A prescribed health app in Germany sells for 200 euros. Adham Kassab, COO of haelsi, on where 120 of it goes.

Germany lets public health insurers pay for a prescribed app. That sounds like the easiest distribution deal in consumer health until you price the entry: an information security certification, an audit, a randomised controlled trial, ongoing reporting, and a further charge every time you change the product. And once you are listed, the person using the app is not the person paying for it.

Adham Kassab ran Selfapy, one of Germany's best known prescribed digital therapy companies for mental health, through its sale to MEDICE. He is now Chief Operations Officer at haelsi in Vienna, a network of health centres that sells corporate memberships, rents capacity to doctors and builds its own digital services on top. He has run the software side and the physical side of the same market.

In this conversation:

- Why prescribed health apps in Germany cluster around the same price, and what is actually left per order

- Why "customer" is the wrong word in healthcare, and which of the three stakeholders blocks the deal

- Why most digital health products have not reached profitable unit economics

- Why doctors stopped being persuaded by downloads, retention and engagement

- What the fitness industry has to prove before an insurer will pay for strength training, and the one step a gym operator can take this week

Recorded in early 2026.

Chapters:

00:00 Three people in a restaurant: who is the customer

00:12 Unit economics and how fitness gets paid, in brief

01:26 What Selfapy is, in plain terms

03:12 Three tiers of health app, and only one gets reimbursed

04:40 One orders, one eats, one pays, and what listing costs

06:10 200 euros per prescription, 80 euros of margin

07:18 haelsi: centres, corporate memberships and doctor rentals

09:39 GLP-1, muscle loss and why there are no fitness partners

11:05 Why doctors do not prescribe strength training

11:31 What fitness has to prove, and one step to take this week

14:29 What a clinic chain and a therapy app share

15:40 Outcome-based reimbursement changes the top metric

16:53 Big tech in health: more potential, not more effectiveness

17:26 Consumerization is not reversible

18:15 Pulse check: seven questions, seven answers

Links:

• Adham Kassab on LinkedIn
• Haelsi
• Natalia Karbasova on LinkedIn
• Tomorrow Health
• Apply to join FitTech Club