Digital health applications, colloquially called 'prescription apps,' have been reimbursed by German health insurance funds since 2020 for mental health disorders like depression. However, experts point to a fundamental problem of low retention, meaning many patients prematurely abandon the therapy. A key recommendation is to use these tools exclusively with therapeutic support and to thoroughly analyze the reasons for discontinuation.

Reimbursement of Prescription Apps

The DiGA system has enabled the reimbursement of digital therapeutic applications by German health insurance funds since 2020. The register contains over 75 programs.

High Dropout Rate

The fundamental problem is the lack of consistent app usage by patients. Many of them discontinue digital therapy at an early stage.

Recommendation for Therapeutic Support

Psychologists emphasize that apps should be used under the care of a doctor or therapist, not as a standalone form of treatment.

Analysis of Reasons for Therapy Discontinuation

In case of discontinuation, it is recommended to pause and reflect on the reasons, which may indicate the need for more intensive, traditional therapy.

The German system for reimbursing digital therapeutic applications, introduced in 2020, faces an effectiveness challenge. Despite the availability of over 75 programs in the official DiGA register, often referred to as 'prescription apps,' the key problem turns out to be patient retention. Experts, such as psychologist Enno Maaß, indicate that many users abandon these programs early on, undermining their potential effectiveness in treating disorders like depression.Digital mental health support tools emerged with the development of mobile technology in the first decade of the 21st century. Earlier, non-governmental wellness and self-help apps were not subject to strict medical regulation, which changed with the introduction of certification for tools with proven clinical efficacy. Psychologists and psychotherapists, including Lasse Sander, emphasize that these apps should not function in a vacuum. In their view, DiGAs bring benefits only when used as part of a broader therapeutic process, guided by a specialist. Independent use without supervision increases the risk of failure. The recommendation for patients considering discontinuation is clear: they should pause and analyze why the app has stopped being helpful. Such self-analysis may reveal that the underlying problem is deeper and requires direct, professional intervention, which the app alone cannot address. „Viele Nutzer brechen die Programme frühzeitig ab” (Many users discontinue the programs early.) — Enno Maaß The DiGA system represents a significant step towards digitizing healthcare and increasing access to certain forms of assistance. However, the high dropout rate calls into question the long-term effectiveness and cost-effectiveness of this form of therapy for the payer, the health insurance funds. Further development of this sector will likely require not only improving the apps themselves but also better integration with the traditional healthcare pathway and strategies to motivate patients to persist with treatment. Without solving the problem of adherence, meaning regular compliance with recommendations, even the best-designed digital tool may fail to fulfill its basic therapeutic function.

Mentioned People

  • Enno Maaß — Psychologist, psychotherapist, commenting on the problem of dropout from DiGA apps
  • Lasse Sander — Psychologist, psychotherapist, recommending the use of DiGA apps under specialist supervision