why? a $500 pill bottle

Smart bottle poppin’

The other day I was casually flipping through the Tiffany catalog as I normally do, and I found the cure to medication adherence (kidding).

Since digital health has been a category, one of the most common beliefs has been that medication adherence can be improved with smart boxes, smart pill bottles, etc. by reminding people to take their meds. We’ve seen lots of startups get funded in this area.

Except now studies seem to say this isn’t the case. Maybe just sending people a reminder actually isn’t that helpful by itself.

But this week there was an interesting development. The first digital pill from Proteus and Otsuka called Abilify MyCite was approved by the FDA. It combines the anti-psychotic drug Abilify with an ingestible sensor that communicates with a patch, which also monitors vitals from a patient. This is a big milestone for Proteus, which has raised more than $400M since 2004 (if you’re in digital health, you’re playing the long game).

Abilify as a candidate was probably a deliberate choice. The blockbuster drug went off-patent in 2014 and generics started entering the market the following year (which Otsuka tried to fight but lost). This is obviously worrisome considering Abilify is one of the best-selling drugs in the US with more than $7B in sales a year at one point.

As pharma companies struggle with more and more generics coming out, some of these previously money-making drugs are becoming commodities. How do you differentiate a commodity? One way is by adding services.

This is where Abilify MyCite fits in. The drug now has a services aspect baked in with caregivers/practitioners able to reach out if they there are issues while they monitor you. Adherence is no longer just a text to your phone, it’s someone other than yourself holding you accountable.

This is an evolution of the pharma industry as a whole towards services and outcomes – which we’ve talked about before. This can also be a way for pharma companies to form relationships with patients after they take their drugs, and get valuable data about how patients react to the medications. Otsuka plans to get anonymized, aggregated data back from patients that consent.

Clinical Trials 2.0

Medication adherence can also be a hassle for clinical trials. It’s one area we highlighted in our new market map for expert research clients about companies aiming to change the pharma R&D process.

These companies are making it easier to test new compounds and therapies – the biotech “stack” of tomorrow is being built.

Stay healthy,

Nikhil
@nikillinit