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Making the Case for Smart Combination Drug Delivery Devices & Systems

Pretish Borde

Manager, Life Sciences Business Consulting, EPAM Continuum
Blog
  • Life Sciences

The arrival of home-based and wearable technology in the last decade has given patients greater control in how to manage their health at home. While COVID-19 forced the change in routine practices, most patients have begun to embrace remote care given the convenience and desire to manage risk of infection. Around the start of the 2020 pandemic, a mere 0.1% of Medicare primary care visits were conducted remotely via telehealth. By April that year, that percentage had dramatically increased more than 400 times to nearly half of all visits (43.5%).  

Is this trend here to stay? Can the healthcare industry embrace a simply more effective way of empowering patients to benefit from the same (or even enhanced) services as traditional clinical care? 

How Smart Combination Drug Delivery Devices & Systems Can Help

For this way of healthcare to continue, we need sophisticated smart combination delivery systems with the right technologies, standards and processes that must be developed, deployed and supported accordingly. Smart combination drug delivery devices and systems enable patient-friendly control of data and metadata collection without the need for patient interaction. This means a delivery device or biologic coupled to a drug source that transfers the drug onto or into the patient’s body for diagnostic or therapeutic purposes. Oral inhalers, eye drops, prefilled syringes for chronic drug delivery and pen injectors are examples of traditional patient-use combination devices.

Combination drug delivery has been shown to be more effective than conventional methods. For highly complex diseases that vary across individual cases like cancer, often one treatment solution does not fit all. A combination drug therapy that involves multiple complementary approaches to addressing a specific disease condition can provide a better treatment option. A recent example can illustrate its effectiveness:

Researchers from the Indian Institute of Technology Bombay explored a new method of smart combination drug delivery in which they targeted solid tumors using an ultrasound image guide, delivered the drug deep into the desired tissue and killed tumor cells using a naturally occurring lipid, simultaneously. With two spherical, ball-shaped objects stuck together, the larger “nanobubble” expands, contracts and eventually bursts, which helps loosen the tumor tissue for easier penetration of the drug carried in the smaller “nanocapsule.” The two components work together to treat cancer effectively, with the nanobubble enhancing the delivery of the drug in the nanocapsule. The results of this study showed that the smart combination drug delivery system along with the ultrasound was significantly more effective than any other sub-combination that omitted one or more constituent components.

Tackling the Challenges Needed for Effective Smart Combination Delivery Devices

While the on-paper benefits of greater convenience and lower cost provided by remote care for routine and repeated drug delivery is clear, widespread adoption from both patients and providers has been less than enthusiastic. This slow response in uptake is due to several factors including: 1) social inertia (institutional change takes time!), 2) a lack of reimbursement coverage needed to create economic incentives, 3) a lack of quality patient-use devices and 4) a degree of doubt by healthcare providers that patients can manage these routine tasks with accuracy and reliability. Along with providing better devices, healthcare providers must be able to confirm that their patients are demonstrating compliance (did they conduct the task?) and adherence (did they administer the task correctly, accurately and on schedule?).

The economic environment for the commercial development of combination therapies is without a doubt an overarching challenge. Drug development is funded primarily by the private sector; therefore, business considerations play a role here. The degree of efficacy must outweigh the increased cost and development complexity of a combination product. The good news is that the challenge of economic safety and risk is partly addressed — while the wearable arena has thus far been dominated primarily by watches, smaller and smaller devices (such as rings) are beginning to emerge and become more widely available. Continued use of this technology in the larger world population (along with enhanced maturity and continued development of wearables) will drive tech advancement to a lower cost point so that it may be used in smaller disease scenarios. Saliently, partnerships between companies (risk-sharing and profit-sharing business models), as well as between various sectors (academia, industry and government), can leverage resources and mitigate risk, which is why they have become more common. 

Medical devices (including combination drug devices) must meet a quality standard set by the Food and Drug Administration (FDA). Meeting this stringent standard allows medical device manufacturers to reduce costs and increase profits by focusing on quality measures during medical device design and production. This quality improvement approach pays dividends in patient satisfaction and provides significant competitive advantages. Increased product quality also benefits hospitals, payors, healthcare providers and patients by generating confidence that the devices they rely on will perform as intended. A big way to improve quality in patient-use devices is to refine the Instructions For Use (IFU) for those devices. Quality can also be given a significant boost by provisioning more extensive training to patients in how to use combination medical devices to ensure their familiarity with understanding the correct applications of a given device and the associated risks and risk mitigations.

One way that compliance and adherence can be ascertained is by using secure digital authentication. And the best way of accomplishing this is by partnering with an expert engineering and technology advisory firm to provide secure digital authentication to patients that are utilizing combination devices. Additionally, minimizing discomfort and anxiety in the patient through potential mechanisms like comforting audio or video media to accompany combination drug delivery can result in greater adherence to a prescribed regimen. Utilizing tailor-made mobile apps with audio and video content to remind patients to take medication has proven effective in increasing patient compliance and adherence.  This is again where that partnership with an engineering and technology advisory group that excels at building seamless mobile apps can be beneficial.

The drug delivery space continues to experience tremendous growth, with smart combination drug delivery proving to be more effective than conventional methods. The advancement of home-based technology alongside a pandemic-riddled era has encouraged telehealth remote visits. There is no better time for life sciences organizations to take advantage of the market demand for high-quality, secure, compliant and effective patient-controlled combination drug delivery devices and systems. With the help of a partner who understands MedTech and the underlying technologies, and can provide advisory and consulting services, organizations can act quickly to ensure the successful employment and adaption of these devices.

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