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Understanding Economic Decision-Making in Digital Therapeutics Development: Qualitative Approach.

Yoann Sapanel1,2,3, L Martin Cloutier4, Alec Morton5

  • 1The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

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|September 16, 2025
PubMed
Summary
This summary is machine-generated.

Researchers often overlook economic factors in digital therapeutics (DTx) development due to professional norms and limited economic literacy. Addressing these mechanisms can improve DTx adoption by integrating economic value assessment.

Keywords:
cost-effectivenesscritical realismdecision theorydecision-makingdigital healthdigital therapeuticseconomic evaluationqualitative studysystem dynamics

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Area of Science:

  • Health Informatics
  • Health Economics
  • Digital Health

Background:

  • Digital therapeutics (DTx) offer software-driven interventions but face low adoption due to insufficient economic evidence.
  • Knowledge gaps exist regarding economic decision-making in DTx development, especially among researchers.

Purpose of the Study:

  • Investigate researchers' decision-making on economic impact factors during DTx development and clinical validation.
  • Examine mechanisms and contextual conditions influencing these economic decisions.

Main Methods:

  • Conducted 17 semistructured interviews with diverse DTx researchers.
  • Employed critical realism, deductive/inductive coding, and abductive/retroductive inference.
  • Utilized qualitative system dynamics modeling to visualize causal loops.

Main Results:

  • Identified three mechanisms: professional norms prioritizing clinical validation, researcher inexperience with economic factors, and DTx adoption uncertainties.
  • These mechanisms lead to economic considerations being marginalized in DTx development.
  • Despite recognizing economic evidence importance, it remains peripheral in researchers' frameworks.

Conclusions:

  • Complex interactions between institutional structures, intrapersonal factors, and implementation uncertainties deprioritize economic considerations in DTx development.
  • Identified mechanisms offer intervention points to integrate economic value assessment throughout the DTx lifecycle.
  • Strengthening economic evaluation can enhance DTx adoption in healthcare systems.