By Mike Myers

In the mid 90’s, I worked for a firm in Phoenix and for one year focused almost exclusively on the issue of patient compliance (now commonly called adherence). The statistics I found at the time were daunting.

Roughly 50% of patients never filled their prescription. Almost 70% of patients taking a chronic cardiovascular drug had stopped Rx treatment altogether within six months. The numbers astounded me everywhere that I looked.

I realized very quickly that compliance was the key to all of my clients’ woes. If we could move the needle just a little bit and get people to stay on therapy that their physician thought was appropriate in the first place, we could help our clients increase their sales. Well, I didn’t solve the compliance issue then and no one has fully solved it since then either.

Sure, there are companies that work with pharma, pharmacies and patients that do a great job on it, like Adheris. Companies that offer patient reminder services with pre-recorded calls like Medication Reminders. And there’s even an App for that that’s pending Apple’s approval for your iPhone.

But, no one has truly solved the problem of patients just dropping off, dropping out altogether, or just plain ignoring their physician’s advice.

From personal and professional experience, I know that the compliance issue is very complicated. Patients make their decision to comply with therapy based on a variety of factors including:

• Cost
• Trust in their physician/healthcare professional
• They just feel better and don’t think that they need medication any more
• They have a “silent” disease that doesn’t really force them to stop and recognize that they need therapy of some sort

Well, times they are a changing. Novartis is working with a company called Proteus Biomedical and together they’ve implanted chips in patients’ shoulders that monitor their drug usage. As reported in mobihealthnews, “patients are taking blood pressure drug Diovan and the study organizers track their compliance via Proteus’ “chip in the pill” technology, which reports to a receiver sensor on the patient’s shoulder when the medication has been ingested. The study has improved compliance from 30 percent to 80 percent after six months, according to Novartis.”

On one level, I’m in awe. On another, I’m in shock.

Just this past week, my dog Cosmo got fixed. When under anesthesia, they implanted a chip into him so that we could keep track of him if ever lost. Yes, I get the difference in the two different purposes here, but is the end result much different? Someone is watching.

At some level, this entire technological pathway smells like a George Orwell-fest.

I love technology. I also believe that compliance is an issue that hurts our healthcare system as non-compliant patients in some cases are going to get worse and create a greater cost burden than their previously prescribed medications would have cost.

But as we continue to expand our knowledge, I’m throwing out a personal cautionary note. I saw the Matrix and its sequels. I read 1984. And, I’ve read through the legislation that is being bantered around about chip implants. Heck, I’ve even considered them for my kids. Yet, there must be some level of protection in all of this wired in from the start (pun intended) to ensure that what we ultimately get from our newfound knowledge is what we signed up for in the first place.

On a practical level, I think this new technology for compliance is great. On an emotional and conspiracy theorist level, I want to think about it a bit more. I’d welcome hearing what others think on this one. Let me know.

**Of course,If you’ve accessed this post, I do know who you are …

UPDATE:

Since writing this article,  the world has evolved even further. When it comes to more people dialing in, plans are already in the works.