Health apps in comparison

What is considered a health app?

Health apps are digital web or smartphone applications for the prevention or mitigation of diseases and their consequences.

A legally binding definition does not yet exist. The Federal Ministry of Health describes health apps as applications that "provide functionalities for the areas of health, medicine, healing or wellness"(Chancen und Risiken von Gesundheits-Apps 2016).

A basic distinction can be made between digital health applications (DiGA) and digital care applications (DiPA).

What are DiGA?

Digital health applications, also known as DiGA apps or "apps on prescription", are health apps that can be prescribed. This means that the patient does not have to pay for the app themselves, but the statutory health insurance fund covers the costs or part of them. The basis for this is the Digital Healthcare Act (DVG), which came into force in 2019.

DiGA do not replace a doctor or therapy. However, they can accompany and support the patient during therapy . For example, they help to adjust lifestyle, answer questions and track and classify symptoms.

In principle, the costs can be covered by health insurance without a prescription, but the patient must be able to provide proof of a medical or psychotherapeutic diagnosis. The health app must be approved by the Federal Institute for Drugs and Medical Devices (BfArM). Approved apps appear in the official DiGA directory.

How does admission to the DiGA directory work?

All details on the DiGA directory are regulated in the Health Applications Ordinance (DiGAV) of 2020. To be included in the BfArM's DiGA directory, the health app must be secure, data protection-compliant and compatible with various systems. It must also have a demonstrably positive effect on patient care.

If an app is still being tested during inclusion in the DiGA directory, it can be removed from the directory if it fails to demonstrate a positive effect on care. Affected apps are marked in the directory with the reference "provisionally included".

This also applies if the relevant studies were not completed within the planned trial period or the evidence provided was subsequently classified as inadequate. Examples of canceled apps are CANKADO PRO-React Onco and ESYSTA App for digital diabetes management.

What are DiPA?

In line with digital health applications, the legislator wants to make digital care applications (DiPA) eligible for reimbursement. The basis for this is the Participation Enhancement Act (TeilhStG), which came into force in 2021 and grants those in need of care an entitlement to care support through digital technologies.

DiPAs are intended, for example, to support those affected with household management, train cognitive and communication skills or improve mobility through exercise instructions.

The BfArM is currently planning to set up a DiPA directory. Patients will then be able to apply for reimbursement of up to €50 per month from their care insurance fund.

Approved health apps in comparison

The DiGA directory currently contains 56 health apps (as of 27.03.2024). These include many apps that are not yet permanently approved, as well as apps that have already been removed. Our comparison is limited exclusively to health apps that have been permanently included in the DiGA directory.

The price stated is covered by health insurance companies if a prescription or proof of diagnosis is provided. There are no additional costs for patients for the apps in our overview.

If a "Yes" is entered in the "Panel physician" column, this app can only be prescribed by panel physicians or the patient can only claim diagnoses from panel physicians.  

What other types of health apps are there?

In addition to the official "apps on prescription", there is a huge market for all kinds of fitness and health tracking apps. These apps have not been officially tested for their positive effects. Problems such as expensive in-app purchases or inaccuracies and false information should not be underestimated.

Nevertheless, these health apps can also be valuable everyday helpers if used carefully. Typical types are

• Pedometer apps: These apps track the number of steps a person takes each day and often offer additional features such as distance measurement and calories burned.
• Training and workout apps: These apps offer ready-made training plans, instructions and videos for various fitness activities such as strength training, yoga, running, cycling, etc.
• Nutrition and calorie counter apps: They allow you to log meals, track calories and nutrients and set nutritional goals.
• Sleep tracking apps: These apps monitor the sleep cycle, sleep duration and sleep quality to give users insights into their sleep habits.
• Heart rate apps: They measure the heart rate and provide information on how the heart reacts to various activities.
• Mental health apps: These apps focus on monitoring and promoting mental wellbeing, including meditation, stress management and mindfulness exercises.
• Weight management apps: They help you set weight goals, track progress and offer support in losing or gaining weight.

Health information apps: These apps provide access to medical information, allow you to save health data and offer functions such as medication reminders.

Conclusion: The right app for every need

From healthier leisure activities to therapeutic support - health apps now offer an impressive range of functionalities and customized solutions for individual health goals.

A wide range of tried and tested health apps are available, particularly in the area of mental illness, which can help people with their treatment. Health apps can also make an effective contribution to cancer prevention or the accompanying treatment of diseases such as diabetes or multiple sclerosis. Nevertheless, these apps do not replace medical treatment and can usually only be used as a supportive measure.

Basically, we are only at the beginning of ongoing developments and innovations. Thanks to the possibility of recognition by health insurance companies and the correspondingly freed-up budget, it is to be expected that future apps will become increasingly sophisticated and that there will soon be new apps for a wide range of clinical pictures.

The personal designations used in this article always refer equally to all persons. For the sake of better readability, we have refrained from using double or opposite names.

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