PreferredOne taps Pear to become the first health plan to cover digital therapeutics

PreferredOne will provide broad patient access and reimbursement for reSET and reSET-O for people with substance use disorder and opioid use disorder.

Pear Therapeutics reSET and reSET-O

Pear Therapeutics and PreferredOne announced that reSET and reSET-O, the first two prescription digital therapeutics (PDTs) to receive authorization to treat disease from the FDA, have been added to PreferredOne’s medical benefits as covered products for its members. Both products have been tested in real-world cases and randomized controlled trials and both provide patients with algorithm-driven cognitive behavioral therapy, fluency training, and contingency management — while clinicians receive access to clinical dashboards to inform in-office and tele visits. reSET is used as a monotherapy while reSET-O is used in combination with transmucosal buprenorphine.

Why does it matter?

PDTs are a new therapeutic class that uses software to directly treat disease. Like traditional medicines, PDTs are developed in a GMP-compliant environment, tested in randomized controlled trials demonstrating safety and effectiveness, evaluated and authorized by regulators like FDA, and used under the supervision of a prescribing clinician. Unlike traditional medicines, PDTs are designed to collect real-world data for use by prescribing clinicians and for population health management by payors and health systems.

And with this deal, PreferredOne — which is a wholly-owned subsidiary of Fairview Health Services with more than 364,000 members — emerges as the first health plan to cover digital therapeutics.

On the record

“We are excited to partner and develop an innovative agreement with Pear Therapeutics to provide access to reSET and reSET-O for our members, furthering our commitment to providing evidence-based therapeutics,” said Samir Mistry, Vice President of Pharmacy at PreferredOne. “We are proud to announce during National Recovery Month that we now pay for two innovative PDTs to treat addiction. The addiction crisis was the top health crisis in America before the pandemic, and it has since grown worse. PreferredOne is doing its part to help fight the addiction crisis by adding reSET and reSET-O to our covered medical benefits.”

“The Pear team is proud to work with PreferredOne to continue to expand patient access to reSET and reSET-O in Minnesota and across the nation,” added Corey McCann, M.D., Ph.D., President and CEO of Pear Therapeutics. “We won’t rest until everyone who is suffering from addiction has covered access to our PDTs.”

The context

According to Valuates Reports, the global digital therapeutics market size was valued at $2.24 Billion in 2018 and is expected to reach $9.64 Billion by 2026 with a CAGR of 19.9% during the forecast period.

The major factors driving the growth of global digital therapeutics are increasing mobile and tablet adoption, growing healthcare applications, growing need to monitor healthcare costs and increasing incidence of chronic diseases. Furthermore, high growth prospects in untapped markets would create substantial profit opportunities for producers in the digital therapeutics industry.