Did you forget to take your medicine? Your doctor will be informed immediately!
Once again, innovations in health care follow one another at a frenetic pace, with their procession of fascinations but also of questions about what we are becoming. It's the turn of the American startup Proteus to announce that it is in a position to obtain marketing authorisation from the FDA (Food and Drug Administration) for a connected pill.
Dn some conditions, regular medication is vital. However, one study of the World Health Organization (WHO) has established that in 50 % of cases, prescribed drugs are not taken correctly. This represents an astronomical cost of some $100-300 billion each year in the US alone.
This is particularly frequent for certain mental illnesses where interruption or abandonment of treatment is synonymous with a considerable worsening of cases. So scientists have developed a drug that can warn the patient's doctor if treatment is interrupted.
The Californian company Proteus has been working on connected drugs for a long time. After numerous clinical trials, it has just submitted a new type of pill for a schizophrenia drug (Abilify) to the FDA. This pill contains an electronic sensor at the centre of the drug substance. This sensor is released into the patient's body as soon as the pill is dissolved in the stomach. A signal is then sent to a receiver on a patch that the patient must wear. The patch records the information and collects other data about the patient, such as the patient's activity during the day. All of this information is transmitted to the patient via his or her mobile phone, but also, with the patient's consent, to his or her doctor.
According to the news release of Proteus, this is the first time the use of this type of drug has been studied by the FDA (Food and Drug Administration), the health agency in charge of monitoring and regulating drugs in the United States.
A sensor in the body
Contrary to what comes spontaneously to mind, this sensor is not an RFID-type electronic chip. Each Proteus sensor is composed of a tiny amount of copper and magnesium. These two metals, brought into contact by gastric juice as one would do in simple electrolysis, immediately feed a device that creates a signal. It is the body tissues that carry this signal to the patch on the patient's body. This patch contains a Bluetooth antenna connected to the patient's smartphone. At present, there are not yet sufficient studies to measure the degree of harmfulness or safety of the nanoparticles that make up the sensor. The laboratory that designed the device claims that its technology is safe and has been successfully tested in many clinical cases.
The idea of making a living organism ingest a sensor is not new. As early as the 1980s, NASA had developed a capsule ingested by astronauts to measure their temperature and certain metabolic data. Other researchers have developed mini-cameras embedded in pills to scan the digestive systems of certain patients. We remember Richard Fleisher's movie, the Fantastic Journeywho was already imagining this type of solution in 1966. More recently, we reported in UP'. Google X Lab research on nanoparticles injected into the human body to detect certain types of cancer.
Today's announcement by Proteus is striking because we are moving out of the realm of laboratories and limited testing and into the field of very consumer applications.
Questions of trust
All Proteus' communication puts the patient at the centre of the system, emphasising that these pills will enable patients to become more autonomous in the follow-up of their treatment. The marketing is relatively silent on the connection with the attending physician. This is where the questions arise. Indeed, what will be the guarantees in terms of storage of a patient's data? How far will the role of the doctor who becomes a controller go? Can we fear that the data collected on a patient's behaviour will be used to dictate what he or she can or cannot eat, what activities he or she can or must do, what activities he or she is allowed to carry out or not? Until now, the patient has been undergoing treatment. Now will he or she have to "be in good standing" with his or her treatment? The nuance is significant.
We cannot fail to see in this type of innovation the financial consequences that they carry in their wake. Indeed, the figures unveiled by the WTO show that half of the patients would not follow their treatment. The pharmaceutical industry is losing billions of dollars in lost revenue. A windfall that would be easily recovered if controls on the actual taking of medicines were carried out. On the insurance side, this type of innovation also promises a bright future. They could take into account behaviour proven by monitoring patient data to reduce or even eliminate coverage for negligent patients.
Trust is therefore at the heart of this issue. What will be done with the data collected, how will it be processed? The answers to these questions will trace the future of this type of innovation which can help us, bring us comfort and progress, but also, and at the same time, irreversibly compromise our freedoms.