Smart pills that tell patients and their doctors if medication is being taken properly are to go on sale in Britain.
Patients take their drugs along with an extra tablet embedded with a tiny edible sensor which sends back information to a receiver in the form of a patch worn on the shoulder or arm.
This tracks when the drugs were taken and the dose, as well as monitoring heart rate and body temperature. It also alerts a patient to when the next dose is due and records whether the patient is sleeping well or taking enough exercise.
Older patients, in particular, may need to remember to take five or more different pills at a time, three times a day, for problems such as heart disease and diabetes.
Around half of patients do not take their medication properly, meaning they are not getting the full benefit.
The Helius system could prove useful for patients on complex medication regimes. However, it will only be offered privately
Under the Helius system of smart pills, they would get the five drugs they need each time in a blister pack. The pack would also include the Helius tablet embedded with a sensor the size of a grain of rice.
This is made from food ingredients that react with stomach fluids to power a digital signal for around five minutes which sends information to the shoulder patch about what pills have been taken and when.
The information is then downloaded for the patient and doctor to check that the medication is being taken correctly. The estimated cost to the NHS of unused medication is thought to be almost £400million a year.
High street chain Lloyds-pharmacy has signed a deal with U.S.-based digital healthcare provider Proteus Biomedical to bring the system to Britain. Patients will be able to buy it privately for around £50 a month from September.
The sensor is swallowed along with the patient's pills. It creates a unique electrical signal picked up by the skin patch. The patch transmits this data to a mobile using bluetooth
The sensor is the same size of a grain of rice
However Nick Pickles, of civil liberties group Big Brother Watch, said: ‘This technology has massive potential benefits for healthcare, but it should not be adopted at the expense of patient privacy.
‘Patients taking this medication, and their families, should be aware that they are doing so and be able to see a full breakdown of what data is captured and who it is accessed by.’
Steve Gray, healthcare services director of Lloydspharmacy, said: ‘Anyone taking several medications knows how easy it can be to lose track of whether or not you’ve taken the correct tablets that day.
‘Add to that complex health issues and families caring for loved ones who may not live with them and you can appreciate the benefits of an information service that helps patients get the most from their treatments and for families to help them remain well.’
Chip and pill trials have been carried out in the past but it is thought this is the first time it has been made available to consumers to buy.
A few years ago, a report by the New England Healthcare Institute claimed that patients not taking their medications as prescribed incur a staggering US $290 billion in increased medical costs - or about 13 percent of total US health expenditures. Technology reaching drug store shelves later this year in the UK and which is under review in the US could help cut the costs significantly. First, a little background.
About a year before the Institute's report came out in 2009, there was an article in MIT'sTechnology Review magazine about a Silicon Valley start-up company called Proteus Biomedical that was developing a microchip about the size of a grain of sand called an "ingestible event marker" (IEM). It was to be embedded within a pill and swallowed along with a patient's medicine. The IEM, reported the TR article, consists of:
"... a thin-film battery that is activated on ingestion, as it is exposed to water. The battery, Proteus says, is nontoxic because it is made from materials similar to those in a vitamin pill. Once swallowed, the IEM sends through the body's tissues a high-frequency electrical current that's modulated in such a way that it provides a unique marker of the pill. It's not an RFID technology: it uses the conductive tissues of the body to conduct the signal, rather than a radio, and the signal is confined within the body."
The high-frequency current is picked up by a disposable monitoring patch worn by the patient or a monitor placed under their skin. The monitoring system is able to discern biophysical parameters such as a patient's heart rate, respiration, body posture as well as sleeping patterns. The information can then be transmitted to a patient's cell phone or the computer of the patient's physician. Based on what the physician is seeing, he or she might decided to change dosages or change medications altogether.
Monitoring chemistry-based parameters which would greatly help understand a drug's efficacy is "possible in principle" says the TR article, but that application wasn't what Proteus Biomedical was first targeting.
Well, in today's Financial Times of London, there is an article that reports that the UK's Lloydspharmacy chain will be selling pills using the Raisin system in September. The program, called Helius, will "... include a red placebo sugar pill containing a safe and soluble microchip developed by Proteus that patients swallow alongside their existing medicines; an adhesive patch to be changed once a week; and data support." The cost of the monitoring service is slated to be £50 a month.
Currently, the Helius program operates outside the UK's National Health Service (patients wanting it will need to pay for the monitoring capability out-of-pocket). However, the NHS is interested in it for some medical problems such as "... monitoring complex and costly treatments such as organ transplant rejection therapies," the FT reports.
According to a press release at Proteus Biomedical's web site, Lloydspharmacy has 1640 pharmacies in the UK. It also states that Proteus Biomedical is "... developing and commercializing a range of digital health care products in partnership with global leaders from multiple industries, including Novartis, Medtronic, ON Semiconductor, [and] Kaiser Permanente..." in addition to Lloydspharmacy.
The TR article raised a couple of privacy issues (e.g., "... a company wanting to know what medications its prospective employees are taking"), which seemed to focus mainly on ensuring that the information being transmitted from the monitoring system to the patient's call phone or physician's PC wasn't being intercepted (the information from the IEM itself is secure since it isn't transmitted). Proteus Biomedical said that it was confident that it could manage any privacy issue that arose. However, there may be a different type of privacy issue that needs to be thought about assuming the use of the technology becomes widespread, which looks likely.
For example, given the cost of medical prescription non-compliance in the US, I can easily envision a time when this type of technology becomes a mandatory practice, i.e., required by your health insurance company (or your employer who is paying for your insurance or maybe even the U.S. government in the case of Medicare or Medicaid) for getting your prescription covered/reimbursed. And given that the information is being electronically captured, I can also see a point in future where such information automatically becomes part of a person's electronic health record. For those on medications for a long period of time, especially those with mental health issues, such technology could be seen to be pretty intrusive.
Any thoughts on the privacy or security implications of this technology?
Lloydspharmacy Partners With Proteus Biomedical to Launch Innovative Digital Health Product
REDWOOD CITY, Calif.--(BUSINESS WIRE)--UK community pharmacy chain Lloydspharmacy and US company Proteus Biomedical, Inc., a pioneer in digital health, have today announced an exclusive strategic collaboration to commercialize and launch Helius™, a digital health product focused on consumers and family caregivers. Helius has been designed to provide assurance and peace of mind to individuals struggling with complex medication regimens and health issues, and to connect these individuals to the family, friends and professionals caring for them. As part of the agreement with Proteus, Lloydspharmacy will launch Helius in the UK and sell the system through selected pharmacies. Helius will be paid for by consumers and their families.
Combining sensor-enabled tablets, a sensor patch worn on the body, an advanced mobile health (mHealth) application and information service, and Lloydspharmacy’s current medication adherence packaging, Helius allows consumers to remain independent in their own homes and their loved ones to help take care of them. Helius helps to monitor when medications have been taken along with a range of additional patient information including sleep patterns and physical activity. These metrics are then combined to provide useful information to allow the patient, carer or family member to follow progress and collaborate on maintaining patient wellness.
The World Health Organisation estimates 50% of patients fail to take their medicines correctly¹. This can result in patients not gaining the full benefit of their treatment, or worse, being at risk of harmful reactions. Unused prescription medicine is also estimated to cost the NHS in the UK around £396 million² a year.
Commenting on the new partnership, Andrew Thompson, Chief Executive Officer at Proteus, said: “We are delighted to be working with Lloydspharmacy to launch Helius in the UK. Proteus and Lloydspharmacy share a common vision of how advancements in technology can be captured to improve the well being of patients struggling with complex medication regimes and health issues. The intimate knowledge that Lloydspharmacy’s healthcare teams have of their communities, patients and families makes the company a perfect partner with which to introduce a patient-focused service like Helius.”
Steve Gray, Lloydspharmacy Healthcare Services Director, added: “Lloydspharmacy is committed to improving positive health outcomes for patients and the Helius system is an exciting development which takes our current medication adherence offering to a whole new level. There is a huge problem with medicines not being taken correctly. Anyone taking several medications knows how easy it can be to lose track of whether or not you’ve taken the correct tablets that day. Add to that complex health issues and families caring for loved ones who may not live with them and you can appreciate the benefits of an information service that helps patients get the most from their treatments and for families to help them remain well.”
Proteus Biomedical is pioneering digital health care, an emerging field of advanced therapies that integrate in-body and on-body sensor and mobile communications technologies into existing pharmaceutical, medical device and consumer products. Proteus is developing and commercializing a range of digital health care products in partnership with global leaders from multiple industries, including Novartis, Medtronic, ON Semiconductor, Kaiser Permanente and Lloydspharmacy. Proteus is also establishing digital health technology standards by non-exclusively licensing aspects of its platform to an ecosystem of partners that embed Proteus innovations into their own branded products, including Avery Dennison and BodyMedia for the Metria™ line of wearable sensor products. More information about Proteus Biomedical can be found at www.proteusbiomed.com.
Lloydspharmacy has over 1640 pharmacies across the UK. These are based predominantly in community and health centre locations. The company employs over 17,000 staff and dispenses over 150 million prescription items annually.
Lloydspharmacy which is a community pharmacy has primary care at the heart of its business. This is why it has launched a range of products aimed at improving community health such as affordable blood pressure monitors and allergy relievers, as well as a suite of convenient professional health check services including free blood pressure and diabetes testing, and cholesterol and heart checks in the comfort of a private consultation room.
Lloydspharmacy is the trading name of Lloydspharmacy Ltd, a wholly owned subsidiary of Celesio AG based in Stuttgart.
Celesio is one of the leading international service providers within the pharmaceutical and healthcare markets. It is active in 27 countries worldwide and employs approximately 47,000 employees in our three divisions Patient and Consumer Solutions, Pharmacy Solutions and Manufacturer Solutions.
Just under 2,300 of Celesio’s own retail pharmacies, as part of Patient and Consumer Solutions, serve over 550,000 customers every day. In its wholesale activities, the core business of Pharmacy Solutions, more than 130 wholesale branches deliver to around 65,000 pharmacies – day in, day out. In the Manufacturer Solutions division, it offers pharmaceutical manufacturers logistics, marketing and sales solutions and operate in the area of Efficient Care Pharma
Some key facts about Lloydspharmacy:
In 2010 Lloydspharmacy had turnover of £1.8 billion
We dispensed over 150 million items
Over 1.3 million free Type 2 diabetes screening tests with 75,000 people referred to their GP
Over 1.7 million blood pressure tests completed to date
Lloydspharmacy offers more private consultation areas than any other pharmacy – currently they are available in 97% of Lloydspharmacy pharmacies
Finalist in the UK Customer Satisfaction Awards 2012 (Customer Focus, large enterprise)
Lloydspharmacy’s national charity partner is the British Heart Foundation
In 2011 Lloydspharmacy was accredited with Investors in People (IiP) – for the fourth time in a row.
It sounds Orwellian—like science fiction. But the reality of every aspect of your biological processes being monitored by Big Pharma and your doctor—and whoever else might want to profit from it—is upon us. Novartis has just purchased the technology to encapsulate a chip inside a pill that allows doctors—and government and Big Pharma and and the compliance police—to monitor how well you're following orders to take pills. And see if you metabolize them properly, perhaps needing another drug to make the first one work better. And while they're at it, perhaps they'll make sure that you're eating GMO foods and whatever products Big Agra is trying to get rid of this week. Yes, Novartis, the company that has brought you the MF59 adjuvant with squalene, is now in the Big Brother business.
Apparently, once a human has been absorbed into the medical system and renamed "patient", then health is defined as taking the right pills.
The smart pill isn't futuristic. It's already been tested. Before purchasing the technology, Novartis ran a trial to test for patient compliance in taking their blood pressure drug, Diovan. It must have been successful, since Novartis has purchased the technology.
Novartis's chief of pharmaceuticals, Joe Jimenez, says, "This industry is starting to explode." Andrew Thompson, the CEO of Proteus Biomedical, the company that developed the product, estimates that its share of the smart pill industry will be about $100 billion.
The scariest part of this technology is that it's cheap, so it will quickly become available across a wide range of drugs. Thompson says:
We’ll do all of this for the same price as the drugs you buy now. For one daily price of your medicine you get the drug, the monitoring, the applications and tools, the incentives and the connectivity.
Imagine that you're a pain patient. You need your oxycodone to get out of bed. But your doctor insists that you also take an SSRI drug, and refuses to give you what you need unless you agree to take it. You've always pretended to take the SSRI, but secretly you've just set it aside. After all, you're only depressed when you're in pain and you know just how dangerous SSRIs can be—and the drug can't hurt you if you don't take it.
This scenario isn't unusual. Many pain patients experience it. With the advent of smart drugs, your doctor could force you to take the SSRI.
Patients who are told to take any drug, such as Diovan, the one already tested with a smart pill, could be forced to take it against their will. In the case of Diovan, the risks include potentially fatal liver damage, abnormally high potassium, angioedema, or white blood cell disorder, and several other conditions, including headaches and infections. The risks would be yours, not the doctor's—but you'd better take them or risk your doctor's refusal to treat you, or perhaps an insurance company's refusal to cover treatment.
Not only is Big Pharma creating virtually endemic chronic diseases—such as asthma, diabetes, and neurological disorders—with their vaccines and drugs, they're profiting by treating them with more and more toxic drugs, which create more ill health and an even bigger market for their drugs. Once on the pharmaceutical conveyor belt, you'll be forced to stay on it with smart pills. The electronic chips will be included inside pills and you'll be monitored for compliance.
Trevor Mundel, Global Development Franchise Director, Immunology and Infectious Diseases for Novatis, says, "This technology has tremendous utility." As much as one-third of pharmaceuticals are not taken as prescribed and many aren't taken at all. In new think that only modern medicine could devise, it's believed that this leads to poor health—as if lack of drugs is the cause of poor health! So, the faulty logic of modern medicine is used as an excuse for smart pill technology.
Apparently, once a human has been absorbed into the medical system and renamed "patient", then health is defined as taking the right pills, and to save patients from themselves, they need to swallow electronic chips with their pills to assure that they take the prescribed poisons.
Pharmaceutical manufacturers believe that they lose billions of dollars in sales when people don't fill their prescriptions. Smart pills will help enforce doctors' orders to take medications—and Big Pharma's profits will continue to rise.
When Medtronic, a huge medical device manufacturer that sells many implantable devices, such as pacemakers, neurostimulators, and drug pumps, is nervous about a technology, then it's time to sit up and take notice. According to The Economist, Stephen Oesterle, Medscape's Senior Vice President for Medicine and Technology, has referred to the technology as "a bit Orwellian for drugmakers to keep such intimate tabs on their customers".
You need to sit up and take notice when a company like Medtronic, which manufactures implantable devices, considers a product to be Orwellian.