Speaker 1: In November seen the Food and Drug Administration of the
Speaker 1: United States approved a pill that knows when it's been swallowed.
Speaker 1: I'm Jonathan Strickland and this is text stuff daily. The
Speaker 1: pill is called abilify my site. It contains a medication
Speaker 1: called a rip of Result, which is used to treat
Speaker 1: bipolar disorder, depression, Tourette syndrome, and schizophrenia. It belongs to
Speaker 1: a class of pharmaceutical products called atypical antipsychotic drugs. The
Speaker 1: FDA had previously approved the drug for such use back
Speaker 1: in two thousand two, but this new pill adds something special. Namely,
Speaker 1: it's a digital sensor. That sensor can detect when someone
Speaker 1: swallows the pill, but the sensor is just part of
Speaker 1: the overall digital ingestion tracking system. The sensor records when
Speaker 1: a patient swallows the medication and sends a signal that
Speaker 1: gets picked up by a wearable patch on the patient's
Speaker 1: left side. The patch can then transmit data to a
Speaker 1: mobile device with a customized app that can monitor the patient.
Speaker 1: Patients also have the option to allow their physicians or
Speaker 1: caregivers access to this information so that they can make
Speaker 1: certain the patient is taking their medication regularly. Patients can
Speaker 1: also revoke access to the data at any time that
Speaker 1: they like. The sensor itself is tiny, According to a
Speaker 1: press release published on the website for Proteus Digital Health,
Speaker 1: which in turn creates the sensor for Otsuka Pharmaceutical Company Limited,
Speaker 1: The sensor is about the size of a grain of sand.
Speaker 1: The Verge reports that the sensor consists of silicon, copper,
Speaker 1: and magnesium, and that it's the acid in a person's
Speaker 1: stomach that triggers the sensor. The FDA's Director of Division
Speaker 1: of Psychiatry Products, Dr. Mitchell Mathis, said the FDA supports
Speaker 1: the development and use of new technology and prescription drugs
Speaker 1: and has committed to working with companies to understand how
Speaker 1: technology might benefit patients and prescribers. According to the I M.
Speaker 1: S Institute, misuse of medication, including the failure to take
Speaker 1: it regularly, leads to billions of dollars in healthcare costs.
Speaker 1: The institute estimated a two hundred billion dollar cost back
Speaker 1: in twelve. For example, if doctors or caregivers can quickly
Speaker 1: determine if a patient has taken a dose or not,
Speaker 1: it could save lives and money. Because the sensor only
Speaker 1: activates after coming into contact with stomach acid. The time
Speaker 1: recorded by the system is a few minutes after the
Speaker 1: patient actually takes the drug. It's also not one successful
Speaker 1: in registering when a patient takes a dose. For those reasons,
Speaker 1: you aren't supposed to rely upon the pill to give
Speaker 1: real time feedback on when a patient takes it. Not
Speaker 1: everyone is super on board with this approach. Some civil
Speaker 1: rights advocates have warned that digital pills could compromise a
Speaker 1: patient's privacy. There's also a fear that digital tracking could
Speaker 1: lead to scenarios in which doctors punish patients for failing
Speaker 1: to stick to a medication schedule, or not just doctors.
Speaker 1: Arthur Kaplan, who is a bioethicist at New York University,
Speaker 1: suggested in two thousand fifteen that digital pills could lead
Speaker 1: to ethically questionable situations in the courtroom. Kaplan created at
Speaker 1: a hypothetical situation in which a judge would require, as
Speaker 1: part of sentencing that a convicted person go on a
Speaker 1: regimen of medication, miss a dose and get your chance
Speaker 1: for parole taken away from you. Being legally compelled to
Speaker 1: take a medication is problematic. There's a concept called the
Speaker 1: right to refuse treatment. Barring a court order, healthcare professionals
Speaker 1: can't treat a patient against his or her will. In
Speaker 1: all but the most extreme cases, patients have the right
Speaker 1: to decide what happens to their own bodies. In some implementations,
Speaker 1: the use of a digital pill could be really helpful.
Speaker 1: For example, elderly patients who find it difficult to keep
Speaker 1: track of their medication use might rely on pills with
Speaker 1: digital trackers to do it for them. They can do
Speaker 1: a quick consultation with the app to see if they
Speaker 1: had remembered to take their medications, thus avoiding either over
Speaker 1: or under medicating themselves. But there are other scenarios to
Speaker 1: get more invasive. For example, requiring patients to use such
Speaker 1: a system to track their use of pain management drugs
Speaker 1: could help prevent overdoses and opioid abuse, but it comes
Speaker 1: with a lot of tough privacy questions. There's also concerned
Speaker 1: that insurance companies could start creating incentives for patients to
Speaker 1: use such drugs, and those incentives could be so extensive
Speaker 1: as to tread into coercion. That's the concern of Dr
Speaker 1: Eric Topol, the director of Scripts Translational Science Institute. If
Speaker 1: the incentives reach a point that it seems as if
Speaker 1: patients who do not choose to be tracked are being penalized.
Speaker 1: That's a potential ethical quandary on its own. Some experts
Speaker 1: don't necessarily have an issue with a digital tracking approach wholesale,
Speaker 1: but rather for this particular instance. Dr Paul Applebaum, who
Speaker 1: is a director of Law, Ethics and Psychiatry at Columbia University,
Speaker 1: said this to The New York Times. Many of those
Speaker 1: patients don't take meds because they don't like side effects,
Speaker 1: or don't think they have an illness, or because they
Speaker 1: become paranoid about the doctor or the doctor's intentions. A
Speaker 1: system that will monitor their behavior and send signals out
Speaker 1: of their body and notify their doctor, you would think that,
Speaker 1: whether in psychiatry or general medicine, drugs for almost any
Speaker 1: other condition would be a better place to start than
Speaker 1: a drug for schizophrenia. We're waiting on evidence to see
Speaker 1: if this pill is actually affected in the way it
Speaker 1: is intended. In the meantime, make sure you subscribe to
Speaker 1: the Tech Stuff podcast, where we explore ethics and technology
Speaker 1: along with all other aspects of tech. Shows published Wednesdays
Speaker 1: and Fridays, I'll see you against him.