Express Scripts and Propeller Health Bringing Smart Inhalers to Market


Does this represent an opportunity for pharmacists to use such devices to help monitor adherence in patients?

Previously, I wrote about smart inhalers and their expanding growth as possible new tools for clinical trials and to monitor patients' adherence to therapy. Riding on the coattails of the news that the first smart pill was approved by the FDA, Express Scripts has announced a partnership with Propeller Health.1

For those unfamiliar with smart inhalers or Propeller Health, essentially imagine a standard inhaler that has a built-in sensor that communicates via Bluetooth when it is used.2 These data can then be tracked to determine a patient's adherence to chronic therapy (eg, LABA/ICS) or use of breakthrough medications (eg, albuterol rescue inhalers). In Propeller Health's case, the sensor is designed to fit on top of the propellant used in most metered dose inhalers. The company also makes sensors for new Respimat formats and Diskus inhalers.

But, collecting data alone is meaningless without action, and that is the beauty of what role these products will play in helping managing patients therapy and adherence. Express Scripts sees a value proposition where it can intervene in low-adherence patients who may have worsening pulmonary disease and through appropriate intervention help increase adherence and, hopefully, maximize and improve therapy endpoints.

That is where pharmacists come into play. Express Scripts has a Pulmonary Therapeutic Resource Center dedicated to helping patients with low adherence and by teaming with Propeller Health will have access to more objective data to access adherence. Pilot data showed a reduction of 80% use in rescue events per day, which is quite meaningful in multiple ways.

Although current smart inhalers cannot determine if a patient is using a device appropriately, though some companies are looking to create such an inhaler, the fact that adherence can now be tracked is a useful tool for clinical practice. My concern with the use of these "digiceuticals" has been the alert fatigue that may affect practitioners who seek to use them in their daily practices. Seeing patients and getting alerts about what medications they are missing each day and then acting on that information could be overwhelming.

For that reason, I like that Express Scripts has a department dealing with such data and acting on it.

However, there is definitely an opportunity for pharmacists to use such devices and smart medications to help monitor adherence and intervene on behalf of patients. This may be an expanded role for pharmacists in the future and one that would not have been possible a decade ago.


1. Propeller Health and Express Scripts partnership offers innovative digital respiratory care to improve health for people with asthma or COPD [news release]. Madison, WI and St. Louis, MO: Propeller Health; November 16, 2017. Accessed November 20, 2017.

2. Propeller Health website. Accessed November 20, 2017.

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