Compliance with medications is considered one of the best ways for patients to stay on track in managing their health. However, driving adherence is a complex problem influenced by not only medical, but also economic, social, and geographic factors. Ensuring patients continue taking their medications, while understanding and addressing the source(s) of an individual’s tendency to unintentionally or intentionally miss a dose, represents the goal of many medication adherence programs. Recent innovations in digital health have tackled medication adherence with software, hardware, and combined solutions to achieve this goal.
One company, AdhereTech, is taking the approach of reimagining the role of the medication pill bottle. Most of Medgadget‘s readers are familiar with the often white or translucent orange pill bottle that functions as the vehicle and storage unit for medications picked up at most pharmacies. Beyond acting as a storage unit, AdhereTech is taking the concept of a pill bottle to a whole new level by integrating the same technology used in cell phones to track a pill bottle’s usage and contents. Medication adherence can now be quantified wherever the bottle is taken with follow ups to the patient triggered when medication is missed. As CEO Josh Stein shares in the interview below, AdhereTech is more than a medical device company, however. The data captured through the company’s technology-enhanced pill bottles is analyzed on the backend to provide significant insight and value to both clinical and patient stakeholders, all of whom benefit from increased medication adherence.
Medgadget, Michael Batista: Let’s start with who AdhereTech’s business model is focused on, who do you work with, and who are your users?
Josh Stein: At AdhereTech, we work with pharmaceutical companies and pharmacies to ensure that patients on certain medications receive those medications from the pharmacy in one of our bottles at no additional cost to the patient. AdhereTech’s pill bottle technology works right out of the box making it incredibly easy and straightforward to use for any patient. The average age of patients using AdhereTech pill bottles is 70 years old. For some of those patients, an AdhereTech pill bottle is the first piece of technology they have used.
For patients, there are two areas of value. First, if you miss a dose, you receive a reminder to help drive compliance. The second area of value comes from data analysis done on the backend. If a patient needs additional care and support, or if the system thinks the patient needs a push to stay on track, the patient or specialty pharmacy is engaged to ensure the patient can get the care they need, when its needed.
Medgadget: How does the technology work in order to provide such streamlined usage and avoiding the need for patient setup?
Stein: Inside each and every pill bottle is a worldwide, cellular chip, the same technology inside a cell phone. Anywhere the pill bottle goes around the globe, sensors measuring use and contents beam the data back to us 24/7 so the system can track what the patient is doing and compare that against what they should be doing. All this happens in a largely passive manner meaning a patient doesn’t need a cell phone or even know how to use one in order to use our device.
Medgadget: How does a patient receive and start using an AdhereTech pill bottle? Does the device need to be charged?
Stein: The first fill the patient receives from the pharmacy will come in an AdhereTech pill bottle. The pill bottles themselves come with a full charge which typically lasts about 6 months. The device alerts the patient when a recharge is necessary and this is done using a standard USB cable that we provide along with the device.
Medgadget: How does each AdhereTech pill bottle know which medication is inside it, what that medication’s regimen is, and how to contact the patient via text message if necessary?
Stein: The information about the medication as well as the regimen for taking the medication are known by the pharmacy. Similarly, the pharmacy collects information about the patient, like their phone number.
Medgadget: The network of caregivers around a patient can help drive compliance. Does AdhereTech also engage this patient support network?
Stein: Yes, when patients sign up and information is collected at the pharmacy, they can provide information about their caregivers who can be kept in the loop with notifications and alerts as well.
Medgadget: What kind of medications are AdhereTech’s pill bottles being used for today?
Stein: Our technology is being used for many drugs though we typically work with drugs in the specialty medication space distributed by specialty pharmacies as well as some non-specialty medications. While the definition of “specialty medication” varies, in general it refers to medications that are less common than those you would find at the corner store pharmacy since they are often used to treat rarer diseases, and, as a result, are often more expensive.
Medgadget: Does AdhereTech have technology for other forms of medications besides pills?
Stein: Today we focus on our pill bottle hardware. However, we are working on other pieces of hardware that can be used for other types of form factors and which are covered by our intellectual property.
Medgadget: Earlier you mentioned the importance of data analysis performed on the backend. Tell us more about how data plays a role in AdhereTech’s business.
Stein: We believe we have developed a really beautiful product that patients very much enjoy using. Our device has actually won numerous international design awards. That said, even though people think about our bottle when they think about AdhereTech, we really consider ourselves a data and software company given how much insight and value is generated on the backend. We spend a lot of our time using the data captured to solve the challenge of delivering the right interventions to the patient at the right time.
We’re collecting data about how patients use their medications at a scale that has never been seen before. The result is really useful insights into which interventions are the most effective for different types of patients. Using predictive analytics, we can identify trends that can be used to route information to the right party at the right time. We like to think about our offering as less about the physical pill bottle and more about providing patient support programs driven by information coming from our hardware.
Medgadget: Does the data analysis conducted by AdhereTech pull data from other sources besides just the pill bottle?
Stein: Yes, there are really three feeds of data: (1) patient data coming from AdhereTech pill bottles, (2) insights captured when we reach out to a patient via text message or phone call to see why they might have missed a medication, and (3) insights captured by pharmacies. One of the most important factors about all three of these data feeds is that we’re capturing it in real-time.
Here’s an analogy we like to use: imagine I asked what you had for lunch last Monday. Chances are you might remember, but you won’t recall all the details like what you liked or didn’t like. Those things are going to be easily forgotten. Today, weeks or months typically pass before a physician connects with their patients and tries to understand the reason for non-compliance. By capturing those reasons at the time of non-compliance, the insights gained are much more reliable and provider greater value in determining how to help patients improve.
Medgadget: Since the goal is to help patients remain more compliant, does AdhereTech proactively try to help patients course correct or is that role still delegated to the clinical team?
Stein: The company’s mission is to create software and devices that seamlessly connect patients to care. The important term there is “connect.” We collect information and allow the care provider to have relevant insight at their disposal, when they need it. It’s all about using data to optimize steps that are already taking place today and trying to do more of that in real-time.
Medgadget: Can you share some of the outcomes and successes seen in patients using AdhereTech technology?
Stein: Since many of our studies are sponsored by pharmaceutical companies, we are limited in what we can and cannot share. There’s data from some studies available on our website to check out. In general, we see large improvements in adherence as well as in duration or time on a therapy. We have some exciting reports coming up showing 10-20% improvement in adherence and 20% improvement in duration when using AdhereTech.
Medgadget: How do you view other digital health companies focusing on medication adherence? How does AdhereTech compare to the alternatives?
Stein: While we’re friendly with some of the other players in the space, many of those other solutions require patients to take a lot of action. Solutions requiring a smartphone which then require downloading an app to capture information that can be inaccurate have multiple potential points of failure that we are able to avoid. Patient’s do not have to do anything new to use our solution.
Medgadget: Can other technologies seeking to incorporate a medication adherence solution integrate with AdhereTech?
Stein: All of our customers use us as a standalone solution. However, we do have APIs that allow our tools to integrate with other systems. For example, a lot of pharmacies and pharmaceutical companies have their own mobile app that they have developed. Some have used our APIs to integrate AdhereTech into the workflow of their mobile solutions.
Medgadget: Finally, can you share some of your background and what makes you excited about what’s coming next for AdhereTech?
Stein: Both of my parents were in healthcare and I have always been near the intersection of technology and business. I firmly believe that medication adherence is one of, if not the, biggest challenge in keeping patients healthy. It’s been exciting to work at the forefront of medication management and we look forward to continuing to grow the number of patients using AdhereTech and sharing some new outcome reports in the coming months.