Author: Ms. Amita Puranik ( puranikamita@gmail.com )

Have you ever forgotten to take your medicine? Do you feel a little annoyed to complete the course of your medicines and so you skip some of the dosages, especially when you start feeling better with the initial few dosages? Do you cleverly reschedule your prescribed medicine to save money and/or time on treatment?  I believe most of us have witnessed one or more of such circumstances at a personal level, for our closed-ones, friends, or colleagues. Such a situation is termed as ‘Non-adherence’ in medical terms. 

According to the ‘World Health Organization’ (WHO), around 3.8 billion prescriptions are written each year, out of which 20% are never filled. 50% of the patients receiving medicines for serious chronic conditions are observed to be non-adherent with their oral regimens, resulting in almost $300 billion added healthcare costs every year in the USA. Poor adherence to the prescribed medication may lead to disease progression, untoward health impacts, increased hospitalization, and ultimately extremely higher healthcare cost. It is a lot more serious than you might have thought, right? 

Now imagine how brilliant and convenient it would be for the patient as well as healthcare providers to keep track of patient compliance. The cherry on the cake would be if you get special discounts by your health insurance providers due to your impressive track record of drug compliance. Like the popular fitness apps, aqua-alert apps, or period tracker, how pleasing it would be if the pill that you are taking is itself keeping a record of reaching its destination (ex. in the stomach). No, I am not talking about those reminder based apps currently available where the patient needs to place manual entries. I am talking about a system where the patient just has to take the desired pill and that set, relax. All further work will be done by ingested medicine, a body patch, and a computer or smartphone. Doesn’t it sound tempting?  

What Is It?

A ‘Digital pill’, also termed as ‘Ingestible sensor’ or ‘Smart pill’ is an innovative drug-device technology where the pharmaceutical dosage is present along with an ingestible sensor inside the pill. This combinatorial approach provides traditional medicinal benefits along with a monitoring system to automatically record drug adherence and physiological changes in patients. The technology of making pills and the data transmitted by a sensor inside the pill is considered as part of Digital medicine. Ingestible sensors are typically used for sensing different types of gases as a result of metabolism, imaging purpose and to monitor drug absorption or patient compliance. As they are optimized for movement through hollow organs, digital medicines are ideal for data collection throughout the digestive system from the mouth to anus (i.e. terminal part of the digestive system). 

The mechanism of working of digital pills comprises of intake of pill having ingestible sensor embedded in medicinal drug and automatic movement of pill to stomach (like other regular pills). Once reached to the stomach, the sensor gets activated by a specific environment in the organ (for ex. stomach acidity) and sends signals (such as time, dose, type of drug taken, etc.) in few minutes to the patch worn by the patient. This information from body patches is further transferred to the smartphone or desktop where patients can monitor the data and with the patient’s consent, it could further be shared with family and doctor to track adherence. So, as highlighted by Eric Topol (director of the Scripps Translational Science Institute in La Jolla, California) – smart pills are like your big brother watching you for taking medicines regularly.   

Is It Reality?

‘Abilify MyCite’ is the first digital pill approved by US-FDA in 2017. This product has been collaboratively developed by Proteus Digital Health (manufacturer of ingestible sensors) and Otsuka Pharmaceutical’s antipsychotic drug – Abilify (Aripiprazol). The drug was developed for schizophrenia, bipolar disorder, and depressive disorders. However, the drug has not yet been prescribed outside the clinical trials. Similarly, Proteus Digital Health has recently (in 2019) launched oral chemotherapy – digital capecitabine for the treatment of patients with stage 3 and 4 of colorectal cancer.    

As quoted by Andrew Thompson, Proteus CEO, and co-founder, digital medicine especially would offer remote healthcare, new and enhanced insights to healthcare providers about the impact of therapeutics and reduced duration of hospitalization. Though the technology is very much fascinating, it is surrounded by numerous ethical concerns such as patient’s rights of privacy, probability of misuse of information along with the risk of hacking due to compromised working. However, in the era of digitization and artificial intelligence with self-driven vehicles and obedient women like Siri and Alexa, digital pills are revealing new frontiers in the field of healthcare.  

About Amita Puranik:

I am a passionate learner currently pursuing a PhD in the field of Biotechnology. I have been working in the field of biopharmaceuticals for the last 4 years with 2 years of industrial working experience. Being an avid reader I also like to write short stories and communications. I enjoy exploring historical facts, literature, etc. Travelling, net-surfing, listening to classical music are some of my leisure time interests.

REFERENCES:

  1. https://www.uspharmacist.com/article/the-promise-and-pitfalls-of-digital-medication 
  2. https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0443-1 
  3. https://en.wikipedia.org/wiki/Digital_pill 
  4. https://www.pharmaceutical-technology.com/comment/digital-cancer-pills/ 
  5. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwi_5t6h88zqAhXLR30KHcclCLAQFjAKegQIARAB&url=https%3A%2F%2Fwww.pharmaceutical-technology.com%2Fcomment%2Fdigital-cancer-pills%2F&usg=AOvVaw12aIKrxfcDnXVEQEI5bcFR 
  6. https://www.fiercebiotech.com/medtech/proteus-launches-its-first-digital-cancer-chemotherapy-pill 
  7. https://www.uspharmacist.com/article/the-promise-and-pitfalls-of-digital-medication

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