Redwood City, CA — Over the last few years, we’ve been watching the development and eventual FDA approval of Proteus’ ingestible sensor for medication management. It’s an entirely automated system that lets doctors – and users – see how medication is used in the real world and how those usage patterns effect overall health.
The ingestible sensor itself is a tiny microchip that is attached to or manufactured in a pill. It activates upon contact with stomach acid, then an external patch picks up its signal and records when the user took the medication. It can also monitor heart rate and estimate the patient’s amount of physical activity. A wireless glucose monitor is in development, too, to correlate medication dosage and timing with changes in blood glucose levels.
Not surprisingly, in their various trials, Proteus founds lots of inconsistency in how and when real people remembered to take their medication. It turns out, they weren’t exactly following doctors’ orders:
Shortly after the FDA approval, Forbes reported that Proteus was in talks with manufacturers of Metformin – a potentially game-changing alliance. Metformin is the most prescribed drug in the world, and the most likely starting point for someone just diagnosed with Type 2 diabetes. The modern epidemic of diabetes is progressive. Once you’re diagnosed, the disease will take a natural course. But that doesn’t mean it looks the same for everyone. With the right medication and lifestyle change, people can stretch that inevitable progression from, say, a few decades to a path that would take hundreds of years to complete.
The challenge is: You have to fight it every day. Inconsistency steals control and shortens the time to the next, inevitable conversation: Your diabetes has progressed and we need to move to a stronger medication.
That’s why monitoring at the Metformin stage is such a compelling idea. Not only could it help new patients more effectively start and monitor a habit, it would also give doctors a much stronger sense of who that person really is – how she manages her disease, what barriers stand in her way, how dedicated she is to treatment. It could improve the relationship and transparency between doctor and patient while also extending time to progression. Win-win, right?
Of course, there are barriers. Metformin is largely filled as a generic these days. Would BMS or others find enough unique value in a monitoring program to reactivate the Glucophage brand?
And, what about the cost? Early releases of the technology are $46/pill. A huge price tag at face value, but perhaps not as overpowering when thought of in the broader cost context of managing chronic disease. As some payers increasingly transfer risk to patients and doctors, upfront management may be the most valuable commodity in healthcare. For example, in the Netherlands, the value of disease management was promoted with the nationwide introduction of disease oriented funding of chronic care in January 2010. Under the system, a group of healthcare providers receive a monthly lumpsum payment to care for patients with particularly chronic diseases. The more efficient they can make that care, the more profit potential they have.
Posted by: Leigh Householder