IDEAS home Printed from https://ideas.repec.org/p/zbw/zewdip/321863.html
   My bibliography  Save this paper

Market entry of digital health providers after the introduction of a new reimbursement pathway

Author

Listed:
  • Janßen, Rebecca
  • Reif, Simon
  • Schubert, Sabrina

Abstract

Digital therapeutics are increasingly used to complement traditional health care. In a pioneering move, Germany became the first country to introduce a structured regulatory framework - known as the DiGA scheme - that enables developers of digital therapeutics to be reimbursed in the statutory health insurance system. Our study evaluates the impact of this novel regulation on the development and market entry of patient-centered digital health applications. Using a panel dataset of app availability by language and month from the Apple App Store, covering the period from January 2018 to September 2021, we compare trends in health app availability in German to those in other languages. Applying event study designs and a set of synthetic control methods, we find that the DiGA regulation likely stimulated the development of German-language digital therapeutics in the app market. While the number of apps increased, our results suggest that neither the diversity of health conditions targeted nor the number of high-quality apps expanded significantly. To the contrary, the increase was almost exclusively driven by apps that sell patient data for advertisement. This suggests that the initial enthusiasm surrounding the new reimbursement pathway did not translate into a broad increase in high quality apps with strong data privacy protections. Further research is needed to assess the longer-term effects on innovation and quality, especially as other countries begin to adopt regulatory frameworks inspired by the German model.

Suggested Citation

  • Janßen, Rebecca & Reif, Simon & Schubert, Sabrina, 2025. "Market entry of digital health providers after the introduction of a new reimbursement pathway," ZEW Discussion Papers 25-034, ZEW - Leibniz Centre for European Economic Research.
    • Handle: RePEc:zbw:zewdip:321863
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/321863/1/1930383487.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Alberto Abadie, 2021. "Using Synthetic Controls: Feasibility, Data Requirements, and Methodological Aspects," Journal of Economic Literature, American Economic Association, vol. 59(2), pages 391-425, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Cruz A. Echevarría & Serhat Hasancebi & Javier García-Enríquez, 2022. "Economic Effects of Macao’s Integration with Mainland China: A Causal Inference Study," Journal of Economic Integration, Center for Economic Integration, Sejong University, vol. 37(2), pages 179-215.
    2. Manuel Funke & Moritz Schularick & Christoph Trebesch, 2023. "Populist Leaders and the Economy," American Economic Review, American Economic Association, vol. 113(12), pages 3249-3288, December.
    3. Maximiliano Marzetti & Rok Spruk, 2023. "Long-Term Economic Effects of Populist Legal Reforms: Evidence from Argentina," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 65(1), pages 60-95, March.
    4. Arne Henningsen & Guy Low & David Wuepper & Tobias Dalhaus & Hugo Storm & Dagim Belay & Stefan Hirsch, 2024. "Estimating Causal Effects with Observational Data: Guidelines for Agricultural and Applied Economists," IFRO Working Paper 2024/03, University of Copenhagen, Department of Food and Resource Economics.
    5. Chuku Chuku & Mustafa Yasin Yenice, 2021. "Working Paper 356 - Eurobonds, debt sustainability and macroeconomic performance in Africa: Synthetic controlled experiments," Working Paper Series 2482, African Development Bank.
    6. Sadeghi, Ali & Kibler, Ewald, 2022. "Do bankruptcy laws matter for entrepreneurship? A Synthetic Control Method analysis of a bankruptcy reform in Finland," Journal of Business Venturing Insights, Elsevier, vol. 18(C).
    7. repec:osf:osfxxx:s8ayp_v1 is not listed on IDEAS
    8. Yang, Dianyi, 2024. "Bail out the money printer? The impact of fiscal indemnity on central bank profitability," SocArXiv wz75m, Center for Open Science.
    9. Bischoff, Ivo & Das, Sourav & Kosfeld, Reinhold, 2025. "Does inter-municipal cooperation reduce the intensity of tax competition? Evidence on inter-local industrial parks in Germany," European Journal of Political Economy, Elsevier, vol. 87(C).
    10. Jack (Peiyao) Ma & Andrea Mantovani & Carlo Reggiani & Annette Broocks & Néstor Duch-Brown, 2024. "The Price Effects of Prohibiting Price Parity Clauses: Evidence from International Hotel Groups," Economics Series Working Papers 1043, University of Oxford, Department of Economics.
    11. Dennis Shen & Peng Ding & Jasjeet Sekhon & Bin Yu, 2022. "Same Root Different Leaves: Time Series and Cross-Sectional Methods in Panel Data," Papers 2207.14481, arXiv.org, revised Oct 2022.
    12. Zhentao Shi & Jin Xi & Haitian Xie, 2025. "A Synthetic Business Cycle Approach to Counterfactual Analysis with Nonstationary Macroeconomic Data," Papers 2505.22388, arXiv.org.
    13. Pavlik, Jamie Bologna & Jahan, Israt & Young, Andrew T., 2023. "Do longer constitutions corrupt?," European Journal of Political Economy, Elsevier, vol. 77(C).
    14. Runst, Petrik & Höhle, David, 2022. "The German eco tax and its impact on CO2 emissions," Energy Policy, Elsevier, vol. 160(C).
    15. Di, Wenhua & Pattison, Nathaniel, 2023. "Industry Specialization and Small Business Lending," Journal of Banking & Finance, Elsevier, vol. 149(C).
    16. Pekka Malo & Juha Eskelinen & Xun Zhou & Timo Kuosmanen, 2024. "Computing Synthetic Controls Using Bilevel Optimization," Computational Economics, Springer;Society for Computational Economics, vol. 64(2), pages 1113-1136, August.
    17. Robert Messerle & Jonas Schreyögg, 2024. "Country-level effects of diagnosis-related groups: evidence from Germany’s comprehensive reform of hospital payments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(6), pages 1013-1030, August.
    18. Dominika Langenmayr & Mikayel Tovmasyan & Sebastian Vosseler, 2025. "Bypassing Sanctions: Hide 'N Seek in Tax Havens?," Working Papers 202536, Center for Global Policy Analysis, LeBow College of Business, Drexel University.
    19. Michael Funke & Kadri Männasoo & Helery Tasane, 2023. "Regional Economic Impacts of the Øresund Cross-Border Fixed Link: Cui Bono?," CESifo Working Paper Series 10557, CESifo.
    20. Thales A. P. West & Sven Wunder & Erin O. Sills & Jan Borner & Sami W. Rifai & Alexandra N. Neidermeier & Andreas Kontoleon, 2023. "Action needed to make carbon offsets from tropical forest conservation work for climate change mitigation," Papers 2301.03354, arXiv.org.
    21. Robert Kraemer & Jonne Lehtimäki, 2024. "Government debt, European Institutions and fiscal rules: a synthetic control approach," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 31(4), pages 1112-1157, August.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L52 - Industrial Organization - - Regulation and Industrial Policy - - - Industrial Policy; Sectoral Planning Methods

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:zbw:zewdip:321863. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://edirc.repec.org/data/zemande.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.