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Focus on Managed Care Pharmacy

(M2) Evaluating Coverage for Digital Therapeutics: A Case Study and Lessons Learned

Tuesday, October 17, 2023
10:15 AM – 11:30 AM East Coast USA Time
Location: Sabal
CPE
ACPE UAN:0233-0000-23-050-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based
How do managed care programs assess coverage decisions for digital therapeutic products? What is the effectiveness of digital therapeutics, and what are potential utilization management strategies for them? What are current national utilization trends for digital therapeutic products?

Join faculty as they answer these questions and review a case study with real-world outcome data from a Medicaid plan covering a digital therapeutic product. Presenters will provide an overview of the clinical outcomes demonstrated and the product’s impact on the patient’s overall cost of care and describe lessons learned around the inclusion of digital therapeutic products on a Medicaid formulary.

The session will include a discussion of best practices in coverage policies for digital therapeutics including consideration of creative contracting opportunities (such as value-based contracts).

Learning Objectives::

At the completion of this activity, participants should be able to:
  1. Explain a Medicaid program’s formulary review process for coverage of prescription digital therapeutics.
  2. Discuss a real-world case study, including review of clinical outcomes and overall cost of care impact of a prescription digital therapeutic product.
  3. Summarize lessons learned around coverage strategies for prescription digital therapeutics.