As a new era of digital drug delivery is making headway, Dr Steven Wick, vice president, Product Development & Commercialisation, 3M Drug Delivery Systems, gives his thoughts on this digital future.
Across the drug delivery industry, there is currently a big movement toward digital enhancement of inhalation devices used by patients with asthma and COPD. With fewer step-change improvements in drug therapies, the pharmaceutical industry is now focusing its attention on drug delivery technologies as a means to improve compliance and therefore patient outcomes. The concept of digital health will allow us to properly equip patients to manage their condition and ultimately take control of their health.
A patient-centred model
A focal point of my career in pharmaceutical research and product development has been to drive innovation with a priority placed on improving patient outcomes. The technological advances that have made digital health possible are changing the landscape of device design to a more patient-centric model. Traditionally, drug delivery methods were designed without much consideration for the patient experience. Now, product developers and engineers are considering the challenges facing patients first. They use these insights to improve drug delivery device design, and by addressing patient challenges directly, they improve patient outcomes in the process.
A 2008 research report showed that up to 94% of patients make mistakes when using their inhalers, and these were the dry powder inhalers that were intended to be easier to use. None of the current devices are perfect, with up to 76% of patients struggling to use metered dose inhalers as well. Also, patients struggle to adhere to their medication schedule. When patients forget to dose themselves or inadvertently use their inhalation devices incorrectly, it doesn’t matter how great the drug is — it will be less effective.
Digital health is helping to solve these usability and adherence issues. For example, the 3M Intelligent Control Inhaler (ICI) is breath-actuated so that patients do not have to coordinate their in-breath with triggering of the device, and actuation is triggered at a low flow-rate and at the optimal point within the patient’s inspiration cycle, so that even patients with a severe condition and poor lung function can use the device.
Proprietary flow-sensing technology optimises the inhalation cycle and can detect whether a patient is inhaling the drug properly to ensure a full dose is received.
The device can connect to a smartphone or tablet for reminders and further instructions, and it can record data for sharing with a healthcare provider, to influence and inform healthcare decisions.
The focus of our efforts is to identify areas where drug delivery device technologies could add significant benefits to the patient and help manage costs for the provider and payer. In that vein, 3M has also developed a respiratory tracker to help patients identify and monitor triggers that result in breathing difficulty. The 3M Respiratory Tracker is not a drug delivery device but a consumer wearable designed to give the wearer a greater understanding of how their breathing patterns are related to environmental or weather-related considerations. It provides personalised forecasts tailored to an individual’s potential triggers in their local environment, while delivering dynamic tips and insights relating to breathing and activity.
Bringing the vision to life
One major factor that stands in the way of future advancements in the digital drug delivery space is cost. Billions of dollars per year are invested in digital health start-ups, and creative solutions are always on the horizon. However, these innovative inventions are struggling to move from the development lab to the pharmacy counter because we have yet to generate the pharmaco-economic models and the associated business cases required to create the necessity for these new digital drug delivery technologies.
To move forward, it is important for all parties involved: pharmaceutical companies, payers, providers, and patients, to understand how total healthcare costs will benefit from these new technologies. If a patient is receiving the right dose of medication at the right time on a consistent basis, one could surmise that the patient’s symptoms would be better managed and the patient would make fewer trips to the doctor’s office or emergency room. In the end, this will drive down overall patient costs and significantly reduce the financial burden on the healthcare system.
We must also consider the investment of time. For healthcare providers, helping patients is the ultimate goal. However, it’s typically the provider’s responsibility to teach his or her patient how to properly use the device, which means the provider must first be trained in how to use it. At 3M, we are sensitive to these factors and keep input from patients and providers at the forefront of all development stages. Our goal is a product that is as straightforward and beneficial as possible for both parties. Despite the bells and whistles that new technology allows, an inhalation device must be intuitive to use — plain and simple.
To stay aligned with this new era of drug delivery, organisations across the board have had to adapt. Here at 3M, we must now be more strategic in our R&D efforts than ever before. Because of the unique financial framework outlined above, we can no longer afford to innovate simply for the sake of innovation. Instead, we start by identifying a problem and then search for a feasible solution.
It is an exciting time to be involved in the drug delivery industry. I believe going digital will improve consistency in drug delivery, increase the efficacy of drug products, and reduce the opportunity for patient errors. I also believe it will offer providers and payers valuable new data to help them identify patients who need extra intervention, thus preventing a potentially catastrophic and costly event. Everything you can imagine doing, there is a possibility with digital health, which is why it will continue to be an unstoppable transition in the inhalation therapy for years to come.