Experts estimate that patients who do not take their medications as ordered cost this nation approximately $100 billion a year in additional medical expenses. Much of that additional cost is due to patients getting sicker and needing additional treatments or even hospitalizations.
Several years ago, I wrote a blog about the mind-boggling statistics regarding the number of patients who go to the doctor for a specific ailment but then ignore the doctor’s prescribed treatments. At that time, an estimated one-third of patients did not fill the prescription(s) that the doctor ordered to cure or alleviate the ailment.
The elderly population appears to be the worst about taking medications as prescribed. A study by the US Office of Inspector General (OIG) indicated that 55% of elderly patients do not take their medications as prescribed. That percentage increases to an estimated 75% when elderly patients are prescribed three or more medications.
Earlier this month, the US Food and Drug Administration (FDA) approved the very first “digital pill” and this is a significant advance toward addressing the longstanding issues of drug therapy non-compliance.
A digital pill is an oral medication embedded with a sensor that emits a signal when a patient takes their medication. The sensor—containing safe ingredients normally found in food, like copper, magnesium and silicon—generates an electrical signal when touched by stomach acid.
After several minutes, the signal is detected by a patch worn on the patient’s skin—looks like a Band-Aid. The patch should be located on the skin over the left rib cage and needs to be replaced after seven days.
The patch, after receiving the signal from the ingested sensor material, sends the date and time of the medication’s ingestion to a cellphone app via Bluetooth technology. That information is then transmitted to a database that physicians and others, who have the patient’s permission to do so, can access.
Since 2016, the use of this technology has been tested outside of the clinical trials with specific pharmacies, but commercial use was very limited. Until this recent FDA approval, the sensors and medication were added to a digestible capsule by the dispensing pharmacies. Nine health systems in six states tested the technology with success for conditions that included hypertension and Hepatitis C.
The first digital medication approved this month by the FDA for the embedded sensor technology is Abilify, a medication prescribed to patients with schizophrenia and/or bipolar disorder. Patients with these conditions often do not take their medication regularly, and non-compliance can have severe relapse consequences. This new version of Abilify is called Afilify MyCite.
Additional regulatory clearance is being sought for medications used by heart patients, stroke victims, those with H.I.V., diabetic patients, and post-surgical patients to monitor for taking too much opioid pain medications.
Experts believe that regular compliance to medication therapy by a wide variety of patients, especially the elderly, could lead to reduced costs from non-compliance.
Variations of this initial sensor technology are already in the works with sensors made from magnesium and silver chloride that do not use the patch technology to pick up the signal of therapy ingestion.
Medication embedded with these chemicals generate a low power radio signal that can be picked up by a receiver worn around the neck of the patient. This presents an acceptable alternative for those patients who might be sensitive/allergic to the patch receiver option. There is also receiver technology being developed in the form of watch bands and cellphone cases for additional convenience.
The issue of privacy, as well as the overall argument by some that this is simply another “Big Brother Watching” scheme, is a concern with many patients. At least for the foreseeable future, such technology is merely an interesting option to conventional oral medications, and this new technology can be rejected by patients with privacy concerns.
Thoughts? Comments? I’d love to hear them!