Digital therapeutics

Digital therapeutics are software-based interventions that deliver clinically evaluated treatment for specific medical conditions, typically prescribed by a clinician and reimbursed through payers or paid for by employers. The category sits between consumer wellness apps and traditional pharma - products are validated through randomised controlled trials, run through FDA or equivalent regulatory pathways, and carry indication-specific labels. Reimbursement has remained the central commercial bottleneck. Pear Therapeutics, the publicly listed pioneer of the category, filed for bankruptcy in 2023 after failing to secure broad payer coverage, and Better Therapeutics delisted from Nasdaq the same year. The survivors have largely pivoted to employer-paid and risk-sharing models.

The sector spans prescription digital therapeutics (PDTs) for chronic disease, behavioural and mental health DTx, musculoskeletal (MSK) digital care, cardiometabolic and diabetes management programs, and ADHD and cognitive disorder DTx aimed at pediatric and adult populations.

Revenue comes from employer per-member-per-month (PMPM) contracts paid by self-insured employers and benefits brokers, health plan reimbursement under medical or pharmacy benefit, outcomes-based payments tied to engagement and clinical results, direct-to-consumer subscriptions for non-prescription wellness adjacencies, and pharma partnership deals where DTx products are bundled alongside drug therapies.

Digital therapeutics is part of Digital health.

$7.9B

Global market size

16

Public companies

Techstars
Khosla Ventures
Antler
Right Side Capital Management

Key VC investors

Sword Health
Sidekick Health
Huma
Stella Mental Health

Key strategic buyers

Business model

How digital therapeutics companies monetize?

Digital therapeutics companies monetize through employer PMPM contracts, outcomes-based pricing and pharma co-promotion deals.

Employer PMPM contracts

Self-insured employers pay a per-member-per-month fee for access, plus engagement-tied fees. Now the dominant commercial model for Omada, Hinge Health and Sword Health.

Payer reimbursement

Coverage under medical or pharmacy benefit on a per-prescription or per-episode basis. Hardest path commercially - Pear and Better Therapeutics failed here.

Outcomes-based pricing

Fees tied to weight loss, A1c reduction, pain scores or engagement thresholds. Increasingly required by sophisticated employer buyers and PBMs.

Direct-to-consumer subscriptions

Monthly fees paid by users for sleep, anxiety and CBT-based apps with light or no prescription gating. Used by Big Health, Happify and Sleepio adjacencies.

Pharma co-promotion deals

Upfront and milestone payments from drug makers to bundle DTx with branded therapies. Welldoc and Click Therapeutics built deal flow here with Sanofi, Otsuka and Boehringer.

Risk-sharing & capitated arrangements

Provider or vendor takes downside risk on member outcomes against a per-capita budget. Increasingly seen with Medicare Advantage and ACO contracting partners.

Digital therapeutics valuations in May 2026

Public digital therapeutics comps trade at 3.2x EV/Revenue. Median revenue multiple across digital therapeutics M&A deals was 1.9x in the last 12 months. Median revenue multiple across digital therapeutics VC rounds was 17x in the last 12 months.

3.2x

Median EV/Revenue as of May 2026 for public digital therapeutics companies

0.8x

Alignment Healthcare

Alignment Healthcare is the highest valued public digital therapeutics company based on EV/Revenue (excluding outliers)

1.9x

Median EV/Revenue across digital therapeutics M&A deals in the last 12 months

17x

Median EV/Revenue across digital therapeutics VC rounds in the last 12 months

Sector breakdown

Digital therapeutics market segments

Digital therapeutics spans MSK digital care, cardiometabolic and diabetes programs and behavioural and mental health DTx.

Musculoskeletal (MSK) digital care

Virtual physical therapy programs combining motion sensors, app-guided exercise and remote clinicians for back, joint and post-surgical pain. The largest and most commercially proven DTx category, sold mainly to self-insured employers under PMPM and per-episode pricing. Key players: Hinge Health, Sword Health, Kaia Health and SpineZone.

Cardiometabolic & diabetes DTx

Programs combining CGM data, coaching and behavioural intervention for type 2 diabetes, prediabetes, hypertension and obesity. Most run as employer-paid PMPM with engagement guarantees. Key players: Omada Health, Livongo (Teladoc), Virta Health and Welldoc.

Behavioural & mental health DTx

Software-delivered CBT, mindfulness and psychiatric adjuncts indicated for insomnia, depression and anxiety. Some prescription-grade, most consumer or employer subscription. Key players: Big Health (Sleepio, Daylight), Headspace Health, Click Therapeutics and Happify.

ADHD & cognitive DTx

Prescription software for paediatric and adult ADHD, including video-game-based interventions. The narrowest reimbursement footprint of any DTx subcategory. Key players: Akili Interactive (EndeavorRx), Click Therapeutics, Pear (defunct) and Mightier.

Substance use disorder DTx

Software adjuncts to medication-assisted treatment for opioid use, alcohol use and tobacco cessation. The space hardest hit by Pear's bankruptcy, which discontinued reSET-O. Key players: DynamiCare Health, Quit Genius, Workit Health and Pelago.

Oncology & specialty support DTx

Symptom monitoring, side-effect management and adherence tools for cancer, multiple sclerosis and rare disease patients. Mostly distributed through pharma deals rather than payer contracting. Key players: Voluntis (Aptar Pharma), Medisafe, ResApp and Welldoc.

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Sector KPIs

Key digital therapeutics KPIs to track

Members under contract, PMPM revenue, engagement rate and clinical outcomes are the metrics investors track in digital therapeutics.

KPIDefinition
Members under contractTotal covered lives across employer and health plan contracts. The headline scale metric replacing 'paying users' in employer-paid DTx.
PMPM revenuePer-member-per-month fee multiplied by eligible lives. Reads the contract economics of employer-paid models like Hinge, Sword and Omada.
Enrolled member rateShare of eligible lives that activate. Usually 5-15% in MSK and cardiometabolic; the most-watched commercial efficiency lever in employer DTx.
Engagement rateShare of enrolled members hitting weekly or monthly activity thresholds. Drives the engagement-tied portion of PMPM revenue and clinical outcomes.
Clinical outcomesIndication-specific endpoints - pain reduction, A1c drop, weight loss, depression PHQ-9 score. Increasingly contractually tied to fees.
Net revenue retentionExisting employer revenue 12 months later. Reads the renewal economics; high-NRR DTx businesses look like enterprise SaaS, low-NRR ones like fading point solutions.
Reimbursement coverageCovered lives under medical or pharmacy benefit. Prescription DTx products that fail to reach broad coverage (Pear, Better Therapeutics) do not survive.
Cost of acquisition per memberSales and marketing cost divided by net new enrolled members. The unit-economics input that separates sustainable DTx from cash-burning programs.
Key players

Main digital therapeutics players globally

The most active digital therapeutics companies and category leaders globally.

CompanyHQOverview
Hinge Health
hingehealth.com
San Francisco
Largest digital MSK provider, covering pain and post-surgical care for employer-sponsored populations. IPO'd on the NYSE in May 2025 (NYSE: HNGE) at roughly $2.6B valuation after raising more than $1B privately.
Sword Health
swordhealth.com
Porto
Virtual physical therapy and pelvic care platform serving over 5,000 employer clients. Raised $130M Series E in mid-2024 at $3B valuation; Khosla, General Catalyst and Sapphire are lead backers.
Omada Health
omadahealth.com
San Francisco
Cardiometabolic, MSK and behavioural health programs sold to self-insured employers and health plans. IPO'd on the Nasdaq in June 2025 (NASDAQ: OMDA).
Akili Interactive
akiliinteractive.com
Boston
Maker of EndeavorRx, the first FDA-cleared video-game ADHD therapeutic. Delisted from Nasdaq in 2024 after a take-private by Virtual Therapeutics; the original SPAC trade is one of the cautionary tales of the category.
Big Health
bighealth.com
San Francisco
Maker of Sleepio (insomnia) and Daylight (anxiety), both with CBT-based randomised trial evidence. Sold mainly through employer and PBM channels after pulling back from pure prescription routes.
Click Therapeutics
clicktherapeutics.com
New York
Builds prescription DTx through pharma partnerships rather than self-funded reimbursement. Boehringer Ingelheim deal for schizophrenia DTx (CT-155) is the highest-profile current program.
Columbia, MD
BlueStar diabetes management platform, one of the longest-running DTx products. Distributes through health plan and employer channels with pharma co-promotion partnerships alongside Sanofi.
Kaia Health
kaiahealth.com
Munich
European MSK DTx using computer-vision motion tracking via smartphone camera. Backers include Optum Ventures and Balderton; competes head-on with Hinge and Sword in employer channels.
Virta Health
virtahealth.com
Denver
Clinical care platform for type 2 diabetes reversal using continuous remote care plus nutritional ketosis. Sold to self-insured employers and Medicaid managed care plans under outcomes-based contracts.
Headspace Health
headspace.com
Santa Monica
Formed from the 2021 merger of Headspace (consumer mindfulness) and Ginger (employer mental health coaching). Layoffs in 2023 and 2024 reset the cost base; serves 4,000+ employer customers.

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Market trends

Key digital therapeutics market trends

DTx reimbursement reset, MSK and cardiometabolic IPOs and GLP-1 wraparound care are reshaping digital therapeutics right now.

DTx reimbursement reset after Pear and Better Therapeutics

Pear Therapeutics filed for bankruptcy in April 2023 and Better Therapeutics delisted from Nasdaq later that year. Both ran out of cash before securing broad payer coverage. The category response since 2024 has been to pivot toward employer PMPM contracts and outcomes-based pricing rather than prescription reimbursement.

MSK and cardiometabolic going public

Hinge Health (May 2025) and Omada Health (June 2025) both completed Nasdaq IPOs at lower valuations than their private peaks. The listings re-opened the digital health IPO window and reset comparables for Sword Health, Virta and Kaia.

GLP-1 drugs reshaping the diabetes and obesity DTx market

Wegovy, Ozempic and Mounjaro adoption since 2023 has forced cardiometabolic DTx vendors (Omada, Virta, Livongo) to reposition as wraparound care providers rather than primary intervention. Omada, Noom and Wondr Health all launched GLP-1 companion programs through 2024-25.

AMA CPT codes for digital therapeutics

The AMA added new CPT codes for prescription digital behavioural therapies in 2024, providing the first standardised billing infrastructure for the category. Coverage uptake by CMS and commercial payers has been slow but is providing a path Pear and Better could not access in time.

Employer benefits consolidation

Benefit consultants Mercer and Aon are pushing self-insured employers to consolidate point solutions, putting pressure on standalone DTx vendors to either bundle or be bundled. Transcarent, Included Health and Virgin Pulse are positioning as the consolidating layer.

Generative AI in DTx delivery

Vendors are embedding LLM-based coaches and triage agents into DTx programs to reduce per-member coaching cost. Big Health, Headspace and Sword shipped AI coaching layers in 2024-25; the unit-economics impact on employer-paid DTx is the most-watched question for the next renewal cycle.

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