Vitality’s Internet-Connected GlowCap Targets Behavior Change to Remind You to Stay on Meds
Some people feel guilty when evading their doctor’s recommendations; others need a logical reason to follow an instruction. Cambridge, MA-based Vitality tries to factor in these differences in motivations and psychological makeup to spur patients toward a common goal: to make sure they take their medications as prescribed.
On its most basic level, Vitality’s GlowCap system functions to remind users of when they’re forgetting their prescriptions. It involves an Internet-connected pill cap that also sends signals to a device that resembles a nightlight. When a deadline is missed, the system will blink and sound an alarm, which gets louder as time goes by. If the medication is still not taken, GlowCaps generate an automated phone call to the user to remind them to take a pill and ask them why they’ve forgotten it so far.
“We have a device that notices right in the moment that someone is making a decision and intervenes right away,” says founder and CEO David Rose, who previously founded and ran Ambient Devices, a Cambridge-based company that pioneered the use of household devices like clocks to convey information to people, on everything from the stock market to the weather.
The answers culled in these phone calls, in addition to initial interview questions with the user, help the Vitality system create a profile and determine the forces that motivate them, such as authority, social support, or rewards. Rose says there are many reasons beyond forgetfulness that users skip meds, such as concerns of cost, side effects, or lack of education on the effects of their disease. The GlowCaps system aims to both prevent those factors from becoming hindrances, and implement services that encourage users to take their drugs in the future, based on their individual psychological profiles.
For example, if the co-pay costs of a prescription cause a patient to skip meds, the system could help implement financial incentives for users who take their prescription when they’re supposed to. For patients motivated by authority figures, the system can help coordinate regular reports with their doctors, documenting their prescription adherence. GlowCaps helps coordinate refills with a patient’s pharmacy, too.
It also offers the capability to e-mail your adherence rate to a selected friend or family member, if you’re someone who is spurred by social support. Many patients taking medications to treat diseases that don’t cause immediate discomfort, such as high blood pressure, osteoporosis, or high cholesterol, are more inclined to skip pills. Vitality can target this user with regular, interactive, educational e-mails on the long-term effects of their disease.
“Just like an exquisite friend or boyfriend, we try to make a system that learns to adapt over time with what happens to work for you,” Rose says.
Wade wrote about the Vitality when the company’s Ethernet-connected device hit Amazon.com in August, selling for $99 each directly consumers, skewed toward baby boomers who need a way to keep their aging parents on track with taking medication. But Rose has since evolved his business to market and test-drive the product alongside bigger organizations. And Vitality has a new version of the GlowCap device, which uses a cellular network to connect to the Internet, and will be used in future distribution programs.
Later this month the company will start a pilot program with pharmacy benefit manager Express Scripts, which administers prescription drug programs. Express Scripts will supply thousands of patients with the Ethernet version of Vitality’s system until some time this summer. Rose says this big-scale distribution is more effective than selling to individual customers.
Several parties, beyond the patients and their families, stand to benefit when drugs are taken as often as a doctor’s prescription dictates. The reports generated by Vitality’s system help keep doctors in the loop on their patient’s behavior. Pharmacies profit from increased customer traffic the more often patients come in to refill prescriptions.
The GlowCaps system could also serve as a preventative medicine measure, helping insurance companies ultimately reduce expenses for patients whose illnesses worsen by not taking drugs as prescribed. But Rose is especially targeting pharmaceutical companies, who miss major revenue streams when patients take pills less often than they should. He said a drug such as Pfizer’s cholesterol-lowering drug atorvastatin (Lipitor) currently brings in about $10 billion a year, but could have revenues as high as $17 billion annually if users took it as often as they were supposed to.
“It’s so much easier to make more money for a customer than save money for a customer,” Rose says of his rationale in focusing on drugmakers rather than insurers. He envisions charging pharmaceutical companies a monthly fee between $10 and $25 dollars per patient for supplying their medications using the Vitality system. He says this would be the cost of a few pills a month for many drugs, and could incite patients to take roughly 10 more pills a month, providing a handsome return on investment for the pharma companies.
This isn’t a foreign concept to drugmakers, Rose says. Much of the print and TV commercials you see from drug brands are already designed to encourage current patients to take their prescriptions more regularly, more so than attract completely new customers, Rose says. Drugmakers will always set aside money for these marketing purposes, but Rose hopes drug companies will ultimately choose his device, rather than advertising, as their main form of improving customer adherence.
Rose sees smart packaging for often-forgotten prescriptions as a sweeping public health solution. His ultimate goal is for his company’s pill cap system is to become the default packaging for prescription drugs that are known to have low adherence rates. In the same way that drugmakers can’t package a birth control pill in anything other than a dial pack that delineates what day the user must take the pill, Rose hopes the GlowCaps system will become a standard vessel for many meds.