Adherence to treatment has taken what just might prove to be a giant step forward. The Food and Drug Administration (FDA) has approved the first digital pill that informs physicians whether or not the pill has been taken through its own sensor and App. Is this now the era of “smart pharmaceuticals”?
How the digital pill works
A sensor inside the pill made of copper, magnesium and silicon (ingestible and non-toxic substances) is transformed by gastric juices and then sends out an electronic signal to an adhesive, battery-powered sensor worn by the patient. The signal is transmitted to an App for smart phones via Bluetooth where the doctor, and the other people authorized by the caregiver, can access the information. The App registers the date and time the pill is taken in a database. The patient can also make note of his or her emotional state as well as other details, such as how many hours of sleep he or she gets, to help the doctor evaluate treatment results.
The first digital pill put on the market will be used for the treatment of schizophrenia, depression and bipolar disorders, but will obviously be experimented on many types of pharmaceuticals associated with the adherence to treatment problem in the future, particularly for patients with chronic diseases and the elderly.
The “Big Brother” Question
If a patient’s state of health can be monitored by outsiders, then what happens if corporations or insurance companies have access to this type of information? If health insurance companies, for example, begin to provide incentives for the use of digital pills, offering discounts or preferential rates for clients that adhere to digital therapy, don’t we risk falling into a mechanism that is indirectly coercive instead of voluntary? This is the question asked by scholars, journalists in the sector and physicians. Jeffrey Lieberman, a psychiatrist at Columbia University, in an interview with the New York Times, said the pill has the potential of becoming a “Biomedical Big Brother”. Yet the system has been created so that data remains private. The information remains inside the patient’s body and is transmitted only through the adhesive bandage that is encrypted just before sending the data to the smartphone. The patient can exclude anyone he or she wants from the contact list on the App at any time, keeping the patient in control of personal information.
Adherence and oral therapies- a small revolution
At the root of the digital pill is primarily the need to reduce costs linked to a lack of adherence to treatment, or rather when patients do not take their medication all together or do not take medication as prescribed. In the U.S., in fact, it is estimated that health costs have increased by 105 billion dollars due to carelessness or negligence on the part of patients who to not adequately follow treatment. Yet the adherence to treatment problem is mostly a problem for the patient. As mentioned in a previous article about the advent of oral therapies, especially for patients suffering from chronic diseases, the simplification of oral therapy can have side effects. Patients that are used to a daily relationship with healthcare workers and caregivers find themselves, from one day to the next, with less people to relate to and a feeling of emptiness that could have negative consequences on the patient’s mood and on adherence to therapy. All of this is resolved with the digital pill, consistent with the “digital man” who also, and especially, relates to other people through the App. The patient, via smart phone, is encouraged to share as much information as he or she wants with the physician or caregiver, which helps put the patient at the center of a support network.
© Domedica s.r.l.