Startups serve up ways to get patients to take meds

A prototype for the new WatchRx.
A prototype for the new WatchRx.

When the founders of WatchRx, a startup in Acton, tell people that they are designing a wristwatch that will remind you to pop your pills, they know what the first question is going to be.

Why not just create an app to run on the Apple Watch, Samsung Gear, or some other smartwatch already on the market?

Jayanthi Narasimhan and Arun Buduri have a ready answer — and we’ll get to it in a bit. But the prototype that Buduri wears on his left wrist is just one manifestation of the entrepreneurial drive to solve a problem that costs the health care system hundreds of billions of dollars: medication non-adherence. In plainer terms, that’s when you don’t take the meds you’ve been prescribed, and it causes complications or lands you in the hospital.

Since I last talked to startups working on the problem in 2009, there’s been a whole new wave of attempts, many of them trying to make use of your smartphone or Internet-linked pill cases that will sit on your bathroom counter. One of the companies I wrote about then was MedMinder Systems of Needham. Since its founding in 2007, it has shipped “many thousands” of pill cases that flash, beep, or play a recording of a loved-one’s voice to nudge you to down your daily dose, according to founder Eran Shavelsky.

“Since I started, so many companies have started and disappeared, trying to look at ways to deal with this problem,” says Shavelsky. His conclusion? “There is no one solution that will solve the problem for the whole population.”

The way Niteesh Choudhry sees the problem, about half the population takes prescription meds roughly the way they’re supposed to. “Another 40 percent want to follow the prescription, but they don’t for all kinds of reasons — forgetfulness, the cost, complexity, legitimate side effects, or a lack of communication between them and their doctor about what the medications are for,” says Choudhry, a physician and Harvard Medical School professor who researches the costs of medication non-adherence. The remaining 5 or 10 percent, Choudhry says, “have no desire to take it, understanding all the risks and benefits.”

Even shifting a small portion of the 40 percent who want to take drugs as prescribed, “would be a lot of people, a lot of money to the health care system, and a big win,” he says.

Some of those patients, no doubt, are active smartphone users. For them, apps from companies like Pillpack, based in Somerville, or Medisafe, headquartered in Israel with an office in Boston, can help keep them on track. Pillpack, an online pharmacy, built an app that can issue reminders based on time of day or location — like when you’re at home versus out and about. But unlike some other systems, Pillpack doesn’t try to send a message to your doctor when you miss a dose.

“People always ask why we haven’t built something to let doctors monitor their patients,” says Pillpack co-founder T.J. Parker. “Well, they don’t need another source of data in their life.”

A Harvard Medical School startup, Memora Health, is focusing on people who may have older phones, sending medication reminders by text message. It won a pitch competition earlier this month organized by Brigham and Women’s Hospital, and judged by a panel of physicians. Almost uniformly, the docs said they were wary of any system that would add some new task or piece of software to their workday.

At WatchRx, Narasimhan and Buduri say electronics components are now cheap enough that they can sell a single-purpose wristwatch for about $100; a wireless plan to keep prescription information up to date would cost about $30 a month. Narasimhan has parents in India, and she usually calls them several times a week. “One of the first things I ask is, ‘Did you take your medications?’” she says.

Their watch is designed to keep constant tabs on the answer. It shows a picture of each pill at the time it is supposed to be taken. It will alert family members or caregivers when the wearer misses a dose. And there’s a built-in speakerphone that will let them call to nag. The watch’s only function not related to taking meds? It displays and can speak the time and date.

Multi-purpose smartwatches, Buduri says, “are really expensive, and they have complex menus. Using them is confusing, and most of them require a Bluetooth connection to a smartphone.” WatchRX wants to simplify things.

One person who is familiar with the product, Cindy Hickey of the Somerville Council on Aging, says, “Our mission is to keep elders in their home as long as possible. I think this is a tool to help do that, and keep them in touch with the health care system.” Her council may participate in a pilot test with WatchRx.

Choudhry says that many such pilot programs are in the works, and he hopes they’ll generate data that could help startups like WatchRx persuade insurance companies to cover the cost of the devices for certain patients. “When we subject great ideas to rigorous testing, sometimes they don’t pan out and sometimes they do,” he says. “There are lots of examples in health care of stuff we paid for that doesn’t actually save us any money.”

Unlike the Apple Watch, which benefitted from Apple’s Barnum-esque promotional skills, WatchRx’s product will have to prove its value before it winds up on thousands or millions of wrists.

Scott Kirsner writes the Innovation Economy column every Sunday in the Boston Globe, in which he tracks entrepreneurship, investment, and big company activities around New England.
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