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New tech lets doctors deliver drugs virtually

What if doctors could deliver medicine virtually? New tech is making that a reality

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LAS VEGAS (Circa) - Thanks to major tech developments, health care is being put back in the hands of consumers.

In the last two years, the number of health apps available to consumers has nearly doubled, reaching 318,000, per IQVIA Institute research. Digital therapeutics – aka "software as drugs" – are the latest trend to shake up medicine and have the potential to disrupt not only how we receive treatment, but also how we pay for it.

"Software as drugs" refers to a fresh type of mobile tech, where apps and smart devices are being deployed to treat and diagnose conditions such as diabetes, asthma, heart disease and addiction. Of the hundreds of health apps available, 40 percent could be categorized as digital therapeutics, IQVIA Institute data shows.

Using personal tech to monitor your health goals is in vogue, and as such, 20 percent of American households now own wearable fitness trackers, Consumer Technology Association (CTA) data shows. Insiders at the Consumer Electronics Show (CES), which is put on by CTA, told Circa they are betting on this trend to only grow from here.

"We're really just at the beginning of a digital revolution that will make the use of wearables and other digital therapeutics commonplace," Will Shanley, communications director for United Healthcare, told Circa.

In fact, in the medical community, all eyes are on not if, but when "digital drugs" take off as the next wave of treatment. Because doctors delivering medicine digitally, right through your smartphone or smartwatch? Well, *that's* disruptive.

Digital drug delivery

The idea behind digital therapeutics is that software can be harnessed to improve both health and patient experience. And as the health care industry embraces emerging technologies, investors are keeping a finger on the pulse of the evolving trend.

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This is what the medical community believes "software as drugs" has the power to do. (Circa)

"Each year, we invest more than three billion dollars in data technology and innovation to help make the health system work better and to help people live healthier lives," Shanley said. In a recent collaboration, United Healthcare teamed up with Dexcom on a device that helps people with diabetes manage their condition.

Dexcom makes continuous blood glucose monitoring devices and participants receive it, along with an activity tracker and one-on-one diabetes coaching. What this does is allow people with diabetes to see how their diet and activity levels are impacting their condition, and then adjust their actions.

"It's about arming people with information in real-time [and enabling] them to make lifestyle choices that will positively impact their health, and ultimately help reduce the healthcare costs for our country," Shanley said.

"We are on the cusp of change where small censors, understanding how physiology works on a person, and moving health care from clinics to patients is the wave that's going to change the future."
Bakul Patel, U.S. Food and Drug Administration

Digital health apps could save the U.S. healthcare system an estimated $7 billion each year just among diabetes, asthma, cardiac and pulmonary rehabilitation patient populations, IQVIA Institute research shows. If digital health apps could eventually treat a broader set of patient groups, or all patient groups, IQVIA estimates the savings could reach $46 billion annually. At the same time, these tools could enhance and simplify data flow between patients and care providers, resulting in more accurate diagnoses and better treatment – without the side effects.

"We are on the cusp of change where small censors, understanding how physiology works on a person, and moving health care from a clinic to the patients themselves is the wave that's going to change the future," Bakul Patel, associate director for the Center for Devices and Radiological Health at the U.S. Food and Drug Administration (FDA), told Circa.

Like TSA Pre-Check, but for digital therapeutics

As health-conscious Americans turn to digital tools for help with their well-being, the medical community is taking note.

There are over 500 ongoing clinical trials for digital health tools, IQVIA estimates, as more companies leap into medical tech. There's medical device company Proteus, which has created the first digital, edible sensor in pill form. Health-tracking company Cardiogram is using machine learning to analyze Apple Watch data to determine when you'll be sick. And Google's health brand, Verily, developed software using artificial intelligence that it says can predict heart disease by scanning a patient's eyes.

Meanwhile, Omron Healthcare has been in the business of blood pressure for decades. Leveraging their extensive tech and knowledge, the company has now created a wearable blood pressure monitor.

"When you go to your doctor and he puts that cuff on your upper arm, and he inflates it, it's the same technology, we've just miniaturized it into the size of a watch," Jeffrey Ray, executive director of business and tech with Omron Healthcare, told Circa.

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Omron Healthcare miniaturized their blood pressure monitoring technology into a smartwatch. (Omron Healthcare)

Omron looks to develop AI and machine learning tools to help gather and sift through patient data, that can then be turned into immediate feedback for blood pressure patients. "So as you're trying to figure out how to make those behavior adjustments in your life, that we can give you recommendation," Ray said.

Currently, you don't need a prescription from your doctor to purchase Omron's product, though it varies from app to device. As for cost, insurance doesn't cover digital therapeutics, at least not yet, but these companies are working with insurers to see how this might change down the road.

"These are what we consider OTC, over-the-counter," Ray explained. "Currently, blood pressure monitors are not reimbursable through payers, so this is something if your physician says that you should be using it, that you would have to go out and purchase it on your own."

While certain studies have shown predictive analytics and software can improve patient care, there are still regulatory hurdles these apps and software will have to clear.

"Given all the work that's happening in this field, we need it to look at it a completely new way of … overseeing this type of products. Given that the speed is very different, the volume is very different," Patel said.

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The FDA's pilot pre-certification program, like TSA Pre-Check, would allow for faster approval of new digital therapeutics. (Circa)

To help address this challenge – that is, the rapid pace at which tech evolves – the FDA is piloting a software pre-certification program (think of it kind of like TSA Pre-Check) to fast-track the roll out of new medical software. The program launched last summer and takes "a more agile approach toward digital health technology that focuses on the software developer rather than an individual product." Some of the pilot participants include Apple, Fitbit, Johnson & Johnson, Verily, Pear Therapeutics and Tidepool.

"What we are trying to do with our programs and initiatives at FDA is how do we accelerate that in a way that's responsible," Patel explained. "Then we can then allow certain types of products made by these companies to go straight to market."

"Your smartphone can be an incredible catalyst for the delivery of healthcare therapeutics."
Joel Sangerman, Click Therapeutics

The key difference between existing wellness apps and digital therapeutics is that these newcomers are tailored to treat targeted diseases such as diabetes. Digital therapeutics brands are also conducting the equivalent of clinical trials to demonstrate that they actually work.

"Your smartphone can be an incredible catalyst for the delivery of healthcare therapeutics and healthcare programs," Joel Sangerman, chief commercial officer for Click Therapeutics, said. "It's really a juxtaposition of treatment modalities."

Click Therapeutics has nearly a half dozen applications in the pipeline designed to treat everything from depression, insomnia and substance abuse to an app that helps you quit smoking. And they recently partnered with Magellan Healthcare to bolster research and development of prescription digital therapeutics.

As Sangerman sees it, "The consumer can expect a lot more options and can expect to have a better chance at improving their outcomes or for optimizing their health."

See more related stories from Circa:
The world's first digital prescription pill has arrived. Here's what it can do.
These self-heating blankets are helping save preterm infants in resource-scarce regions
This executive says the biggest problem in health care is not knowing costs up front

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