Digital πŸ“± Prescriptions πŸ’Š

What is it?

Prescription Digital Therapeutics (PDTs) are basically prescription medication - but in a digital form, i.e. replacing a pill with the phone.

PDTs are not Digiceuticals - the Luminosity 🧠πŸ’ͺ of the world. PDTs are subject to randomized clinical trials πŸ‘©β€βš•οΈ and held to the same standards of other prescription medicine. Digiceuticals aren't - they're wellness products similar to the conventional Vitamin D supplement.

How effective are they? πŸ“ˆ

Very. By definition, PDTs are required to meet the same standards as other conventional therapies. They have received state recognition, e.g. FDA approval. As a result, they are just as if not more effective effective than conventional therapeutics.

Getting people to buy into this, however, will be the problem. So, for the uninitiated, let's break down why PDTs would be effective.

Let's start by refuting prevalent and subconscious concerns. The reason most people feel uneasy about PDTs are because the prototypical approach to disease is as follows:

person πŸ€’ is sick ➑️ person gets drug πŸ’Š or treatment 🩺 ➑️ drug does science magic 🧬 ➑️ person gets better πŸ˜„

The thinking goes, PDTs don't really fit into this framework - because what change can an app that doesn't interact with the body do?

  1. Through behaviour modification πŸ˜’βž‘οΈπŸ˜‹ - a lot of conventional treatments work through behaviour modification and not the interaction of biological and chemical matter - and indeed in areas like cognitive behavioural therapy we have seen great strides in PDT. PDTs can either work as an additional tool to bridge the gap between efficacy (potential impact) and efficiency (real life effectiveness), or, as replacement themselves. It's easy to grasp that smartphones can change our behaviour to hook us onto Facebook, so it should be easy for them to change our behaviour in ways beneficial for our health.
  2. AI + Data πŸ–₯ - PDTs are often distilled over a smartphone, allowing for the use of its technology to better track behaviour. This provides valuable, quantitative feedback as to how well the patient is doing. In situations where treatment isn't just a drug-and-done, and where there is experimentation, this will provide much quicker routes to personalisation and effective treatment.
  3. Constancy 🏭 - there is a certain level of replicability and guaranteed levels of treatment.

  4. Low cost πŸ€‘ and ease to replicate - in addition to being great alternative tools in the fight against disease, they also make possible the cheap and quick dissemination of personalised treatment to many people .

In short, the inability to trust PDTs stems from fundamental assumptions of our health and care system: that illnesses is a state that can be fixed with chemical reactions. 🧬

This ignores that very real mental 🧠 and trial-and-error πŸ§ͺcomponent of many illnesses, and assumes an unshakeable acceptance in the shortcomings of current methods of therapy.
This perhaps speaks to the incredible amount of privilege, owing to the efficacy of πŸ₯πŸš‘ modern medicine being good enough to make us reluctant of experimentation. This would be a mistake - as healthcare and progress much march forward. As I've mentioned before - one of the fundamental barriers of healthcare innovation is us - and the paradigms we choose: from [false binaries between "well" and "ill"]pe(https://listed.to/@den/20153/future-of-healthcare-thoughts-from-an-unqualified-humanities-major) to ignoring the mind in healthcare.

What to do? The G2M

Many others more qualified than me, have already pondered on how to physician buy-in is essential, and how to integrate it into their workflows, lower the learning curve, support early adopters, and create confidence. Many others have discussed best ways of monetisation - from D2C to working with insurers. The jury is out on all of that - and I'm excited to see what will happen.

I want to talk more about the power of habit. The PDT struggle to get buy-in reminds me of the story of Febreeze 🧼 - and how it struggled to get people to buy its scentless, odour-busting product at first - until they added a useless scent to piggyback off an existing habit of cleaning. I wonder if PDT might be better of Trojan-horsing it as well. Instead of selling it as a replacement to therapeutics, we might find better use by bundling it with placebos - and selling them as a "medication enhancer" and "tracker". We're adding into the habit loop, rather than changing it entirely - which can only be much easier.


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