Digital Pills & Big Pharma as Big Brother

By Caroline Santoro

     Every year, patients’ failure to take medication as prescribed causes around 125,000 deaths and $100 billion in additional hospitalization and treatment.  To potentially reduce those failures, the FDA last November approved the first digital pill. The pill is equipped with a sensor to tell doctors and up to four family members or friends whether a patient has taken his or her medication as prescribed.  Like a potato battery, the copper, magnesium, and silicon sensor when splashed by stomach fluid sends a signal to a band-aid-like patch worn by the patient. The patch records exactly when the patient took the medicine and his or her activity level and transmits the data to an app through Bluetooth.  The app also allows the patient to log how he or she feels for the doctors and other viewers to see. While patients are required to sign consent forms and have the ability to block viewers at any time, this technology raises important questions about privacy and the rights of pharmaceutical and health insurance companies to monitor patients.  

     For patients motivated to take their medication correctly, this technology could help patients hold themselves accountable and prevent accidentally missing or repeating a dose. However, for patients with mental illnesses (Abilify, the first medication to be administered as a digital pill, treats people with illnesses including Schizophrenia, Bipolar Disorder, and Depression), the pill might seem like a malevolent spy or tattletale.  As a result, although noncompliance for medication is a particularly large problem for patients with mental illness, these types of drugs may not be the best place to experiment with digital pills.

     Besides concerns about privacy, Dr. Eric Topol , a doctor at Scripps Translational Science Institute, explained the problem caused when insurance companies incentivize patients to use digital pills, for example by offering discounts on copayments.  Although this approach may seem “win/win” for both parties, the insurance company also can use the information to deny coverage or alert law enforcement about patients who misuse or attempt to resell their medication, as often is the case with opioids. Digital pills could also be used in the future as a condition for probation or release from psychiatric hospitalization, just as an electronic ankle bracelet is used for parolees.

     This technology could be very helpful in the future, both for patients who want to help themselves and those whom others want to help. Someone in recovery who is concerned about taking too many opioids may appreciate the accountability, but an addict or someone leery of being tracked might not consent to using the pills. Once patients see the benefits of greater compliance, they likely will accept less privacy.  However, patients’ data and rights must be protected to ensure that Big Pharma does not one day become Big Brother.

 

Works Cited

 

Belluck, P. (2017, November 14). First Digital Pill Approved to Worries About Biomedical ‘Big

        Brother’. Retrieved from https://www.nytimes.com/2017/11/13/health/digital-pill-fda.html

 

Mullin, E. (2017, December 13). Digital pills track how patients use opioids. Retrieved from

        https://www.technologyreview.com/s/609592/digital-pills-track-how-patients-use-opioids/