certain therapeutic areas. They also launched pilot programs to further evaluate clinical impact and user experience of additional solutions. CVS Health and Walgreens followed suit shortly after and rapidly expanded their digital health offerings to facilitate easier access to care during the COVID-19 pandemic. A more recent entrant into the landscape includes health insurer, UnitedHealthcare, with their UHC Hub initiated in 2023 and growing to 22 preferred partners in less than a year. The latest and possibly most intriguing new player in the space is Amazon Health, who announced in early 2024 that they will be partnering with Omada, a virtual-first healthcare provider focused on treating and preventing chronic conditions.

CONCLUSIONS: As the number of partnerships between digital health manufacturers and health plans increases, the importance of generating appropriate evidence to support payer assessment needs becomes greater. While some European HTAs have recently assessed DHTs, the collaboration between ICER and Peterson Health Technology Institute with the first DHT category reviews upcoming marks the first ever fully independent, third-party evaluation of DHTs in the US. This represents a major milestone as it not only provides health insurance companies and PBMs with another resource for assessing DHTs, but also should help guide evidence needs for DHT manufacturers.