Ask a question like how many companies are chasing after the $300 billion market opportunity of medication adherence and you’re liable to discover that it’s easier to narrow down companies that aren’t pursuing a strategy tied to this complex problem. A better way to break down is by strategy. Looking back at the various approaches entrepreneurs have developed, they include a fairly broad range of strategies particularly combining text, emails and phone messages and apps that set off an alarm. There’s also plenty of interesting technology under development that offers an alternative perspective to the issue. This is far from an exhaustive list but it reflects how companies are thinking about this topic.
Video proof Although medication adherence is just part of mobile health business, Emocha takes an interesting approach to managing the problem of tuberculosis. A spinout of Johns Hopkins Center for Clinical Global Health Education, its MiDot app involves patients recording themselves taking their medication, a requirement for the tuberculosis medication regimen. Earlier this year it began a pilot with the Baltimore Health Department. About 10,000 people were diagnosed with TB in the U.S. in 2012. Other conditions the company is tackling include smoking cessation, weight management and diabetes. Although the company has been offering its app for free to get enough participants to demonstrate its impact, the plan is to eventually charge providers.
Smart pill bottles Adhere Tech has focused on specialty pharmaceuticals in areas such as cancer treatment and HIV where medications are accompanied by a high price tag. Its connected technology is tied to a pill bottle with a sensor that can detect when it’s been taken. It collect data and transmits reports to physicians. It also senses when a dosage has been missed and that can trigger alerts that can be customized to users, either in the form of an automated phone call and text messages and/or the pill bottle flashes and chimes. Common Sensing took the concept of embedding sensors in pill bottles to medical devices. Its GoCap on insulin pen caps tracks each dose and transmits that data to physicians. An LCD screen on Gocap shows the number of units and time since the patient’s last dose.
Artificial Intelligence The developers of AI Cure‘s technology liken it to a personal trainer in a gym working directly with a client to achieve their goals. It involves facial recognition and motion-sensors in a mobile device. It records patients taking their medication and transmits that data back to a clinician through a HIPAA-compliant secure network, who can then confirm that patients took their meds. It can also flag up adverse events or potential barriers and work with patients to overcome them. Although the company has focused on clinical trials and has worked with some health systems and pharmaceutical companies, a new pilot will monitor and intervene with patients seeking therapy for opioid addiction. Next IT’s Alme Coach talks to patients in the hopes of generating a conversation not only about a missed dosage, but also how they’re feeling. Although the service can be triggered by a missed dose or sleep alarm, the developers want it to have a conversation with users that goes beyond a yes or no interaction to generate insights behind what’s motivating patients’ behavior such as depression, financial concerns or side effects. Patient with chronic conditions are the primary interest for this platform because the patient population is so large and because so many things can contribute to someone’s worsening condition beyond medication, such as diet, sleep, emotional state and exercise.
Data aggregation One of the interesting issues in adherence is using the most up to date information about a person’s physical state to make observations and insights about their response to medication. The development of Proteus as a sensor that can be swallowed that works alongside a skin patch electrode has created the ability to track how medication is affecting vital signs, as well as adherence and other data to make more informed medical decisions on dosage levels. Glooko’s collaboration with Joslin is also pretty interesting because it offers a direct answer to the question of what problems can be solved by harnessing data from fitness trackers. They’ve created a way to inform diabetics based on their level of activity whether they are at risk for a hypoglycemic event and advising them what they can do to avoid it.
Low tech design PillPack takes a simple but elegant approach to ordering and packaging medication in daily packets to help patients take their medications. Customers enter their prescription, physician and insurance information on PillPack’s website and pay a flat fee on top of their standard co-pays. The company ships all of a customer’s prescriptions, over-the-counter medicines and vitamins in a 14-day supply of individual packets that come in a roll. Each packet is printed with the contents and instructions on when to take the pills.About one month before a customer’s prescription runs out, PillPack’s pharmacists contact a customer’s doctor and the insurance company, if needed. And if a customer needs to add a new prescription to an order, PillPack overnights an interim supply and then automatically includes the new drug in the next 14-day shipment. As of October its mail-order pharmacy was in 40 states but by the start of 2015, it wants to be nationwide.
