What's the Future of the Digital Pill?

Digital medicine, also known as digital health, is the joining of digital and genomic revolutionary innovations with healthcare. Innovations in digital health are improving health and access, reducing costs, increasing quality, ensuring patient safety, and making medicine more personalized. In November 2017, a digital pill called Abilify MyCite was approved. The pill is targeted at individuals with mental health conditions such as schizophrenia and bipolar disorder. It is equipped with a tiny sensor that can be swallowed and that creates an electric signal when it reaches the digestive juices. The electric signal communicates with some type of external device, such as a wearable patch or an app, and lets doctors know if and when patients take their medications.

The digital pill is a project created by a digital medicine service called Proteus Digital Health and a Japanese pharmaceutical company called Otsuka. It is introduced after several years of conducted research with an aim to reduce unnecessary healthcare costs. In fact, it was estimated that patients misusing their medications, skipping their medications or not taking their medications on time led to more treatments and hospitalization time. This, in turn, costs taxpayers in the United States between $100 to $289 billion dollars on an annual basis.

In cases involving schizophrenia, there is an immense need to improve health outcomes. While there are medications available to help monitor and control the disease, there are also several problems that can be brought about from these medications. If patients are not taking them as prescribed or are misusing them, these medications can pose harmful side effects. According to the World Health Organization, 21 million individuals around the globe are suffering from schizophrenia - a chronic mental disorder that affects how an individual thinks, acts, and feels. It is also one of the most common causes of disability. Disorders, such as schizophrenia, are a growing problem because more than 70% of individuals do not take their medications on time. In retrospect to the digital pill, the ability to combine it with a sensor that can track and share information with healthcare professionals is potentially huge. It may not work for every individual, but it will definitely work for those in need of severe improvements. In turn, these improvements in health outcomes can lead to a better quality of life.

The digital pill is a huge step in the field of medication monitoring. The hope is to provide healthcare professionals with a sort of GPS tracking system of the human body, for the purpose of adjusting dosages and personalizing medications for patients. Some experts even believe that the digital pill has opened the door to the possibility of one day being able to replace pills altogether. Yet, what are the pros and cons of the digital pill?

• The ability to track patients’ use of medications in an appropriate and timely manner.
• The ability to allow doctors to be informed of any patients’ missed doses.
• The ability to monitor patients’ use of opioid medication after surgery for the purpose of preventing dependence.
• The ability to reduce the need for more treatment/hospitalization time.
• The possibility of taking action against the opioid crisis.

• Patients would be consenting to a lesser degree of privacy.
• There is no 100% guarantee that patients’ medical information cannot be hacked and used by third parties.
• The pill does not track other details apart from use of medication.
• The pill may lead to a reduced need for clinical visits or home-visits by nurses.

The greatest potential of the pill is the ability to improve health. However, the greatest challenge remains that of patients’ privacy, as security and privacy of two of the most important issues when it comes to healthcare. “So, we have done everything we can to ensure that this system, in its entirety, is compatible with the highest standards. That is a fundamental issue that we have addressed,” said Kabir Nath, CEO of Otsuka in North America. Other concerns are regarding the access to patients’ gathered data. “This really is between the patient and the physician. Let me be very clear here: This system will only be used when this patient chooses with their treating physician to be treated with Abilify MYCITE. It is not going to be every patient with schizophrenia and bipolar disorder for whom this is an appropriate treatment,” said Nath. Otsuka has stressed that they are planning to start off production of the drug slowly, offering it to certain healthcare professionals and individuals with a couple insurance plans. “We are optimistic and ambitious that this can help to measure ingestion and ultimately, we might be able to demonstrate evidence around better outcomes for patients,” said Nath.
Nowadays, with the high number of medications being prescribed, it can be easy for patients to get lost and have a hard time keeping their schedules straight. Ultimately, the idea behind the digital pill is to alert the harmful effects of medications that are misused or skipped. Being able to track patients’ use of medications can help doctors and family members to identify what type of strategies might work best for the individual patient. For instance, patients with dementia need reminders to take their pills due to forgetfulness. For those who are isolated or do not have family members to help them, simple phone call reminders or written reminders can allow them to maintain their health.

Still, in terms of technological limitations, some medications need to be taken with specific conditions so that they do not cause potential side effects. This type of tracking may give patients a false sense of security. Moreover, face to face social interactions with healthcare professionals may be useful to patients in terms of asking questions and addressing concerns. With digital health, the information is available but relying solely on medications such as digital pills may not be enough. “If the goals of psychiatry are to help reduce suffering, improve function, and help people live the lives they want to lead, we cannot rely on medications alone to achieve this, particularly for those individuals with significant symptoms. Even if the data shows that someone is taking medications daily, that process measure is meaningless if the person’s overall function and quality of life remains poor,” wrote Maria Yang, psychiatrist.

New developments, such as digital pills, may help doctors to be able to monitor and treat diseases remotely, all the while preventing complications and avoiding expensive hospitalization stays. For patients, it is equally important that they are self-aware and educated on therapies that can improve their lifestyles and health statuses. New technologies will allow patients to become more engaged and take health into their own hands by offering more individualized and personalized approaches to their preferences and needs. Still, it is vital for the growth of healthcare that doctors are able to interact with clinical information and interpret it via computer or mobile device in order to make necessary adjustments.

Years ago, guidance from a doctor was often the only available source of health-related information. Today, the internet allows individuals to be more informed about their health – even before going in to see their doctor. They gather a sense of empowerment, engagement, and personal responsibility for their own health. As technological innovations continue to advance, they will transform the healthcare industry. That being said, digital health and other technologies will continuously change where, when, and how healthcare is delivered. The age of digital medicine, or rather digital health, is here to stay and new developments must be embraced for the purpose of improving the lives of patients – making them stronger and healthier. “We live in interesting times. We live at an inflection point of human history in that the evolution of technology – the desire to reform health care, the issues around an aging population, the issues of an empowered patient – is all coming together and things are going to change,” said John Nosta, founder of NostaLab.