What happens to health technology once a country decides to pay for it. Germany spent 234 million euros on apps on prescription between September 2020 and the end of 2024, well over a fifth of the admitted applications has meanwhile been taken off the list again, and since February 2026 the price depends in part on measured outcome.
Frequently asked questions
Why is the user of health technology not the buyer?+
Health technology has a problem other software does not: the patient uses the application, but a third party — often the health insurer — pays, and only pays once you prove something. What the technology can do therefore matters less than whether it is reimbursed.
What does Germany's DiGA system teach about reimbursing digital care?+
Germany was the first country to introduce a reimbursement route for prescription apps, and the experiment has run long enough to learn from: over a million prescriptions, €234 million in spending, and more than a fifth of the admitted applications since removed from the list.
What does outcome-based pricing mean for a health-tech company?+
Since February 2026 the price in Germany depends partly on measured outcome, and the manufacturer must supply data on real-world use every quarter. Reimbursement is then no longer a fixed amount but follows demonstrated effect — gathering evidence becomes a permanent obligation, not a one-off hurdle.
Why does documentation AI in healthcare save less time than expected?+
The most-used form of AI in healthcare is not diagnosis but documentation. According to randomised research it saves less time than is generally assumed — a reminder that the assumed effect and the measured effect can differ.
What evidence must health technology deliver before it is reimbursed?+
Increasingly, clinical and real-world evidence of measured outcome, not just of safety or ease of use. Whoever pays the reimbursement decides which evidence counts — and that evidence is moreover requested continuously rather than assessed once.