Utah Payer to Cover Prescription Digital Therapeutic for Opioid Use Disorder

SelectHealth, a Utah-based health insurer and a wholly owned subsidiary of Intermountain Healthcare, has added reSET-O, a prescription digital therapeutic, as a covered benefit for some members.

The Food and Drug Administration-authorized reSET-O, developed by Pear Therapeutics, is designed to treat opioid use disorder. The prescription digital therapeutic is a 12-week program that provides cognitive behavioral therapy (CBT) through a tablet or smartphone. It is meant to be used alongside outpatient treatment that includes transmucosal buprenorphine and contingency management for adult patients supervised by a clinician.

Clinicians get access to a dashboard showing them various metrics for patients participating in the program, including lessons completed, patient-reported substance use, and patient-reported cravings and triggers.

SelectHealth will offer reSET-O as a covered benefit for its fully insured commercial members. The health plan has more than 1 million members across Utah, Idaho, and Nevada.

"Both organizations are focused on keeping people healthy and providing high-value care that is accessible throughout the communities that we serve," said H. Eric Cannon, chief pharmacy benefits officer at SelectHealth, in the news release. "This move to provide access is vital to the treatment of opioid use disorder and highlights another example of our commitment to clinical programs that improve outcomes and embrace innovation."

An opioid crisis has long raged in America, and the COVID-19 pandemic contributed to the worsening of the epidemic. The estimated number of overdose deaths from opioids rose to 75,673 in the 12 months ending in April 2021, up from 56,064 the year prior, according to the Centers for Disease Control and Prevention.

The stress and anxiety brought on by the fast-spreading and deadly coronavirus, combined with lockdowns, economic uncertainty, and social isolation, likely spurred the rise in substance abuse, according to interviews conducted by The New York Times.

Pear Therapeutics' reSET-O aims to increase opioid use disorder patient retention in outpatient treatment. According to data provided by the company to the FDA, the use of the digital therapeutic was associated with statistically significant increases in patient abstinence from heavy drugs and drinking and retention in treatment.

"With the opioid epidemic impacting more people than ever across the country, we applaud SelectHealth for its leadership in being the first in the state of Utah to provide patients seeking recovery coverage of innovative FDA-authorized treatment delivered through their mobile devices when and where they need it most," said Julia Strandberg, chief commercial officer at Pear Therapeutics, in the press release.

Over the past decade, the digital therapeutics industry has gained steam. The number of products on the market has increased, and they address a wide array of medical conditions, including musculoskeletal pain and attention-deficit/hyperactivity disorder.

But there are several risks associated with digital therapeutic use. These include potential data security threats, according to a report from Forrester.

Further, recent research suggests that digital therapeutic solutions and applications have high attrition rates and low patient engagement.