Big Brother in a Little Pill

I see you. After you swallow the pill and it reaches your stomach, the chip is activated by stomach fluids. From there, inside your stomach, it sends a signal to a microelectronic receiver on your shoulder, either in a small skin patch or inserted under the skin.

| Oct 3, 2009

"Poor medication adherence," the latest euphemism to replace the much-disliked "poor compliance," is a hot topic these days. According to the New England Health Institute, a third to a half of American patients don't take their medi­cations as prescribed. And people with chronic conditions, including diabetes, are reportedly the worst when it comes to medication adherence and "persistence" (the length of time they continue to take a prescribed drug).

Because three-quarters of the U.S. healthcare budget goes to treat chronic disease, poor medication adherence is getting a lot of scrutiny from budget watchers. Drug-related morbidity, which includes the consequences of poor adherence, costs about $290 billion annually, 13 percent of total healthcare expenditures. Diabetes patients with poor adherence, for example, are twice as expensive to care for as those with good adherence: $16,498 versus $8,886 every year. And it's not just about money: A study of diabetes and heart disease patients revealed that those who did not adhere to their medications died at nearly twice the rate of those who took their medications as prescribed.

These statistics are fueling big interest in technology that can get people to take their medicine. One company, called Proteus, has come up with a kind of internal spyware: a little digestible chip that's embedded in prescription pills. After you swallow the pill and it reaches your stomach, the chip is activated by stomach fluids. From there, inside your stomach, it sends a signal to a microelectronic receiver on your shoulder, either in a small skin patch or inserted under the skin. The receiver records the date, time, type of drug, dose, and even the place of manufacture. It also measures and reports your heart rate and respiratory rate. Then the receiver wirelessly relays that information to doctors. By checking the logs from the receiver, doctors can tell whether you are actually taking the medication as often as you are supposed to. They can also monitor your vital signs, such as heart rate, before, during, and after taking the medication, allowing them to understand how you are responding to the medication.

Joe Jimenez, head of pharmaceuticals at Novartis (which is partnering with Proteus), told the Financial Times that after the smart pills, called "Raisins," were used to deliver a blood pressure medication to 20 patients, their "compliance" rose from 30 per cent to 80 per cent after six months. "This industry is starting to explode," he said. In fact, he noted that he may designate a "compliance tsar" to oversee the various Novartis partnerships and programs to "strengthen appropriate use of medicines."

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Proteus website

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Posted by gandalf888 on 3 October 2009

And then what? If a patient isn't taking his/her meds in "compliance" the insurance company will drop them? Or the pharmaceutical company will not allow them to have the drugs they need? I've had diabetes for 53 years and heart disease for 20. I take my meds absolutely as directed, and yet my life is totally dictated by the insurance companies now. God help us all if this ever comes to pass. This is Big Brother in all its horror.

Posted by Anonymous on 4 October 2009

What if we are being given inappropriate medication for our diagnoses? What if we choose to discontinue our medication b/c of the side effects and try an herbal alternative?
This will take away our autonomy over our own body and how we see fit to treat it.
I have been given the wrong script by Docs and later told to stop the medication due to interactions with other meds, luckily I knew not to start these scripts. I would have been considered "non-compliant"

Posted by Anonymous on 4 October 2009

Are you kidding? This technology has so many scary implications, that they cannot even begin to be addressed. This is a very dangerous way to go. Really!!

Posted by Anonymous on 5 October 2009

I agree, I have enough to worry about without something keeping an eye on my from the inside. And another thing, with as litigious as we are, if somebody has an adverse reaction to medication, will this be another lawsuit against the doctor for not observing and contacting them quick enough. We should be in charge of our care, not a middle man. Take the insurance companies out of the control position and health care becomes affordable again. Let people shop for care and know what the up front costs are and costs will go down. Give doctors the tort reform they want and malpractice insurance is more affordable (yet another insurance, uggh!).

Posted by Anonymous on 5 October 2009

Wouldn't it be cheaper to have payors provide comprehensive diabetes self-management education so individuals actually understand the benefit and importance of taking their medications as prescribed...

People need to have a working knowledge of their diabetes if they are going to treat it successfully, which does not mean "perfectly".

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