INTRODUCTION:
Prescription digital therapeutics are emerging as regulated, evidence-based software interventions with potential relevance for public health systems. However, their integration into publicly funded care raises questions regarding equity, access, system readiness, and ethical considerations related to governance, accountability, and data protection.

METHODS:
A narrative policy and systems analysis was conducted to examine current regulatory approaches, implementation pathways, and public health implications of prescription digital therapeutics with a primary focus on health systems operating under comparable regulatory frameworks, particularly within the european context. Policy documents, regulatory frameworks, and peer-reviewed literature were reviewed and synthesised using a health systems and equity lens.

RESULTS:
findings indicate substantial heterogeneity in how prescription digital therapeutics are evaluated, reimbursed, and deployed across health systems sharing similar regulatory baselines. While these interventions may improve access to evidence-based care for chronic and behavioural conditions, risks were identified related to digital exclusion, fragmented implementation, and limited integration with public health strategies. System-level facilitators included clear regulatory pathways, alignment with primary care, and mechanisms for population-level evaluation.

CONCLUSIONS:
Prescription digital therapeutics have the potential to contribute to more equitable and scalable public health interventions if embedded within coherent policy frameworks. Public health institutions should play a central role in governance, evaluation, and implementation to ensure that digital therapeutics advance, rather than exacerbate, health inequities.