Medication adherence startups talk hardware, reimbursement, efficacy

Medisafe to launch $20 connected pill bottle cap next month; AdhereTech focused on specialty pharma
By Jonah Comstock
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As the connected medication adherence space matures, companies that have led the space for the past few years are fine-tuning their technology platforms, business models, and approaches to efficacy. 

At the Partners Connected Health Symposium in Boston today, representatives from Abiogenix, AdhereTech, AiCure, and Medisafe shared updates on their shared mission to combat the $290 billion medication adherence problem in the country. 

Among the most interesting of those updates was from Medisafe EVP of Marketing and Business Development Jon Michaeli, who shared the news, originally announced a few months ago, that the company is moving into hardware via a partnership with TimerRx. 

“In about a month we will be shipping Bluetooth-connected pill bottle caps that retrofit on 95 percent of amber vials, that when opened will communicate to Medisafe that a patient has taken their medication,” Michaeli said. “Because the infrastructure is in the cloud, we are gathering all of these insights, all of this data within that platform that can then be shared appropriately, sometimes in a deidentified fashion, sometimes with patient opt-in, actual patient data can flow through to doctors, nurses, specialty pharmacists, etc.”

The devices, called Medisafe iConnect, will be sold in two form factors: a smart cap and a smart pillbox with multiple compartments. They will be available direct to consumer for $20 and $50 respectively.

“We wanted something that could be available to the mass market,” he said. “We didn’t have to question affordability or who’s going to reimburse.”

The partnership seems to bring Medisafe into a closer space with AdhereTech and Abiogenix, which both make connected pill containers. Both those companies have refined their approach and their business models.

AdhereTech CEO Josh Stein said that his company is increasingly distributing its smart pillboxes via relationships with specialty pharmacies, such as Avella, their main distribution partner in the United States. He says they’re also just starting to work with payers.

“Most of our customers are not payers, it’s typically pharma or specialty pharmacies, but we do work with a few payers,” he said. “In our experience they’ve been a little bit slower to invest time and resources in medication adherence technologies. The one area we’ve seen adoption with payers is in the Hepatitis C space. Some Hep C medications are incredibly expensive. It requires a lot of upfront payment to pay for this medication, but if the patient doesn’t take the medication that leads to even more in treatment costs. That’s where we’ve seen adoption.”

Abiogenix, whose uBox smart pillbox can be locked, has found its niche with mental health and addiction recovery and is working with rehab centers as some of its initial partners, according to CEO Sara Cinnamon. She said one of the biggest learnings has been to make the device helpful but unobtrusive.

“If you make the interaction as natural as possible, you’re going to get the most authentic data,” she said. “But if you make it so annoying that people turn the handle just to turn off the alarm, we don’t want that. So we make it very easy to snooze or dismiss an alarm, and the noise itself is customizable to how loud do you want it. Maybe it goes off once every two minutes, realizing we all have real lives and maybe we can’t get to it whenever we want to.”

Finally, all the panelists talked about the importance of establishing robust efficacy data for their various devices. Adam Hanina, CEO of AiCure, which uses visual AI to confirm that a patient has taken a medication dose, said they’re careful about their outcome measures.

“You need to have an accurate validation system,” he said. “We don’t believe that validation through self-reporting is really a reliable means to confirm that someone’s doing something correctly. It’s like asking someone to self-report their driving speed down the highway. If you have an accurate mechanism — at AiCure we use drug concentration levels in the blood — it’s critical to show that evidence. Because then people begin to trust your technology."