More than 78 million Americans rely on Medicaid or CHIP for their health care. Yet many still cannot access FDA-approved digital therapeutics because their state does not include them in covered benefits.
Prescription digital therapeutics (PDTs) are software-based treatments authorized by the FDA. They are delivered through smartphones or tablets and are used to manage conditions such as substance use disorder, ADHD, diabetes, and chronic insomnia. For people who face long wait times or limited in-person care, PDTs can be a useful tool.
Pharmacists are in a strong position to help address this issue. In managed care, they can take part in formulary reviews and policy discussions. In community settings, they can educate patients, encourage follow-through, and include these products in medication therapy management. Their training and accessibility allow them to contribute to both care and policy decisions. In some states, pharmacists also serve on Medicaid advisory boards or submit feedback during benefit review periods.
Early findings from a Pennsylvania pilot suggest that patients with opioid use disorder who used a digital therapeutic regularly had fewer relapses and emergency visits. Full data have not been released, but the results are consistent with other research showing that PDTs can help with long-term management and reduce hospital use.
Germany has a national program called DiGA that pays for prescription digital therapeutics. Since it began, more than 860,000 prescriptions have been written, with about €234 million spent, which is less than 0.05 percent of the country’s annual health care budget. While the U.S. system is different, the German example shows that digital therapeutics can be included in a national program without excessive cost.
In the U.S., more research is needed to understand how PDTs affect Medicaid costs and outcomes. Still, experts believe that improving follow-up and adherence through these tools could lower preventable hospital visits. The potential to help Medicaid patients is clear, especially in areas with limited access to care.
Most Americans live within five miles of a pharmacy. This makes pharmacists a key access point for digital health tools. But internet access remains a barrier. About one in four Medicaid enrollees either do not have broadband at home or rely only on a smartphone. The federal Affordable Connectivity Program, which helped cover internet costs, ended in 2024. In its place, pharmacists can connect patients to local resources and help them use digital tools at the point of care.
A bill introduced in 2025, the Access to Prescription Digital Therapeutics Act (HR 3288 and S 1702), would allow Medicare and Medicaid to cover these products and create billing codes. Pharmacy groups have supported this effort. Even if passed, state Medicaid programs will still make many of their own decisions. That makes local pharmacist involvement even more important.
Pharmacists already help manage chronic illness, mental health conditions, and patient education. These same skills apply to digital therapeutics. Their day-to-day work with patients puts them in a good position to expand access and improve care.
Access to treatment should not depend on whether someone has private insurance. By helping shape policy, educating patients, and working with Medicaid programs, pharmacists can make sure digital therapeutics reach the people who need them. These tools are already part of health care in other countries. There is no reason they cannot be part of Medicaid too.
Amanda Matter is a doctor of pharmacy student.
