While significant advances have been made in HIV treatment, experts say one of the obstacles still facing many HIV-positive patients is adherence to a daily regimen of medication.
That may soon change. A new smart pill bottle slated for clinical study at Weill Cornell Medical College this fall has the promise to significantly dismantle — perhaps even tear down — that health care barrier.
Weill Cornell and start-up biotech company AdhereTech have won a $100,000 grant from New York City Economic Development Corporation and the Bloomberg Administration to test whether AdhereTech's patented smart pill bottle improves drug adherence in HIV-positive patients. Weill Cornell and AdhereTech are one of 10 partnerships to win an inaugural PILOT Health Tech NYC grant.
"I think it's great," said Dr. Roy M. Gulick, chief of the Division of Infectious Disease and professor of medicine at Weill Cornell Medical College, who will co-lead the clinical trial. "It's a novel project that gives us direct access to a new start-up company with a really cool idea. Now we will see if this can really work and make a difference for our patients."
|Dr. Roy M. Gulick|
AdhereTech's patented high-tech bottle prototype, based on technology from the University of Alabama-Huntsville, contains sensors that measure how many pills were taken and at what time, and how many doses of the medication are left in the bottle. The data is wirelessly transmitted to the cloud, where patients have access to all their personal information. Automatic phone calls, texts, emails — as well as blinking lights and chimes on the bottle itself — notify patients if they took the wrong dose — or forgot to take it at all.
"Our product is designed for patients who have diseases that must be managed correctly — HIV, diabetes, cancer, transplants, hepatitis C, and the like," said AdhereTech CEO Josh Stein. "Now we have a chance to test our solution with Dr. Gulick and his team, which is such an incredible opportunity."
The 12-week randomized trial will follow 70 HIV-positive patients, currently receiving treatment at Weill Cornell, who are taking medication but have demonstrated sub-optimal adherence. While everyone will receive adherence counseling, half will also use the new AdhereTech bottle.
"Our hypothesis is that this AdhereTech bottle will significantly improve adherence," Dr. Gulick said.
From Idea to Prototype
As the son of both a doctor and occupational therapist, Stein, a recent graduate from the Wharton School of the University of Pennsylvania, had always been immersed in health care. In 2009, while brainstorming ideas for start-ups, his parents opened up his eyes to the problem of medication non-adherence: a shockingly large number of patients do not take their medication, and they simply remain sick.
"I thought, 'Wouldn't it be neat if we could put a little alarm clock device on the top of the cap of pill bottles, and it would beep when you should take your pills,'" he recalled.
He began researching what other technology was out there and discovered that all existing devices were flawed. They were inaccurate, hard to use and required significant behavior changes for the patient.
That's when he decided that there was a need for a better, more user-friendly device. He negotiated an exclusive license to a patent that was issued to the University of Alabama-Huntsville in 2011, developed a prototype, and recruited two engineers as cofounders. By the next year, the triumvirate completed a health incubator program and launched AdhereTech.
Matchmaking Health Care Industry with Biotech
With the New York City health care ecosystem bustling, city officials and leading health care organizations joined forces this year in launching the inaugural PILOT Health Tech NYC grant program. The intent was to spark partnerships between early-stage health care tech companies with key health care organizations in New York City and fund 10 innovative pilot projects that would address key issues in the health care industry.
AdhereTech had tossed its name into the hat and was looking for a partner.
Dr. Caren Heller, associate dean for intercampus and industry initiatives at Weill Cornell, had heard about the program and AdhereTech, and shared the idea with Dr. Gulick, she said.
"I thought it was a good thing for Weill Cornell to get involved in this novel and promising patient-oriented technology," she said. "I think that physicians can help make sure that information technology tools are really appropriately designed so that they are helpful to patients, physicians and the health care system."
After some initial meetings in March, Dr. Gulick and Stein both knew it would be a natural partnership. PILOT Health Tech agreed.
"It's a dream come true for us," Stein said. "It's the perfect trial for us. We could never have imagined working with Dr. Gulick, who's world-renowned. We were honored when he was willing to apply for this program with us. That, in it of itself, was an enormous victory."
"I think it's very exciting," Dr. Heller added. "It puts us on the forefront of this new kind of technology, and illustrates to people that we are dedicated to exploring new technology and partnerships."