Drs. Oz & Jennifer Miller on the ethics of digital pills

Today, the Dr. Oz Show discussed the 1st FDA approved digital pill, Ability MyCite. The pill has a sensor to digitally track if patients take their medicines. Jennifer Miller, discussed 4 points about the ethics of the new technology on the show.  See the clip, here.

First, medication adherence is complex. It involves more than just ensuring a patient swallows a pill. Prescriptions need to be called into the pharmacy, picked up, and taken correctly. Around 30-50% of prescriptions are never filled  and 1/2 aren’t picked up from the pharmacy (sometimes because the pharmacy line or wait time are too long). There isn’t any evidence yet showing the tracker will improve compliance with treatments or health outcomes. It just tracks. It also isn’t 100% reliable yet. According to the FDA, detection may be delayed or not occur.

Second, we need to create a system to respond to non-compliance. It isn’t clear  what a doctor should do when he or she learns that a patient hasn’t taken their medicine.

Third, what will the digital pill cost and will it always remain voluntary?  Will it be significantly more expensive than regular Ability without the tracker? Will the pill always be optional or will some insurance companies and formularies decide to only cover the pill with the tracker, thereby limiting choice and potentially raising prices?

Finally,  trust in the medical system is an important element in medication adherence. Some are calling this new technology the snitch pill, medication with a tattletale, and big brother in your belly. Distrust issues need to be addressed.  It may help to be transparent and educate about exactly what the pill can, does or will track and who will be able to access this information.  Will this information ever reach insurance companies or employers?  Could premiums ever go up for non-compliant patients?

While this new tracking technology may prove helpful in reminding patients to take their medicines and thereby improve health outcomes.  At this point, real world data are needed to assess these outcomes.  I hope these outcomes are studied and I look forward to seeing them published in the near future.

PS:  I am not necessarily a critic of this pill, like Dr. Oz said. Had a lot of fun on the show.  See the full clip here: http://www.doctoroz.com/episode/marie-osmond-exclusive-her-secret-health-struggle-revealed?video_id=5708784657001