Boehringer Ingelheim partnered with HealthPrize to deliver a platform that uses gamification, patient education, and tracking mechanics to help patients adherence with inhaler adherence, in a recent pilot study.
Mount Sinai Health System has been using Wellth to reward patients for their medication adherence. Monetary rewards play well in the behavioral economics model of using digital health to change habits. Often these days, digital health has been said to be a behavioral science—though I am not too sure—but I do believe it plays a significant role.
Riding along this example, another company in digital health news is HealthPrize.1 Now, HealthPrize has been around for some time, and they have grown immensely as a platform to engage patients. Using gamification, education, and rewards to encourage patient participation, HealthPrize offers a solution that can address issues ranging from medication adherence to survey and lifestyle tracking.
Who would want to use them? Well, payors see value as a means to encourage adherence to lifestyle modification, and adherence to therapy they are covering, pharma for use in clinical trials, and even some pharmacy organizations. Walgreens, for instance, uses the HealthPrize medication adherence platform to motivate patients to take their medications on a daily basis.2 This includes having patients record when they take their drugs, but also condition-related quizzes, health information, and quizzes to keep them engaged. It's no surprise pharmacy companies are concerned about adherence. After all, if they don't refill them on time, it means lost profits, when a significant part of the business is based on drug dispensing sales.
But it doesn't stop there. Pharma is interested, and recently it was announced that HealthPrize, and Boehringer Ingelheim are expanding a program that they have been working on.3 In this case, the platform RespiPoints is focused on increasing adherence to inhaler utilization in patients with COPD and asthma.4 The platform is geared towards BI new players, such as Stiolto and Spiriva Respimat, and their handihaler formulation. This initiative is based off a 9-month trial of the platform in 2016, where BI saw an 85% decrease in gap days between filling medications. That's a sizable increase in adherence (at least based on medication possession ratios). The platform rewarded patients with points, which can then be exchanged for e-gift cards. Patients got disease information material, quizzes, and surveys alongside tracking their adherence to therapy.
Jean-Michel Boers, president Human Pharma Boehringer Ingelheim Pharamceuticals, Inc., said, "We strongly support the role of innovative health technology solutions in respiratory treatment plans to help improve healthcare outcomes... We partnered with HealthPrize to adapt their interactive patient solution, and we are very pleased with the impact of RespiPoints, which has made a positive difference in patients’ adherence to daily treatment plans and their understanding of the disease.”
The results of the pilot are interesting. In addition to the increased possession of medications, participants spent 50 minutes a month on the platform over the course of about 5 visits to the website. Well, more than half of the participants would recommend the platform to friends or family, and remained active in the platform themselves for the 9-month pilot.
Tom Kottler, co-founder and CEO of Healthprize said, “The results from the RespiPoints program confirm the value of the HealthPrize platform to enroll, and engage people who may need additional support to better understand and manage their health... Understanding the multiple challenges of non-adherence, an engagement program that gets patients to take specific actions, such as refilling their medication after a long gap, can help people increase their adherence, follow their healthcare provider’s treatment plan, and improve their health.”
But here are some of my thoughts: HealthPrize is an excellent piece of technology to help individual patients with adherence. As noted in the study, only 56% of users were still active at the end of the pilot. We already know no program or platform is 100% at keeping those enrolled engaged. At the end of the day, this is a program to get users to get their medications. It doesn't objectively tell us if the patients take their medications as prescribed, or if it leads to fewer medical events, or if they are adherent. For some companies, that may not be a factor—Pharmacy companies, and Pharma bottom lines are based off sales, while payors would be more circumspect, I imagine, regarding wanting to know actual adherence to therapy and reduction of events that drive up their costs.
That brings me back to some of my considerations of adherence, that there are companies focused on tracking adherence, and promoting adherence. HealthPrize is a company actively designed for promotion, with some data tracking. They do remind patients to refill their medications, can record self-reported adherence, which factor in the tracking aspect. But, for some patients, a platform like HealthPrize is what they need to help enforce health habits, namely taking their medication, and understanding its purpose. I often think these types of programs should be started while a patient is in the clinic or in the hospital, and can be used earlier in interventions for patients that we can identify as possibly benefiting from its use. Hopefully, we'll see future data that can steer us one way or another on which patients to target this digital intervention.