[Edaily Reporter Kim Seung-kwon ] “Cognitive behavioral therapy is like a roadmap that outlines the basic principles and direction of treatment. Going forward, it must evolve into an approach that guides treatment based on each patient’s actual condition.”

Kang Sung-ji, CEO of Welt, cited technological advancements in digital therapeutics (DTx) as a key change on the horizon. As the next step, he proposed “treatment intelligence” that incorporates patient data in real time. He explained that apps must evolve beyond existing cognitive behavioral therapy-based models to analyze changes in individual patient conditions and lifestyle patterns in order to adjust treatment plans accordingly.

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Welt develops and operates “SleepQ,” a digital therapeutic for insomnia. SleepQ is a product that corrects patients’ sleep habits based on cognitive behavioral therapy for insomnia (CBT-I).

CEO Kang explained that insomnia cannot be viewed simply as a lack of sleep duration. He noted that insomnia patients often split their sleep into segments—such as through naps or irregular sleep patterns—and that the core issue lies in their inability to get sufficient sleep during the necessary hours. “The goal of treatment is not simply to make the patient fall asleep, but to regulate sleep pressure so that they feel sufficiently sleepy at the appropriate time and can fall asleep in bed,” he said, adding, “Reducing naps and unnecessary time spent in bed is part of the treatment process.”

SleepQ collects the user’s sleep data for the first week or so and then suggests personalized bedtime and wake-up times. It then adjusts the sleep schedule based on the previous day’s sleep quality and the next day’s schedule.

CEO Kang said, “If a patient decides their condition has improved during treatment and arbitrarily changes their sleep habits, their condition may worsen again,” adding, “Digital therapeutic devices play a role in helping patients maintain their treatment course for a certain period.”

Regarding the domestic regulatory environment, he predicted that insomnia DTx is more likely to remain in the non-covered market rather than be included in national health insurance coverage. CEO Kang explained, “Essential medical areas for which the government must take responsibility are highly likely to be covered, but conditions like insomnia—where patient choice and self-management play a significant role—are likely to be approached as non-covered services.” He added, “Even after formal listing, it will not be easy to have the existing non-covered price levels recognized under insurance coverage.”

Welt views out-of-pocket insurance coverage as the primary access route. SleepQ is classified as a recognized non-covered item, and a significant portion of the prescription cost can be covered by out-of-pocket insurance. The company explains that the patient’s out-of-pocket cost is approximately 20,000 won. CEO Kang said, “Insomnia is a condition with a high prevalence, and there is clearly a demand from patients whose symptoms do not improve even after taking sleeping pills,” adding, “As doctors’ and patients’ understanding of DTx increases, prescriptions are likely to expand.”

Regarding assessments that the initial growth of the domestic DTx market is slower than expected, he noted that this should be viewed as part of the industry’s formative process. “As the number of domestic products increases, a market environment is emerging where doctors and patients can compare and choose options,” he said. “Welt has secured operating capital to sustain operations over the long term until the market matures.”

“In-Person CBT-I Exists, but Its Practical Application Is Limited”

Cognitive behavioral therapy (CBT-I) for insomnia is listed in clinical guidelines as a treatment that should be considered first before prescribing sleeping pills. However, it has been pointed out that this approach has not gained traction in actual clinical practice.

Currently, cognitive behavioral therapy for insomnia administered directly by a doctor is covered by health insurance. However, CEO Kang explained that it is difficult for medical institutions to operate this service because it requires seeing patients weekly and involves approximately six hours of counseling time for the entire course of treatment.

“While treatment principles dictate that CBT should be administered first, in reality, there weren’t many medical institutions capable of providing it,” he said. “As a result, treatment often centered on sleeping pills.”

Welt’s strategy is to fill this gap with DTx. The plan is to reduce the clinical burden on medical staff through digital-based therapy and support patients in continuing their treatment as part of their daily lives.

CEO Kang explained that the decision to include only validated CBT in SleepQ 1.0 was made with regulations and clinical evidence in mind. “While we could have added white noise or various sleep-aid features to the app, it would be difficult for healthcare providers and regulatory agencies to evaluate them if the clinical evidence were unclear,” he said. “We focused first on commercializing CBT based on textbooks and clinical guidelines.”

The next step Welt is pursuing is “digital therapy intelligence,” which refines treatment based on patient data. This approach analyzes sleep patterns, lifestyle habits, and changes in symptoms to predict the likelihood of a patient’s sleep deteriorating and propose treatment strategies accordingly.

However, CEO Kang made it clear that this feature has not yet reached the stage of commercialization. “We must clinically and technically demonstrate to what extent we can predict changes in a patient’s condition and incorporate them into treatment,” he said, adding, “This is an area we need to demonstrate through future research.”