Digital pills: The future of oral therapy?

Digital pills: The future of oral therapy?

Patient adherence is critical to improving health outcomes and reducing costs to the health care system1. However,  patient adherence remains a significant challenge, particularly in chronic diseases requiring frequent and ongoing pharmaceutical treatment. Health care professionals and health systems recognize this as a significant and persistent problem and have made many attempts to improve adherence by employing various technologies and strategies. Despite these efforts, nonadherence remains an issue with evidence indicating that only about 50% of patients adhere to long-term therapies2.

One of the most recent attempts to improve patient adherence is the digital ingestion tracking system pioneered by Proteus Digital Health in collaboration with Otsuka Pharmaceuticals, Abilify MyCite® (aripiprazole tablets with sensor). The system was approved in 2017 to treat schizophrenia and intends to improve patient adherence by tracking medication intake through signals from the pill’s sensor3. Since its initial launch in schizophrenia, Proteus has expanded its digital pill to integrate with other FDA-approved medications, most recently the chemotherapy agent capecitabine.

Proteus is confident that digital pills can improve patient adherence has stood behind their technology by inking an outcomes-based contract with Minneapolis based Fairview Health Services. Under this agreement, there is no additional cost to the plan or the patient beyond what they would normally pay for capecitabine, and Proteus will only receive payment if patients take the medication as prescribed for at least 80% of the time4.

Outcomes-based contracts have been a mainstream topic in the US healthcare plans, but actual implementation remains limited in large part due to operational challenges associated with collecting and analyzing patient data over a period of time5. However, Proteus plans to overcome this by housing the data in a cloud-based system and feeding it into a user-friendly application where both patients and health care providers (with patient consent) can access it. The system is taking a personalized approach to medication adherence, such that the notifications and reminders are less generic and more specific to the patient and treatment plan.

The greater availability of data through the use of Proteus’ digital pill and the personalized approach to improving adherence may very well lead to a clear demonstration of benefit in the outcomes-based contract with Fairview Health Services. This would be quite an accomplishment as adherence has historically been both difficult to track and promote. Are digital pills the future of oral therapy? It is possible to envision a future where digital pills play a role in gathering data to support certain outcomes-based contracts, help manufacturers demonstrate the value of their therapies and improve the standard of care for patients.

Jupiter has considerable experience understanding payer perception and developing payer strategies in the digital health and therapeutic space – please contact us anytime to discuss this or any other market access related issue

About the authors:

Bill Shimp is a Director in Jupiter’s San Francisco based practice and Sandie Hong is a Senior Analyst in the Los Angeles based practice.

References
  1. Roebuck, M. C., Liberman, J. N., Gemmill-Toyama, M., & Brennan, T. A. (2011). Medication Adherence Leads To Lower Health Care Use And Costs Despite Increased Drug Spending. Health Affairs, 30(1), 91-99. doi:10.1377/hlthaff.2009.1087
  2. Hanse, L. Impact of nonadherence to cancer therapy. Journal of Hematology Oncology Pharmacy Online first. Retrieved at http://jhoponline.com/ton-online-first/3639-ton-3639
  3. FDA News & reviews. (2017). FDA approves pill with sensor that digitally tracks if patients have ingested their medication. Retrieved at https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm584933.htm
  4. Robbins, R. (January 17, 2019). A ‘digital pill’ for cancer patients is rolled out for the first time, in hopes of improving outcomes. Retrieved at https://www.statnews.com/2019/01/17/a-digital-pill-for-cancer-patients-is-rolled-out-for-the-first-time-in-hopes-of-improvingoutcomes/?utm_source=STAT+Newsletters&utm_campaign=4a0432fa62-Daily_Recap&utm_medium=email&utm_term=0_8cab1d7961-4a0432fa62-151159301
  5. Brow, M., Macher, D., Hughes, K. (July 12, 2018). Health Plan Interest in Outcomes-Based Contracts Increasing.  Retrieved at https://avalere.com/press-releases/health-plan-interest-in-outcomes-based-contracts-increasing