In the future, medicines + digital experiences will bring more effective drugs

For decades Big Pharma has struggled with the thorny problem of low patient adherence and engagement.

Now the worlds of pharma and digital health are intersecting as the former leverages tools created by the latter to go “beyond the pill.” One such company that is helping Big Pharma understand patient engagement and boost patient adherence is Propeller Health.

Propeller Health has developed an FDA-cleared remote monitoring sensor for inhalers to help physicians monitor medication adherence among asthma and COPD patients and help patients track their own adherence data.

Several pharmaceutical manufacturers, such as GlaxoSmithKline and Boehringer Ingelheim, have partnered with Propeller Health and adopted its technology, as have payers like Amerigroup Florida/WellPoint and providers such as Dignity Health.

Chris Hogg, the Madison, Wisconsin startup’s chief operating officer , will be a speaker at MedCity ENGAGE conference on October 18-19 in San Diego. Hogg took some time to respond to questions via email, reflecting on the “beyond the pill” trend.

MedCity: What has impressed you most about the beyond the pill trend? 

Hogg: What has impressed me most about the ‘beyond the pill’ trend is that after a decade of talking about it, it is actually starting to happen on a broad scale!  We see a number of digital health companies, and most pharmaceutical companies, now working to deliver services around medications to make them more effective and more patient-focused.

I think digital health companies have evolved enough and have now generated enough evidence to convince pharmaceutical partners of the value of “beyond the pill” solutions.  This is leading to significant partnerships, commitments to conduct clinical studies to generate more evidence, and commercial agreements.

MedCity: What kind of insights have your remote monitoring sensors yielded on adherence patterns regarding COPD, asthma medications?

Hogg: We have learned a lot about the individual patterns of adherence, insights that have not been possible before without the granular adherence data we collect.

We are developing a much more detailed and objective assessment of adherence phenotypes (adherent, non adherent, varying adherence, seasonal adherence, intermittent adherence due to poor control and other factors) and then figuring out what predicts those phenotypes.

One interesting trend we have seen is that people are less adherent on weekends than during the week. For instance, our data show that people are 12.5% less adherent on Saturdays than they are on Wednesdays.  This type of analysis hasn’t been possible before with only Rx records, which do not necessarily represent medication-taking behavior.

MedCity: What are some exciting trends, particularly with respect to pharmaceutical companies investing in digital health technology/medtech to support drug development?

Hogg: I am very interested in the incorporation of digital health solutions and patient-generated data early in the clinical development process.  We are starting to see digital health + medications developed as combination products, with increased efficacy over the drug alone.  These combination products allow for new endpoints (e.g., quality of life or medication adherence), enhanced data collection (leading to smaller and shorter trials) and even adaptive, data-driven dosing of medications.

In the next few years we will begin to see new, differentiated products approved with the combination of medicines and digital experiences.  These will be marketed as line extensions for existing branded drugs or as repurposed generic medications.  In some cases the digital component will be integrated directly into the medication or medication dispenser (i.e.: Propeller or Proteus Digital Health), or in some cases as a “digital wrapper” around a medicine (i.e.: Pear Therapeutics or Glooko).

MedCity: How widely available has adherence monitoring tech become to the asthma and COPD patient population? Are you winning hearts and minds with payers?

Hogg: We are definitely seeing the broader adoption of digital health solutions, like Propeller’s, within health systems and among payers.  Rather than being limited to small pilots within innovation groups, we are now seeing enterprise- and population-wide rollouts championed by chief medical officers and chief medical information officers.

This is largely because we have now sufficiently demonstrated that patients who use our products see better outcomes, high retention and high engagement, and customers who use our products see improved efficiency, improved patient satisfaction and lower costs.  It has taken awhile, but I think we are definitely starting to win the hearts and minds of payers and healthcare execs.

Photo: Propeller Health