More Health Apps, but Little Improvement in Quality
Research
09.07.2025
ZEW Study on Health Apps
In 2020, Germany became the first country in the world to introduce a structured reimbursement pathway for digital health applications, or DiGAs (Digitale Gesundheitsanwendungen), within its statutory health insurance system. This created a new business model for health apps. A new study by ZEW Mannheim is the first to examine the effects of the reimbursement model on the overall market for health apps – not just on the approved DiGAs themselves. The study does show a clear increase in the number of German-language health apps, but not in the number of high-quality apps that could qualify as DiGAs.
“Since it became known that apps on prescription would be reimbursable in Germany, data has shown a significant increase in the number of apps available for the German-speaking market compared to other markets. But this initial enthusiasm has not led to greater diversity in apps or an increase in applications that collect less data. The rise also has been driven almost exclusively by apps that use patient data for advertising purposes,” explains Sabrina Schubert, researcher in ZEW’s Research Group “Health Care Markets and Health Policy” and co-author of the study.
Entry barriers too high
“It is also striking that the number of apps supported by scientific publications has barely increased. Yet more scientific backing would serve as a clear signal of quality, confirming that health apps offer a real added value. For many app developers, the hurdles to reimbursement through health insurance still appear to be too high. As a result, many focus on alternative business models, such as the use of data for advertising purposes. This leads to fewer high-quality, data-efficient digital health services being available to insured individuals. The system could benefit from lower entry barriers combined with lower reimbursement rates,” adds Professor Simon Reif, head of the “Health Care Markets and Health Policy” Research Group and co-author of the study.
About health apps and the study
Doctors can prescribe DiGAs if the health apps have been approved after a successful review. For app developers, such prescriptions are financially attractive: In the first year after the approval, they receive an average of 135 euros per prescription per month.
Using data from all health apps in the Apple App Store, the ZEW study investigated whether the introduction of app prescriptions by doctors has prompted the development of more digital applications tailored specifically to the German-speaking market.
