What Drug Delivery Devices are Ripe for Digital Health Transformation?

The Premise

It comes as no surprise that with all the hype surrounding the use of technology to transform healthcare, that companies (startups & Pharma) are looking to transform traditional medication use. As a pharmacist, this is perhaps the biggest interest I have in the Digital Health sphere, as I feel it may have the largest impact on my profession, and role as an educator. 

With that in mind, I have been trying to keep up on what industry has in the pipeline for design, and what companies are heavily invested in this sphere. As follows is a personal list of companies and areas of disruption I have noticed.

Drug Delivery Products List

Inhalers

The over all premise behind the use of digital health technologies in inhalers is that it offers a means for providers to see when and how often patients are using their treatment for asthma or COPD. One example I see being potentially very beneficial is tracking when patients are using breakthrough treatment (such as with their rescue inhaler [albuterol]) and if they are using their chronic treatment appropriately. This may be very beneficial in patients with frequent exacerbations. Two systems I see benefiting from this include health systems and Pharma. Health systems could look into this technology to spot patients who may need intervention prior to an exacerbation and ER/Hospital admission, while Pharma could use this data in their clinical studies.

• SmartInhaler by Adherium - Currently in partnership with AstraZeneca, and recently announced they were working together for a COPD study in the US. The drug being investigated is Symbicort, which based on recent changes to the inhaler design makes sense for what Adherium Limited is creating.
• Propeller Health - Currently in partnership with UK Vectura and GSK. Currently, GSK is looking to integrate Propeller's technology into it's Ellipta product for use in clinical studies.
• CareTRx by Teva - Formerly from MIT, Gecko Health was bought by Teva Pharmaceuticals to bring its technology into asthma and COPD inhalers. Perhaps biggest difference is that the technology appears to be sensors that go on-top of MDIs, which may limit it's application in certain inhalers, and also with the changes of many MDI going DPI (ProAir) or Respimat formulation.
• 3M Intelligent Control Inhaler - New comer to the field, 3M is still looking to partner with a pharmaceutical company to use its device. Honestly, it really looks similar to the new ProAir DPI coming to market and I could potentially see it fitting that niche well.

Insulin Delivery

The delivery and management of insulin therapy is a costly and complicated affair. The close relationship between monitoring blood glucose levels and insulin use is often conducted via SMBG monitoring, and CGM (which many companies including Google) which is quickly becoming a hot area in diabetes management. One thing I am curious about is what companies will do to to disrupt the delivery of insulin to patients.

Now, there are many companies looking to create new insulin formulations which I find fascinating (including oral insulin and time activated insulin) that will not be my focus here, rather what devices are being created.

• Companion Medical - Currently in the process of creating a smart insulin delivery system separate from Insulin pumps, they have received backing from Eli Lilly.
• Emperra Esysta Insulin Pen - Bluetooth enabled insulin pen delivery device that seeks to allow users to track how much insulin administered and recorded via an app.

Surprisingly, I have not seen to much done in this sphere, but then again it makes sense to a certain extent. Most insulin pens used in the US market are disposable, though there are pens with cartridges, and those pens I expect (if they take off more) to eventually integrate this technology.

Oral Medications

Proteus Health. Enough has been talked about, though as it stands, the use of a wearable patch that must be worn to get the data seems rather limiting for large scale application. Other companies are currently interested in this area as well, though Proteus has garnered the most support. Recently I have seen alot of publications from Proteus, and several leveraging the system for pharmacists to track medication adherence and disease treatment which I am really excited for. Proteus and Otsuka were pursuing a new Abilify product that integrated the technology into depression/schizophrenia management, but the FDA has not yet approved this product.

Other possibilities?

• Naloxone Kits - I am still waiting for someone to create a smarter naloxone kit that can build in education or a walkthrough and alert system.
• EpiPen - This device I feel could use and upgrade, including the verbal instructions that AuviQ had, and alert on expiration. Whether someone could make it trackable that when used it sends out an alert to providers and caregivers it was used and alert EMS may be of interest.
• Biologics - Not to sure in regards to this area, as most of the products are once and done and may not really be beneficial for cost.

Anything I am missing? Would love to see what areas are being developed!