- mHealth technology could save the nation’s healthcare system roughly $290 billion in medication management costs. Unfortunately, doctors, patients, payers and pharma all have different ideas on how it should be used.
That’s the upshot of a new report from Lux Research. It finds that while patients prefer smart packaging to help with their care management, their doctors want technology that delivers the medication to the patient and monitors adherence, such as a smart pillbox. Pharma, meanwhile, prefers physiological monitoring – such as wearables – and payers prefer technology that confirms that the medication is being taken, such as ingestibles.
The best avenue for medication management? Smart drug delivery systems, which ranked highest in an analysis of 13 factors.
"User-friendly interfaces combined with effective technical capabilities are both required for addressing this market which will continue to grow due to population aging and epidemiology trends," Milos Todorovic, a Lux Research analyst and lead author of the report, said in an accompanying press release. "Seamless integration into objects people use on a regular basis would go a long way toward increasing the utilization of the technology and reducing the social stigma that comes with continuous monitoring.”
The report analyzes different medication management and adherence platforms based in usability and impact, and finds that patients and their doctors have different ideas of what works and what doesn’t. The patient favors an inexpensive, easy to use method that fits into his or her daily lifestyle, while the doctor is more focused on clinical and regulatory validation, and wants something that proves that a drug is being taken and that it’s working.
For that reason, the report says, doctors favor hardware solutions like remote monitoring platforms that use video or photos to confirm medication adherence. And they don’t like software solutions, such as apps.
“Physicians find the ease of use and drug abuse prevention to be among important parameters that distinguish the hardware solutions from their software counterparts,” the report says. “On the other hand, as the most glaring example of a technology that does not meet user’s needs, logging software/apps solutions do not provide any significant value to physicians, due to the combination of low impact and usability scores driven by the low accuracy, clinical and regulatory validation, and measurement type scores.”
According to the study, pharma is more focused on solutions that track medication consumption and capture data on the effects of those drugs. They favor smart pills and patches, though those solutions don’t rate well on usability because they’re not popular with patients. So the better technologies for them are physiological monitoring solutions that detect consumption.
“The importance of physiological monitoring to pharma companies extends beyond the medication adherence monitoring, as it gives the companies the ability to track the physiological impact drugs have on patients, which is a critical value add during clinical trials,” the report said.
Payers also see value in detecting consumption, but they’re naturally worried about cost.
“An interesting thing to point out is that telemedicine solutions score low in payers’ view, predominantly due to the fact that the frequent patient/doctor interaction adds significant costs to the cost of care due to the high cost of medical professionals’ services, most of which is borne by insurance companies,” the report points out. “This represents a significant barrier to adoption from the payers’ perspective, and companies developing solutions that integrate the functionality that allows doctors and patients to use telemedicine to boost adherence need to consider limiting the amount of interaction to contain the costs.”
For that reason, the study finds that payers prefer smart delivery technologies that track adherence but aren’t cost-prohibitive.
The report concludes that while all technologies have their advantages, none will be used if they aren’t used consistently by the patient. An effective platform, therefore, must:
- Support the sharing of data between patients and providers;
- Be prescribed by providers;
- Qualify for reimbursement; and
- Work well for patients who rely on medications to live comfortably or to manage multiple chronic conditions.
In addition, the report notes that pharma will increasingly turn to adherence monitoring. That’s because the typical clinical trial now costs close to $100 million, and a 40 percent non-adherence rate means the typical trial needs twice as many enrolled patients.
Finally, the report says spiraling healthcare costs will compel both payers and the government to mandate the use of medication adherence monitoring.
“Both the governments and insurance companies that bear the brunt of health care costs will require patients to adhere to their therapies, with the goal to minimize the expenses currently resulting from poor adherence,” the report says. “The likely mechanism to impose the mandate will include penalties for those patients who fail to comply. As a result, patients will be economically incentivized to use adherence monitoring solutions to prove the adherence. This will significantly increase the addressable market, as more than 4 billion prescriptions are filed every year in the U.S. alone, and each will require the use of one of the adherence monitoring solutions.”