Nigerian Man travels (at great expense) to the nearest medical facility. He is diagnosed with Disease X. Nigerian Man is given medicine and told to take three pills a day for the first week, then reduce to 2 pills daily for two weeks, then 1 pill until they are gone. He goes home, takes pills for a few days, feels better, then stops taking them. Failure to follow drug therapies is certainly not a problem that occurs only in developing countries. Non-adherence costs employers, insurers, doctors, patients, and drug companies. An oft-cited 2012 study of non-adherence estimated lost revenues at $188 billion a year in the US, and $564 billion globally.
As with many aspects of health services, however, nascent technologies promise a different future. One recent study in JAMA Internal Medicine found that SMS message reminders can double the odds of medication adherence in patients with chronic disease. A California hospital is embedding a sensor into pills to record data from inside patients. The data are uploaded to the cloud and available to doctors and researchers. Similarly, several drug companies are partnering with Qualcomm to send data from medical devices like inhalers to the cloud. Sproxil, a US-based company, has developed a popular mobile-based product verification service to combat drug counterfeiting. The service – growing fast in Africa and South Asia – promotes adherence by ensuring drug efficacy and building trust in the health system.
Any of these new technologies could change the game for doctors, researchers, health system administrators, and of course patients. Better data on drug adherence means better data on drug efficacy, which means better M&E of treatment programs, which means better health outcomes – at least for those paying attention to the data. It’s also an opportunity for pharmaceutical companies to show a substantial value add by developing and offering mobile-based compliance plans, rather than little-read, micro-printed “directions for use” inserts. New technologies can help established drug companies validate higher costs and distinguish their products from generics. Nigerian Man wouldn’t just pick up a packet of pills; he would also get mobile-enabled support tools that encourage adherence and promote healthy behaviors in areas like diet, exercise, vaccinations, and follow-up care.