Move over, wearables. Swallowable computing has arrived...
First, there were wearables. Now, there are swallowables
Suddenly, a computer on your wrist doesn't seem so
amazing.
Zack Guzman 5 Hours
Ago CNBC.com
In the evolution of computing, from the desktop computer
to the smartphone to the watch, it seemed like just a matter of time before the
technology would come to be swallowable — and now it is.
The innovation at the heart of it is an FDA-approved
ingestible sensor housed in pills, designed to help patients adhere to the
medications their doctors prescribe. Except the sensor isn't powered by a
battery, it's powered by the gut of the patient swallowing it, using technology
discovered two centuries ago.
"We have a small, food-particle-sized piece of
silicon, an integrated circuit, and on one side of that circuit is a film of
copper, on the other side a very thin film of magnesium," explained
Proteus Digital Health co-founder Dr. George Savage. "When you swallow,
these minerals get wet and two dissimilar metals in aqueous contact define a
battery, so you become a battery." From there, the powered pill sensor
sends a signal to a patch worn on the body, which sends data via Bluetooth to a
phone or tablet and on to the cloud for a doctor or caregiver.
The patient-as-a-battery idea sounds simple enough, and
the company likens the process to a child's science-fair experiment, but this
one garnered more than 350 patents and received more than $400 million in
funding from some of the biggest names in health care, including Novartis,
Medtronic, Kaiser Permanente at a unicorn valuation.
"What's the most common thing that somebody who is
sick is supposed to do every day? Swallow their medicine," Proteus CEO
Andrew Thompson told CNBC.
The only problem is, they don't.
According to the World Health Organization, about half of
all patients with chronic illnesses, such as cardiovascular disease or high
blood pressure, fail to take their medications as prescribed. By some
estimates, such nonadherence in the U.S. can add up to 10 percent of
hospitalizations in older adults, costing the health-care system $100 billion
to $300 billion.
"If you give people, for example, five medications
to take a day and you say take this in the morning, take this at lunch time,
take this in the evening, that's very complicated," Thompson said.
"So what we're showing is the beginning of a solution … to one of the
single biggest problems in all of health care, which is to help you take your
medicines appropriately."
In the latest of Proteus' 67 clinical trials, preliminary
results demonstrated that patients suffering from uncontrolled high blood
pressure who were prescribed the digital pill had "dramatically lower
blood pressure … with about 85 percent of patients at four weeks in the Proteus
groups achieving their goal, versus about 33 percent in the usual care
group," Savage said.
Noting the differences between tech and health care,
Thompson said the company isn't looking to expand its services too quickly,
only starting its first use outside of a clinical setting this January with
hundreds of patients and their doctors at South Lake Tahoe, California–based
health system Barton Health, before looking into licensing the technology to
big pharma companies.
While the implications have many in the medical field
excited at possibilities, questions surrounding the technology have shifted from
"will this work?" to "how will this be used?"
"If I'm taking pills to control my hypertension,
that's one thing, but if I'm taking pills to control my drug addiction, who
gets to see that and who knows about it is a very different thing," New
York University bioethicist Arthur Caplan told CNBC. "I think there are
vulnerable groups out there for whom this technology might not be seen as the
world's biggest gift."
Thompson said the company had initially explored
alternative use cases such as monitoring antibiotic adherence in tuberculosis
patients to prevent the rise of antibiotic resistance, or parents working to
help children with mental-health issues, but wanted to make clear Proteus'
mission is "the empowerment and the enablement of our patients to get
well."
The FDA recently rejected Proteus' first attempt to place
its digital sensor directly into its first medication, Abilify, a drug commonly
prescribed for schizophrenics. The agency requested more data and testing to
evaluate use-related risks.
Yet as cutting edge as the idea of swallowing a computer
seems, at the heart of the issue is a problem as old as the Hippocratic Oath.
As the ancient Greek physician Hippocrates notes in On Decorum, "Keep a
watch … on the faults of the patients, which often make them lie about the
taking of things prescribed. For through not taking disagreeable drinks,
purgative or other, they sometimes die."
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