Chris Netherton, M.D.

The digital pill has now arrived

In November, US regulators approved the first digital pill. It contains a tiny sensor that helps track whether patients are taking their prescribed medication properly. This represents another ground-breaking use of digital technology in healthcare.

The way that this new technology works is really ingenious. The sensor inside the pill is no bigger than a grain of salt. It doesn’t contain a battery and it is made up of elements that are not harmful to the human body, mainly copper, magnesium and silicon. When the sensor reaches the stomach, it reacts with the digestive fluids and emits a faint electrical signal.

The signal from the sensor is picked up by a wearable patch which the patient has on their ribcage. This relays the signal to an app on the patient’s smartphone, enabling them to track exactly when they took their medication. With the patient’s agreement, this information can then be shared with their doctor and any close relatives who may be involved in their care.

Who would need such a digital pill? At the moment, it is being used for a drug called Abilify, which is prescribed to treat patients with bipolar disorder and schizophrenia. Studies show that patients with bipolar disorder and schizophrenia are prone to forgetting to take their medications properly, which can be dangerous for them. The new digital pill is called Abilify MyCite, which is a collaboration between Otsuka, the makers of the drug, and Proteus Digital Health, the company that developed the sensor technology. While this is how it will be used initially, the potential applications of this technology are much broader.

Elderly people who forget to take their heart or blood pressure pills regularly may be helped by a system like this, as would diabetes and asthma sufferers. It is known in the medical world that the cost of non-compliance with prescribed medication is very high. In the USA alone, it is estimated to cost the healthcare system over $100 billion per annum. (The main factor driving this high figure is the cost incurred when a patient is hospitalised as a direct result of not taking their medication.)

The dosing of anticoagulation medication (e.g. Warfarin) can be very difficult to calculate for some patients but is it that they are not suited to the medication or maybe perhaps they are not consistently taking their medication?

Obviously, a new technology like this would need to be carefully regulated, but if it does prove to be successful then there would be additional benefits to this approach, over and above checking that patients are adhering to the correct regime.

Firstly, it is yet another digital system that encourages patients to become actively involved in the management of their condition, rather than purely passive recipients of medical care. I have written many times in these blog pages about my belief that this kind of approach will be vital in helping to ensure that our healthcare system is sustainable in the future.

Secondly, knowledge is a powerful thing. More and more crucial health information is now able to be stored in a patient’s electronic medical record. Over time, more software will become available to allow doctors to analyse this wealth of information and make more informed decisions about a patient’s care. Currently, the way that drug dosages are determined can be a very inexact procedure. By continuously monitoring what doses patients are taking and when, and then by relating this to their overall health as recorded in their electronic medical record, it should be possible for doctors to work out the most effective tailored dosage for each patient. This kind of personalised medicine is definitely the way of the future.

At Microtest, we have seen how digital technologies such as electronic medical records have transformed the way that healthcare is delivered. It will be fascinating to see what applications the digital pill has over the next decade and how it might help us to use our existing health systems to their full potential.