It is estimated that medication non-adherence can cost the healthcare system billions of dollars a year. Twelve companies tell us about their approaches to solve the adherence problem and help improve patient outcomes.
PillPack is the first pharmacy specifically designed to serve people who take multiple medications per day. In the U.S., that population includes the 30 million people (1 in 10) who take more than five prescription medications a day. There are also millions of other individuals who have a few prescriptions and other vitamins or OTCs.
With PillPack, customers receive a shipment every two weeks from the PillPack pharmacy in Manchester, NH. This shipment includes a personalized roll of pre-sorted medications (including vitamins and OTCs), along with a recyclable dispenser and any other medications that cannot be placed into packets, like liquids and inhalers.
Each PillPack shipment includes a medication label that explains what each pill is and how it should be taken. In addition to pre-sorting medications, PillPack coordinates refills and ships all medications at the appropriate time to meet refill times. Easy-to-use online tools allow customers to track their shipments, refills and co-pays. Customers can email or call their PillPack pharmacist any time to ask questions or clarify instructions.
PillPack is currently licensed in 39 states (pillpack.com/availability). There is no extra charge to switch to PillPack. Customers simply pay their normal 30-day co-pays for medications. Shipping and service are free.
MedVantx pioneered first-ever consumer access to free initial medication therapy, including generics, in U.S. physician offices through the company’s proprietary “ATM-like” medication management cabinet and sampling program, MedStart Connect. Through an integrated network of physician offices, MedVantx has eliminated a key structural gap in primary medication adherence—the fact that 30% to 50% of initial prescriptions are never filled at the pharmacy. And, the program supports secondary adherence as well.
Sponsored by manufacturers, health plans and health systems, the MedStart Connect program includes use and support of the MedStart cabinet, free initial therapy samples of medication at the point of care, a consumer helpline providing drug information, adherence follow-up calls and reminders, and convenient consumer home delivery.
MedStart Connect has been shown in studies to improve patient satisfaction with their physician office visit, as well as improving primary and secondary patient medication adherence and reducing overall healthcare costs.
Because patients receive medication immediately at the point of care, there are fewer barriers to patients starting their medication, and this impact has been shown to carry over into longer term use of these medications resulting in overall cost of care avoidance.
With imedipac, the award-winning communicating Smart Pill Dispenser, medissimo invented a new benchmark in connected health enabling correct medication adherence, shared in real time.
imedipac is a communicating and secure seven-day pill dispenser containing 28 compartments for the preparation of unit doses. It comprises a smart pill box and the imedipac tamper-proof NFC pill dispenser, which can easily be inserted into the box. The pill dispenser and its user are recognized by the NFC card. Fitted with optical sensors and supported by LED indicators and alarms, the Smart Pill Box makes it easy for the patient to take their medication safely and regularly and at the right time.
imedipac connects with the medissimo e-health platform using totally secure GPRS technology. The e-health platform offers supervision and allows the patient to share their adherence data with their doctor, pharmacist, nurse, healthcare networks or a trusted third party, remotely and in real time—in a reliable and secure way. Through the imedipac mobile application, patients can access a record of the medication they have taken, be alerted in an emergency or share their statistics using their smartphone or tablet.
With imedipac, medissimo intends to reposition the patients at the center of their own health by giving them a better tool for correct medication adherence. The imedipac device may make treatments more effective, avoid waste, bring down costs and, above all, save lives.
AdhereTech’s smart pill bottles are an ideal solution for specialty medications and clinical trials. These FDA-registered Class I medical devices are built with cellular technology and numerous sensors. They work by automatically sending adherence data to AdhereTech’s servers, where analysis occurs in real time. If a dose is missed, AdhereTech’s system immediately reminds the patient via an automated phone call or text message—as well as on-bottle lights and chimes. If the system notices prolonged non-adherence, it can solicit feedback from patients via text or phone call to immediately understand the reasons for non-adherence, and intervene accordingly.
AdhereTech is taking a unique approach to the issue of medication adherence. This solution focuses on creating a simple and easy patient experience. AdhereTech’s bottles are used just like normal pill bottles, and they require no set up. They connect to the cloud automatically, and the system works equally well for patients with landlines, cell phones or smartphones.
Last year AdhereTech started a pilot with The Walter Reed National Military Medical Center, and the early data shows it works. Throughout this year, AdhereTech is beginning engagements with two top pharmaceutical companies, a leading PBM’s mail order pharmacy and world-renowned research institutions. In early 2015, AdhereTech will be releasing their Generation 2 smart pill bottles, which will work in the same way as their current bottles, but will have the overall size and look of regular pill bottles. AdhereTech is actively seeking additional partners who are interested in their product and technology.
The World Health Organization estimates that 60% of patients fail to follow their prescriptions, while only 10% recognize their non-adherence to a therapy. Today, correctly supporting medication adherence relies heavily on high-cost physicians but penetration is low with a global average of 1.7 physicians for every 1,000 people.
Proteus Digital Health sees taking medications as the most frequent way people engage with their healthcare. We believe that we can make an impact on health by supporting individuals in the moment they take their medicine, whether at home, travelling or in the clinical setting.
Proteus is aiming to transform the medication-taking process with its core technology, the digital health feedback system. The ingestible sensor, one of the world’s smallest medical devices, is made entirely of ingredients found in the human diet. It is currently delivered inside placebo tablets that are taken alongside current medicines, but it will soon be integrated inside active pharmaceuticals.
How It Works
When swallowed, the ingestible sensor is activated by stomach fluid and creates what amounts to a heartbeat-like signal that is transmitted through the same physiologic pathways as a natural heartbeat. This signal is picked up by an adhesive patch worn on the torso that resembles a Band-Aid.
The patch is a proprietary wearable sensing device developed by Proteus, which records the data from the ingestible sensor, along with other health-related metrics (e.g., heart rate and activity). The patch then relays this to the wearers’ smartphone or tablet via Bluetooth. With the patient’s consent, the data can be automatically shared with healthcare providers, family members or other caregivers.
The newest approach to improving treatment adherence is driven by a time-honored academic discipline. Health psychology is the secret weapon guiding the development of strategic and effective patient support programs and adherence interventions.
Health psychology allows us to obtain insights around the real reasons why patients aren’t following their prescribed treatment. Our health psychology specialists use evidence-based tools to understand the beliefs and perceptions that shape how a patient thinks about their health, medicine and wellbeing.
Once we understand why patients aren’t following their treatment as prescribed, we can apply academic constructs from health psychology to change those unhelpful beliefs and, ultimately, the behaviors that stem from those beliefs.
For example, if an asthma patient doesn’t believe asthma is a chronic condition, they won’t take daily long-term asthma control medication—they’ll rely on their rescue inhaler for acute episodes. Once you change the beliefs, however, it’s possible to change the behaviors.
Our team of health psychology experts leverage learnings from their research of the patient population within a disease state to design effective adherence intervention programs. We then use an algorithmic-based personalization engine to ensure each person receives the right message at the right time.
Applications of health psychology to adherence are relevant across the multi-stakeholder landscape, from pharma marketers, to pharmacies and PBMs, to organized customers including commercial health plans and ACOs. The application of health psychology to the field of adherence support may re-define how we talk to patients to empower them to better manage their illness long term.
Not a drug discount card masquerading as innovation, InteliScript, Point-of-Care, Price Compare, a patent pending process, is designed as part of the workflow at PoC, embedded in EMR/EHR and e-prescribing systems.
InteliScript’s “Pharmacy Exchange Network” allows pharmacies to adjust/lower prices dynamically (five lowest prices, geographically suitable to patients’ homes, displayed on the e-prescribing screen), and is designed to drive down the cost of prescription drugs.
Non-adherence is a complex problem, with many contributing factors. But according to Consumer Reports, Best Buy Drugs, “Money also plays a big role: Millions of people every day are unable to take their medicines as directed because they simply cannot afford them.”
InteliScript enables patients to be more engaged in their health decisions, working with their HCP, to determine the most cost-effective Rx solution to decrease abandonment and increase adherence. Additionally, co-pay assistance can be automatically applied for qualifying patients (requiring no card to be redeemed), further reducing the cost of the drug, and increasing compliance. If insurers provide access to the data, InteliScript’s technology can also provide real-time plan benefit check.
Once the lowest cost is determined, InteliScript’s technology platform can “follow the script.” Patients can be notified when the drug is ready for pick-up, showing the amount saved.
Tracking first fill abandonment, InteliScript notifies the practice so the HCP can intervene, improving adherence and outcomes. Patients can also be informed (HIPAA compliant) when their next script is ready and receive relevant education and adherence messages.
InteliScript aims to cover everything from pricing, to automatic co-pay application, to real-time benefit check, to “following the script.”
MediSafe, the first ever cloud-synced medication reminder platform, has expanded its offering to become the first mobile health wearable app on Google’s recently announced suite of Android Wear smartwatches. Users wearing either the LG G Watch, Samsung Gear Live or Moto 360 smartwatches, who also have the MediSafe medication management solution installed on their Android smartphone or tablet, will automatically have a MediSafe “wearable app” loaded on their Android Wear device. Then they will begin receiving medication reminders on their smartwatch when it’s time to take scheduled doses. When it comes to recording the taking of doses they have two choices:
- “Shake to Take”—Users simply rotate their wrists left-to-right.
- “Swipe and Tap”—Users swipe-left on their reminder and tap once to confirm.
In either scenario, the data is seamlessly transferred to the MediSafe app on their smartphones and tablets via Bluetooth. There it becomes part of their full medication adherence file, which they can export and email securely to their personal healthcare providers in between office visits.
Android Wear brings MediSafe one step closer to patients—something central to our mission to connect patients and healthcare providers for constant, two-way communication around medication management.
Facial Recognition Solution
Every year, pharmaceutical brands lose 38% of their revenues due to patients not taking their medication correctly. Likewise, payers and governments spend $198 billion annually on hospitalizations due to medication non-adherence. The Accountable Care Act is also forcing payers to scrutinize the value of products more closely. For all these reasons, it is becoming increasingly critical for brands to align their interests with those of payers and governments, by developing adherence strategies for treating the costliest and highest-risk patients.
AiCure offers the only advanced HIPAA-compliant facial recognition solution to accurately confirm that the right patient is taking the right medication at the right time. There is no need to review video to confirm medication ingestion as the platform’s algorithms are able to confirm the administration. The technology can be used for oral, sublingual, inhaler and injectable medications across multiple patient populations. Since patients may download the app onto their smartphones or tablets, no change to the medication or the packaging is required.
The interactive technology takes just a few seconds to use. Like a personal trainer, it provides reminders, instructions on proper administration, positive reinforcement, unique branded content and even incentives linked to behavior. In the event that the patient does not take their medication, the care provider will be alerted in real time to follow up with the patient.
All these features work together to try to optimize medication adherence and improve the delivery of care, while differentiating the brand. To see how the platform works, visit www.aicure.com.
RxAnte is a leading platform for improving medication use and drug therapy outcomes through predictive analytics and targeted clinical programs. RxAnte’s latest solution, RxEffect, is improving the way patients use their prescription medication by engaging their providers through an easy-to-use web-based dashboard. Research shows that provider interventions are the most effective at changing patient behavior, yet they are often the most expensive. In order to maximize this valuable resource, RxEffect enables providers with the information they need for a small list of patients who are most likely to benefit from their intervention.
RxEffect is built on RxAnte’s proven predictive analytics platform and uses decision support to update recommendations and information daily. Providers access the dashboard for a list of patients who are at risk of not taking their medications as prescribed, relevant patient-specific health information, as well as resources to improve medication-taking behavior.
During a six-month initial test pilot, RxEffect improved patient adherence to chronic disease medications. Providers actively using RxEffect saw as much as a 6% higher year-end medication adherence rate compared to those not actively using RxEffect. The RxEffect dashboard is currently used by nearly 5,000 physicians serving 25,000 at-risk patients across 11 states. Along with our other products, RxView and RxForecast, RxEffect completes a suite of solutions designed to improve prescription medication use before problems arise.
Every patient is a person first. Their circumstances are unique to each one of them.
Nearly one-third of chronically ill patients suffer from behavioral disorders.1 Patients with such comorbidities experience worse outcomes.2 There is a significant opportunity to improve adherence by integrating patient’s behavioral/social circumstances into the care plan. Unfortunately, physicians are limited by time and the confines of their offices.
What if we could have meaningful ongoing communication with each patient? We could relate to them with empathy, keep health on the forefront of their mind and, ultimately, support them on a journey to self-management. That is what CareText is designed to do.
It starts by taking a behavioral snapshot: Our mobile platform takes patients on an engaging self-administered journey through clinically validated screeners for various behavioral and social determinants of health such as living status, depression, anxiety, cognition, etc. Patients complete screenings in the physician’s waiting room. Clinicians get valuable insights without disrupting workflow.
CareText then meets the patient wherever and whenever it is convenient: Our three to six month long texting programs combine personal, medical, behavioral and social elements to deliver empathetic advice and education. CareText interacts with patients three to four times per week and doctors monitor exceptional events. CareText is also able to rapidly learn each user’s patterns and deliver individualized continuity of support.
1. Druss, BG., and Walker, E.R. (February 2011). “Mental Disorders and Medical Comorbidity.” Research Synthesis Report No. 21. Princeton, NJ: The Robert Wood Johnson Foundation.
2. Mental Health Parity, Segal/Sibson, 2009
Traditional forms of print collateral have long been the method of communicating relevant messaging and critical medical information to patients. Since its inception, Americhip has used its expertise in multisensory technologies to increase the effectiveness and impact of traditional print collateral through the use of audio chips, lights, paper engineering and even video.
In order to further increase the effectiveness of these patient communications, Americhip developed a way to continue the conversation with the patient by connecting them with doctors, pharmaceutical companies, case workers and healthcare partners—directly from the printed page. In late 2013, Americhip introduced the first ever Mobile in Print direct mailer.
Mobile in Print is a proprietary technology platform that allows marketers to add a direct communication portal to trade journals, magazine inserts, physician mailers, patient education kits and corporate communications. Using this product, patients with questions or concerns about medical treatments, products and services can now instantly connect with healthcare partners via a call or text.
Available data tracking and analytics further increase patient adherence by allowing healthcare partners to refine and improve patient communications, whether the objective is to deliver critical medical information or to stay connected with patients.