Q&A With Eversana and APACMed

Amardeep Udeshi

Eversana recently announced that it has teamed up with APACMed to create a digital health reimbursement framework across the Asia Pacific region. Harjit Gill, CEO of APACMed, and Amardeep Udeshi, senior vice president at Eversana, spoke with Medical Device & Technology about the importance of creating a framework like this and the challenges they face.

(MD&T:) What complexities are digital health technology innovators facing in the Asia Pacific countries?

Gill: In the Asia-Pacific region, each country has a unique regulatory environment as it relates to digital health. There is also variability in understanding of digital health and how it should be valued or financed for the broader population. This presents challenges for innovative digital health companies looking to bring these new therapy options to the Asia Pacific markets, especially since reimbursement pathways are not clearly defined or funded.

Harjit Gill

For example, how certain digital health interventions are assessed and covered in Singapore could be very different to how they are likely to be funded in Australia or Japan. Meeting the evidentiary requirements of each jurisdiction could be challenging for a manufacturer of digital health solutions as it adds to the development cost and investment of time. Therefore, a consistent framework across countries with similar requirements would help companies generate the right evidence and having a dedicated reimbursement pathway for digital health interventions would be a huge step in the right direction. We believe it is the right time to bring EVERSANA’s knowledge and expertise globally and combine it with experience and leadership of APACMed secretariat and its member companies, to drive the much-needed change to enable broader access to digital health interventions across Asia-Pacific.

(MD&T:) What inspired this connection between EVERSANA and APACMed?

Gill: We see a lot of synergies working together sharing knowledge and expertise. We have worked together for several years on individual projects with APACMed members. With EVERSANA’s growing digital health practice and knowledge of reimbursement across the globe, the time was right for us to come together to support the excellent work that APACMed Digital Health Reimbursement Alliance does in the region.

(MD&T:) How difficult is it to build a framework for reimbursement models for digital health companies?

Udeshi: Reimbursement models are predicated on healthcare context of an individual country and driven by their ability and willingness to pay for healthcare. Asia-Pacific has a variety of healthcare financing mechanisms in place ranging from fully taxpayer funded models to mostly out-of-pocket financing of healthcare. This creates challenges from an equity perspective with varied coverage across the Asia-Pacific.

The next layer of complexity is the evidence requirements. Given the differences in local context in which health technology assessment is conducted, evidence requirements are generally more geared towards pharmaceutical or medical devices.These requirements are often too stringent for innovative digital health intervention to be assessed and valued fairly.

Lastly, the understanding of digital health and how it could improve overall delivery and efficiency of healthcare system in resource constrained environment is lacking, which results in lack of motivation on the part of healthcare stakeholders to build a robust reimbursement framework with adequate funding to improve broader access to promising digital health interventions.

Eversana will work with APACMed as an education partner to share its global experience and expertise to address this challenge and work towards a common goal of making digital health interventions more accessible to patients in Asia-Pacific.

(MD&T:) How quickly are digital therapeutics being embraced in the Asia Pacific region?

Udeshi: Digital therapeutics specifically, are growing in the Asia Pacific region, but a few countries like Japan and Korea are comparatively more evolved than others since they are ahead in terms of building reimbursement pathways. Digital therapeutics companies may need to think through their business models in Asia Pacific region starting with out of pocket payment models initially in most countries, and eventually working towards reimbursement when there is a dedicated reimbursement pathway for digital health interventions and funding in place to improve broader access, however this may take time and will require political champions to drive change, make funding available and enable adoption of digital health intervention more widely within healthcare systems. 

Having said that, we do see pockets of high likelihood of usage and adoption of digital therapeutics, e.g. CureApp’s smoking cessation and hypertension apps that have gained reimbursement in Japan, Aimmed’s insomnia app Somzz that is in the process of getting reimbursed in Korea, and TALi’s app to treat attention deficits that is reimbursed through NDIS in Australia. In digital health as a broad area, we see more examples in the region that include CGM devices such as FreeStyle Libre or Dexcom G6, Heartflow Analysis in AI imaging for coronary artery disease diagnosis, da Vinci robotic surgery, smart infusion Space Pump, Merlin@Home for remote home monitoring, and VNS Therapy System for neuromodulation treatment.

With rising demand for healthcare and an aging population in Asia-Pacific, we certainly see higher uptake and usage of digital health technologies in future.

(MD&T:) How are policymakers reacting to the creation of new reimbursement models?

Gill: APACMed Digital Health Reimbursement Alliance has been working towards that goal for a while now and have made positive start in that respect by creating a robust reimbursement framework, that could be adopted or adapted by many countries in Asia-Pacific. Our understanding is that the initial feedback from payers has been incredibly positive.

We are working with APACMed as knowledge partners to run a Forum in May 2023 where policymakers from the United States, Europe and Canada will join their counterparts in Asia-Pacific to share best practices, experiences, and learnings from reimbursing digital health interventions.This in our view will help promulgate better understanding of unique challenges and opportunities in assessing and funding these promising new technologies for broader population.