Personalization in Medical Dispensing

Medication nonadherence or noncompliance is a multidimensional health problem. Frost & Sullivan has profiled innovative companies that are working to improve medication compliance.

Healthcare commentators around the world have noted with great alarm the growing problem of nonadherence to prescribed medications. Jane Brody, a longtime health columnist with The New York Times, recently termed this phenomenon an “out-of-control epidemic.” Commentators make sure to point out that this epidemic in particular is 100% preventable. The reality, however, is a bit more complicated: medication nonadherence or noncompliance is a multidimensional health problem. Numerous factors affect compliance with a therapeutic regimen, including patient characteristics, the nature of the disease, and insurance coverage. As a result, between 25 and 50% of prescribed medications are not taken correctly. A review article published in the Annals of Internal Medicine estimates that noncompliance to medication claims more than 125,000 lives a year in the United States alone and adds at least $150 billion in medical bills from hospital readmissions and the work required to get treatments back on track. 

Nonadherence to medication can be intentional: the high cost of medication, aversion to the drug because of its taste or psychological barriers may cause a patient to intentionally stop participating in the treatment process. It can also be unintentional: noncompliance is common among the elderly, dementia patients or those without caretakers; a poor patient-physician relationship, improper follow-up planning or difficulty in getting access to medications also may be responsible. While the problem of nonadherence cannot be eliminated (especially if it is intentional), there are certainly measures that can be taken to improve adherence. Frost & Sullivan has profiled innovative companies that are working to improve medication compliance.

Livi System by PharmRight Corp. (Charleston, S.C.)

PharmRight has aligned with the emerging technology trend of the “internet of medical things” and has developed a cloud-based pill dispenser called Livi that can store and dispense as many as 15 solid oral medications for a period of 90 days. Livi dispenses the pills at predetermined times and keeps track of the pills being dispensed. It sends reminders, prompts and updates to the patient, as well as periodic reports to the physician, family member or professional caregiver. In 2016, PharmRight partnered with Zipit Wireless (Greenville, S.C.) to get support in establishing a secure, cloud-based platform that can enable remote patient monitoring.

ScriptSync by CVS Pharmacy (Woonsocket, R.I.)

CVS Pharmacy, the largest pharmacy chain in the United States, developed a medication synchronization program that has already enrolled more than 1 million patients. It is particularly designed to help patients with multiple prescriptions. Logistical problems may prevent multiple visits to a pharmacy for medication pickups and refills, but through ScriptSync the patient and an assigned caregiver are able to manage prescriptions online and schedule all pickups for a single visit. According to CVS, this program has improved compliance by 5 to 10% every year since its inception in 2015.

Genecept Assay by Genomind (King of Prussia, Pa.)

Genomind is a personalized medicine company developing pharmacogenetic tests especially for patients suffering from mental illnesses. The Genecept Assay is used to guide mental health professionals in the treatment of attention deficit hyperactivity disorder (ADHD), depression and anxiety. A genetic test would direct a physician to a definitive treatment. A genetic test-validated medication enjoys a higher probability of success and is likely to boost a patient’s confidence in the treatment. A retrospective study of patients who underwent psychiatric treatments showed that those who used the Genecept were more likely to adhere to prescriptions and demonstrated better clinical outcomes. Analyses of the Medicare and Medicaid databases of such patients also indicated greater cost savings.

The Road Ahead

The ubiquity of smartphones and wearable devices is already empowering patients to be in better control of their health and their treatment programs. Wearables and the emerging trend of connected devices will certainly increase physicians’ ability to monitor patients remotely. Given the comfort with and the dependence on personal communication devices and smart gadgets, the digital platform is a well-entrenched, user-friendly medium on which companies can build adherence services. It is Frost & Sullivan’s opinion that these and other emerging ideas will help patients not only adhere to a prescribed treatment but also actively participate in it and be more engaged in their own treatment process.

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