In the not so distant future, a tiny-weeny microchip will be a part of your prescription medication. While the lawyers and ethicists work out the details the pharmaceutical industry is developing.
This chip will communicate to you, your doctor, anyone else on your future-medical social media friends list, that a.) you’ve taken the pill b.) it’s reached your stomach c.) any other data points the chip can sense while traveling through your body.
Studies find that 50 percent of patients tend to skip or miss taking prescribed meds. This makes it hard for docs to accurately diagnose if the medication is not working or if you have another illness… This technological breakthrough would radically change this evaluation process.
It could also be used to control patients…and could provide insurance companies with a new set of data on your body, health and habits…
We have an article from The Verge on whether tracking meds are worth the risk. Here are some excerpts:
Proteus was formed with an eye towards solving that problem, according to the same health-tracking logic as Fitbit and Apple’s HealthKit. If patients can see how well they’re doing, they’ll want to do better, and adding in external measurements can give them a direct sense of how the medication is helping them get better. “Once a patient is using our solution, they can see how they’re using their drugs, they can see how it affects their body, and we can create all kinds of behavioral tools that enable them to keep doing that,” says Proteus CEO Andy Thompson.
“IT MEANS MUCH, MUCH MORE THAN JUST THAT WE CAN TRACK YOUR COMPLIANCE.”
The Proteus device will still only monitor pill intake, but it can be paired with other metrics for a much more comprehensive picture of how your body responds to the medication. “It means much, much more than just that we can track your compliance,” Thompson says. “It means patients are going to be actively engaging with their health care on a regular basis just by using their smartphone.”
Self-tracking or surveillance?
But not everyone’s convinced that the ability to track pills will be good news for patients. The right to refuse treatment is an important, fragile principle in health care. Many are worried that tracking whether a pill is being consumed will be the first step towards punishing patients that don’t comply. While doctors can’t force a patient to take a pill, court orders frequently mandate treatments involving specific drug regimens.
“IT’S A DIFFERENT WORLD THAN SAYING I CONSENT TO TAKING THESE PILLS.”
NYU bioethicist Arthur Caplan says he can imagine a judge using Proteus to enforce medication as part of a sentence: miss a pill, and your parole is revoked. “The temptation in the legal system to say, ‘I can monitor you and make sure you’re not a threat’ is going to be huge,” Caplan says. “Maybe that’s good, maybe it’s bad, but it’s a different world than saying I consent to taking these pills.” Those court orders are rare at the moment, since there’s no way to ensure a patient is taking medication outside of a controlled treatment facility — but as pill-tracking becomes easier, those measures could become much more common.
That’s particularly likely given the way Proteus is entering the market. The device’s first partnership bundles it with Abilify, a powerful antipsychotic most commonly used to treat mood disorders, schizophrenia, and Tourette’s. The most common effects are improved concentration and decreased hallucinations, but it comes with extreme side effects like increased suicide risk and a lower seizure threshold. It’s most often prescribed in cases of severe mental illness, often in psychiatric institutions or as part of a court-mandated treatment program — exactly the scenarios bioethicists like Caplan are most worried about.
Another tool for courts
Patients’ best protections are medical privacy laws like HIPAA, which prevent medical data from being shared with anyone outside the hospital system. That would stop your boss or your parents from using Proteus to make sure you haven’t fallen behind on your anti-anxiety medication. But those laws won’t keep data out of the hands of healthcare providers, and Caplan is concerned the pill could also be used to enforce compliance. Insurers might offer a discounted rate on tracked pills, then hit patients with a $100 co-pay for every treatment they miss. It’s not as oppressive as a court order, but the end result would be similar.
Proteus says it’s already consulting with patient advocates and bioethicists on the ethical issues involved, but acknowledged that there are serious questions at stake. “We think Dr. Caplan has thoughtfully raised important points,” the company said. “We agree with everything he says.”
Still, those concerns are unlikely to keep Proteus out of the hands of doctors. The upcoming FDA approval will focus largely on safety and efficacy, leaving the larger ethical challenges to be solved after the drug is released to doctors and patients at large. With the technology available, it will be up to the courts to decide when it’s legal and ethical to use it. As far as Proteus is concerned, the power of the technology outweighs the risks. “There are challenges with bringing digital into any sector,” a company representative said. “The reason to embrace the challenge in health care is because the need is so great.”