as often as people in the study who didn’t get the prompts.
Kvedar, who is also an associate professor of dermatology at Harvard Medical School, says that he actually uses a medication-reminder technology called GlowCaps for his daily cholesterol-lowering pill. GlowCaps, which fit onto standard pill bottles, were initially developed at the MIT Media Lab and are now marketed by the Cambridge-based firm Vitality. The system that Kvedar uses got him out of bed one night after his wife heard it beeping to tell him that he had forgotten to take his cholesterol pill. (The bottle caps are designed to light up before they beep.)
Even though such systems have shown to be effective, according to Kvedar, there’s still a question of who should pay for the technology. GlowCaps can be purchased online for $99 and require users to have a broadband Internet connection to their homes. As for MedMinder’s system, individual patients pay $50 per month for use of the firm’s electronic pill boxes and the online services the company provides. The field is also rife with other competition, from iPhone apps like MediMemory to pills from Redwood City, CA-base Proteus Biomedical that deliver wireless signals after they are swallowed. Then there are services like those from Newton, MA-based Aprexis Health Solutions (formerly InnovationRx), which provide e-mail reminders and other outreach to get patients to take their meds.
“The way that the economic models are currently set up,” Kvedar says, “it’s the patient’s responsibility to take their medication, and nobody will give them a cash subsidy to cover a program like this.”
A potential shot in the arm for MedMinder and Vitality could come with potential healthcare reform in Washington. One proposal in payment reform is to give doctors bonuses for improving the health of their patients, which could create an incentive for them to recommend IT systems and other methods to remind patients to take their meds. For now, the companies might get business from health plans that have existing disease-management programs in place that aim to improve outcomes for seriously ill patients, according to Tom Hubbard, a senior program director for the New England Healthcare Institute.
At MedMinder, the firm is focusing its marketing efforts on organizations that have a stake in controlling costs for chronically ill patients, Shavelsky says. “This is the population that industry, health insurance companies, and healthcare providers are really focused on, because that’s where you can suffer the greatest costs if [patients] don’t take their medication on time.”
