By some estimates, the cost of patients not taking their medications as prescribed – known as medical non-adherence or non-compliance – is as high as $290 billion each year and may result in as many as 125,000 unnecessary deaths.
It’s a vexing problem for health care providers, pharmacies, insurers, and almost every other player in the health care system with only 50% of us take our medication as prescribed.
I recently spoke with Tomer Gofer, CEO of Vaica, a company developing digital health products to help us remember how and when to take our medications as we should.
Gofer says “there are many reasons why patients don’t take their medications as prescribed: forgetfulness; side effects; the cost; the complexity of regimen; they don’t understand why they need to take it; or they are getting better and think they don’t need it anymore. And the constant: no one knows exactly what the patient is doing because no one is around to see or help in the event of an emergency.”
He explains that it can happen to anyone: “I was taking B12 and some vitamins. And even as an expert in this field, I didn’t realize that I had an adherence problem. Turns out I did. Mine wasn’t as crucial as for others, but the problem was the same.”
And Gofer says “next time you visit someone, check their medicine cabinet. My bet is that you will find it is full of medications that were never taken. In fact, 50% of patients aren’t taking their meds as prescribed and the patients and their family are not aware of it. Vaica is trying to change this.
“We also know that patients don’t always share the whole truth with their doctors. This is a very big problem because doctors base their decision on what to do next based on what the patient tells them. If the information is partial or doesn’t reflect the true situation, it could lead to the doctor making a wrong decision in terms of medication and dose choices that could worsen the patient’s health.”
Off The Shelf and Customized
There are companies that have devices designed to help medical non-adherence and there are those that have apps. Vaica feels that its solutions are the only ones that combine the two into one complete solution.
Vaica has two main products. Both have a CE Mark indicating they meet European requirements and are FDA exempt, meaning they don’t require full FDA approval. There is the off the shelf SimpleMed+ for multi-dose medication and the customized Capsuled for specialty medications such as biological drugs and meds for MS, HIV & HepC.
Both use a software/hardware combination with a cloud-based software that integrates with any system with an open API – in other words, they can be integrated into existing medical programs in hospitals and physicians’ offices. The solutions also have a physical interface and a smart medication dispensing component that monitors medication extraction and cannot be “snoozed,” so no cheating allowed. That said, the management tools operate remotely and interrupt only when intervention is truly required, not regularly in an annoying way.
SimpleMed+ was designed to establish a connection between the drug dispensing at the pharmacy and patient compliance at home. The pharmacy organizes, fills and refills medications into a special blister pack according to the doctor’s instructions. The prepacked multi-dose blister pack is sent from the pharmacy to the patient’s home, where it slides into the SimpleMed+ device. The device communicates with the cloud, which relays all the necessary information about when to remind the patient to take the meds and alerts the patients accordingly, as well as letting the caregiving team know if a dose is missed.
Capsuled was designed to help patients with chronic conditions to stick with their specialty medication regimens long term and to keep their caregiving teams in the know all of the time. By 2020, 50% of medication revenue will be from specialty meds, although they are only 20% of the marketplace.
Gofer explains, “until now the patient support programs of the pharmaceutical companies were blind to what was going on at home. These programs were intended to provide what the industry calls ‘beyond the pill’ services but at the end of the day, they didn’t have a clue if their patients were taking their meds or not. Sure there were periodic phone calls and visits from nurses and the rest. But this wasn’t enough. We have completely changed this situation.”
Capsuled uses a hardware/software combination, compatible with all medication delivery systems (pills, liquids, injections, inhalers), that provides visual and audio alerts as well as personalized educational videos and a video chat capability with the caregiver. In the video chat, the patient can see the caregiver, perhaps a nurse, but the nurse can only hear the patient. It was designed this way based on patient feedback that they wanted a degree of privacy. Finally, Capsuled knows when a dose has been missed and instantly alerts the caregiving team, which can then respond proactively.
Gofer emphasizes, “we understand that there is no ‘one fits all’ product suitable for all treatments. So, we mostly tailor our products to the specific needs of our partners – pharmaceutical companies, hospitals, their patients, their caregivers, and for all the different therapeutic areas.
He gives one example, “Biodose Connect, which was designed for Quantum Pharmaceuticals and is being used in the UK. It’s the only product that can hold pills and liquids, keeping in mind that 10 percent of the elderly can’t swallow pills.”
Not Too Good to be True
Gofer says that so far there has been a global average success rate of 96% in getting people to take their meds when using the Vaica’s technology – at hospital and home alike.
For example, in a recent study with congestive heart failure patients at Santa Helena Hospital in Brazil, Vaica’s product reduced emergency room visits by 68% and re-hospitalizations by more than 72%. That lead to a 78% reduction in hospital days and an overall 50% savings to the patient, hospital, insurers, and the overall healthcare system. Practically speaking, patients went from the worst to the best category of health using Vaica’s technology and as a result, reduced their average time going to the hospital by 50%.
The most recent success was announced last month in the Journal of Kidney Disease, which cited the results of a study called TAKE IT led by Dr. Bethany Foster, a pediatric nephrologist at Montreal Children’s Hospital of McGill University Health Centre. The study, which was conducted at eight hospitals in North America, showed that teen and young adult kidney transplant recipients who used Vaica’s SimpleMed, in combination with coaching, had 66% higher adherence for anti-rejection medicine. This was significant considering that adolescent rates of non-adherence are 60% higher than adults, and adolescents are 1.6 to 2.6 times more likely than younger individuals to have rejection.
Vaica is now working on designing a customized product for the TAKE IT TOO study based on collaboration with patients, parents and healthcare professionals. McGill will once again lead the clinical effort. This time, however, the study is being sponsored by the U.S. National Institute of Health. TAKE IT TOO is currently enrolling teens & young adults.
Where Can You Get One?
Vaica’s currently has partners in the US (STAAR Alert, Value Pharmacy, Children’s Hospital of Philadelphia, and CCHMC to name a few), as well as in the UK, Germany, the Czech Republic, Italy, Brazil, Israel, Australia and Canada. The company has four granted patents (US, China, Europe, UK) and two pending.
If you want to get a Vaica product, simply call them at (646) 666-3128 or email them at [email protected].
Gofer says, “our goal is to define a new standard of patient care by inspiring pharmaceutical companies to support their products at home. All the innovative medications aren’t worth a thing if you don’t take them as prescribed.”
Here are two videos – the first is about how SimpleMed+ works:
The second is about using Capsuled for a long-term self-injection regimen: