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Pharmaceutical Manufacturing and Packing Sourcer

Tapping into Apps

Research indicates that a patient’s medication adherence is directly linked to favourable treatment outcomes for a variety of chronic therapies, from multiple sclerosis to diabetes. Yet patient compliance with chronic medication therapies is remarkably low – the World Health Organization estimates it at 50% internationally. Non-compliance leads to poor clinical outcomes, lost revenue for pharmaceutical companies worldwide, and increased costs for many healthcare stakeholders – including the patients themselves.

Technology offers a potential new solution to this ongoing problem, with smartphone and tablet app developers attempting to create software that helps chronic disease patients stick to their medication regimens. These tools are coming to market at a time when patients and healthcare providers desperately need them: the delivery of healthcare for chronic conditions is shifting from doctors' offices and hospitals, into the patient’s home environment. This move is being driven by insurers, who are eager to stem the growth of healthcare costs, and patients demanding more independence.

In the US and other countries, both public and commercial insurers are incentivising providers to improve patient wellness, especially for those with more costly chronic diseases. These programmes are collectively referred to as 'accountable care' or 'population health management'.

APP TRENDS

Apps help doctors monitor patient self-care between office visits. In some cases, their use can serve as a proxy for a trip to workplaces, clinics or hospitals – creating accountability and value for both the patient and payer by not only reducing office visits, but also offering more detail about the patient's care than was possible before the smartphone era.

This trend with apps offers numerous benefits to all parties in the ecosystem – including added value both for patients struggling to keep track of self-treatment schedules, and for pharma companies looking to recapture some of the more than half-trillion dollars annually in lost revenues due to medication non-compliance. Furthermore, it can save part of the $290 billion in avoidable costs of hospital readmissions to healthcare providers, as well as costs associated with doctor interventions triggered by patients not taking their meds.

Another exciting development for pharma companies: apps offer the potential for the collection and analysis of valuable data about patient habits and medication usage patterns at home that was previously unavailable. Not to mention, apps also give drug manufacturers further opportunity to reinforce their brands among patients.

CLINICAL APPLICATION

In a now famous US television advertising campaign, a smartphone manufacturer introduced a slogan that has since made its way into everyday conversation: 'There's an app for that'. Since that ad hit the airwaves in 2009, the slogan has become a self-fulfilling prophecy: apps for many competing brands of smartphones now aid consumers with hundreds of everyday tasks, from creating calendar reminders, to checking the weather and even finding lost smartphones.

Apps are steadily making their way into clinical workflows, too. For years,consumers have connected to track their own health and fitness data with apps. More sophisticated apps apply 'gamification' to positively impact outcomes by turning healthy habits into a rewards-based game. For some patients, the simple act of logging in and seeing their healthy activities over time is a reward in itself, reinforcing successful behaviours.

However, it is not always easy for clinicians to determine which apps are clinically effective, and which app developers can be trusted to protect patient data. While, to date, clinical researchers have not conducted many safety and effectiveness studies on specific apps, activity is now ramping up for more frequent evaluation of apps in formal trials. Some of the conditions being researched include adolescent diabetes, alcoholism recovery and tracking heart disease risk.

Soon, the catchphrase ‘There’s an app for that’ will be applicable to helping chronic disease patients adhere to their self-injection routines at home. More and more software developers are working on apps that could be hardwired into the drug development and drug packaging design processes, which could popularise the positive gamification of medication adherence. Many of these apps intend to reward patients for sticking with their drug therapy, and could help reduce the health risks of medication non-compliance.

STAKEHOLDER BENEFITS

The following four groups benefit in different ways from apps tied to medication adherence:

Patients
The advantages for this group are significant, with their phones keeping them on the road to better health by tracking medication adherence, and using prompts to remind them when they miss doses. Apps can also offer additional education about a user’s disease state and provide encouragement in the form of gift cards or other rewards.

Doctors
Survey research from digital health tech company HealthPrize shows doctors would much prefer to prescribe medications associated with an app, because they sustain better fill rates and track adherence: without one, adherence is virtually an unknown quantity. Doctors are interested in patient wellness in general, as well as good stewardship of their corner of the overburdened healthcare system, and aim to conserve resources where possible. On the financial side, those in accountable care organisations stand to benefit from increased adherence too, by preventing costly hospital readmissions due to patients not taking their medication correctly – often not reimbursed by government and commercial payers.

Payers
This group has an even larger economic stake in medication adherence, because they want to pay less for their enrollees’ care. Costly readmissions and sicker patients result in more hospital days, doctor visits, and expensive tests and procedures. When an app helps a patient keep track of their meds and offers reminders on their smartphones, it ultimately tallies less cost in claims for that patient’s insurer.

Health Systems and Accountable Care Organisations
Large health provider networks in the business of population health management can make savings with medication adherence. The more wellness – especially among chronic disease patients, the costliest group they serve – the more ‘shared savings’ payers split with them in the form of increased reimbursements.

INDUSTRY INNOVATION

App-based initiatives are now under way across the industry. In one project, West Pharmaceutical Services is partnering with HealthPrize to develop apps in conjunction with self-injection drug delivery to enhance the patient experience. Product development in the pharmaceutical field is very slow and methodical, so this collaboration – which involves refining HealthPrize’s gamification app, rather than West building its own – will bring added value to patients far quicker.

With ease of use critical to medication compliance, patients will manually scan barcodes, or otherwise enter data about their medication compliance, into the smartphone/ tablet app, or use an internet browser from a computer if they do not have a wireless device.

In the near future, app use will evolve to become even more automated, streamlined and interactive. For example, drug delivery systems or packaging could signal the smartphone with data points about each episode of medication. A self-injection patient’s app might automatically, in real-time, confirm that a particular dose was delivered, the syringe safety system was deployed, all the medication was injected, and other details. As innovations move forward, all eyes will be on health technology regulators and policymakers to see what kind of testing they require for these kind of integrated systems.

CARE THROUGH COLLABORATION

When it comes to healthcare apps connected to self-injection drug delivery systems that incentivise medication adherence, everyone in this chain is interested in the potential for improving patient care. In particular, pharma companies can realise fuller benefit of their self-dosing products with home monitoring data that is currently difficult to collect, as well as predictive data.

Imagine the potential to know who was taking what dose, where, at what time and day, which lot number they were using, and when refills will be needed. Even apps tied to barcodes, QR codes or other static information can currently produce all of those data points. However, patients need some sort of incentive to provide that last link in the data system; so the most successful apps will reward them for providing that extra effort to engage with the system, while also educating them about their condition and therapy.

Improving medication adherence – and, by extension, outcomes – will involve new partnerships that bring advantages to all involved. Patients and healthcare providers are looking for new ways to use technology in their pursuit of improved wellness, especially for chronic diseases. Rewards-based apps may just be what the doctor ordered.


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Chris Evans, Vice President, Research and Innovation at West Pharmaceutical Services, has been in product development for over 20 years, primarily in healthcare packaging and device development, and is the holder of 19 US patents with several more pending. After graduating from the University of Maryland, his first decade spent in business centred on the manufacturing, engineering and commercialisation of new products. Prior to West, Chris worked for Rexam, Nypro and Insight Product Development.Today, he is responsible for new product and technology development, focusing on enhancing the patient experience.
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