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The first ever digital pill – Big Brother or breakthrough?

Your family and doctors can have access to an app that records whether you’re taking your medication – highly invasive or ingenious science?

New technology in the form of a ‘digital pill’, which is attempting to revolutionise mental health treatment, has been approved for the first time by Food and Drug Administration in the U.S. Research continues into medication that’s embedded with a sensor, which tells doctors when and if patients take their pills. It’s called Abilify MyCite.

An ingestible nano sensor in the pill – made of copper, silicon and magnesium – tracks the medicine after you swallow it, sending information as it reacts to your stomach acid to an outside device that stores the data. It passes through your body like anything else. Doctors and health specialists can monitor whether someone is taking medicine on time, and in what quantity through the pill and a patch the person would wear to track the signals. 

The person taking the pill can also choose up to four people, including relatives, to access their data. Via a smartphone app, they can monitor and revoke access any time. Patients can also input their sleeping and exercise activity into the app.

As the New York Times reports, it would be a significant move for researchers attempting to develop technology that monitors medicine intake. It’s been estimated that in the U.S, ‘noncompliance’ with medication can cost around $100 billion a year due to people becoming ill as they don’t take their medicine, and thus requiring more treatment. 

It’s a development by digital medicine company Proteus Digital Health, which creates the sensor, and Japanese pharma film Otsuka.

Abilify is currently prescribed to people with schizophrenia and bipolar disorder, as well as other depressive disorders. Experts however have spoken of their concern for this grouping. Peter Kramer, an emeritus professor of psychiatry and human behaviour at Brown University and author of Ordinarily Well: The Case for Antidepressants, told Dazed that using this technology first in the form of antipsychotics “worries” experts.

Some of the mental illnesses being treated with the digital pill include symptoms such as paranoia and delusions, which mean people can avoid taking their medication, or in this new case, become suspicious or mistrusting of it. It seems a bizarre area of illness and disorders to start developing the digital pill. 

“But in the broader sense, the technology is here,” Kramer says. “And as a doctor, I see an upside. Say a patient comes in and says, ‘my antidepressant is no longer working’ – and I consider raising the dose or adding a second medicine. It would be useful to know that the patient had skipped or forgotten a number of doses – so that having the technology might lead to less prescribing, in total.”

“The pill may alter interpersonal relations, within families. Your parents are looking over your shoulder again. And so on. The mere existence of the technology may have its downside” – Doctor Peter Kramer

Tracking technology like this could also lead to privacy issues and ‘big brother’ implications. Kramer explains: “It’s also likely that courts will take advantage of the technology. Then the medicine will be used coercively – stay on the medicine, or you will have violated parole. Different people may have different views of that likelihood.”

Many court systems set out drug treatment plans in sentences. Though we haven’t exactly arrived at the notion of pill-tracking on parole just yet, the drug Abilify (in non-sensored form) has been prescribed as part of court-mandated treatments, as the Verge previously reported.

“It seems a bizarre area of illness and disorders to start developing the digital pill”

Privacy experts have also voiced concern that the government or private corporations could use the pill to mine personal information from people. As the technology is pretty new and only just entering the public sphere, little regulations currently exist. Speaking to CBS, Dr Jonathan LaPook also detailed the potential for the biometric data to be hacked. 

There is also a question of efficacy, Kramer notes, as the FDA notes that no one has run studies to see whether, with monitoring, patients actually do stay on medication longer. And more so, whether it would actually stop people reaching out for medical help.

“What if, because monitoring is now possible and because they know that their doctor or relatives will demand it, patients, as they fall ill, choose not to consult a doctor in the first place?” Kramer asks. “What if the experience of patients being monitored is such that it causes them not to report subsequent episodes? The pill may alter interpersonal relations, within families. Your parents are looking over your shoulder again. And so on. The mere existence of the technology may have its downside.”

Some people though may want and need some level of monitoring, like the elderly or people with disabilities. With their consent, they can be sure they’re following the care they need. If people stop taking medication also, it’s an opportunity for doctors to have conversations that may not have taken place before, where people just faded away. When it comes to treating mental health, this could be an opportunity to engage on a totally new level when discussing a treatment plan. 

As well as this, there are financial questions to ask. Otsuka hasn’t set out price guidelines for the pill yet. Kramer adds: “Both individuals and the system as a whole will pay for these meds. How much benefit is added, at what cost?”

The Wall Street Journal reports that the FDA is looking over several other applications for digital pill testing, and hopes to produce guidelines for future developments that are ethical and safe.

“Digital pill technology is coming, and it will have its uses,” Kramer asserts. “We may well be seeing the future.”