Medical breakthrough or biological surveillance? In this November 14, 2017 National Post article (2.5 minute read) written by Caroline Chen, “Not taking your medication? These new digital pills will allow doctors to keep track of your adherence”, we learn of a new version of Otsuka Pharmaceutical’s Abilify drug which has a built-in sensor to allow doctors to monitor whether or not their patients are complying with their prescription. Abilify is used to treat depression, bipol…ar disorder and schizophrenia.
The New York Times ran a story (9.5 minute read) by Pam Belluck, the day before, on November 13, 2017, “First Digital Pill Approved to Worries About Biomedical ‘Big Brother’”.
Both Chen and Belluck, among other health and science writers, include intel gathering and ethical considerations. Lucia Savage, chief privacy and regulatory officer with Omada Health Inc. states, “It creates a looking-over-your-shoulder effect. Patients who are prescribed the product, called Abilify MyCite, have to agree that their physicians can see the data. They can also choose whether or not to share information with caregivers, such as family members. Otsuka Pharmaceutical and certain insurers also plan to gather anonymized, aggregated data from patients who consent.”
Dr. Peter Kramer, a psychiatrist and the author of “Listening to Prozac,” raised concerns about “packaging a medication with a tattletale.” While ethical for “a fully competent patient who wants to lash him or herself to the mast,” he said, “‘digital drug’ sounds like a potentially coercive tool.”
At the moment, taking this digital pill is voluntary but it raises questions like, aside from monitoring compliance, what other intentions are behind the gathering of the “anonymized, aggregated data”? There is no indication of what it includes. How does the sensor’s signal interfere with the human body’s natural electrical currents? If the pills are not taken, what are the consequences for the patient and how are they handled? Are patients with severe mental illness like bipolar disorder or schizophrenia in a position to provide legal consent to have their doctors, drug companies and insurers monitor their compliance? This could be the beginning of a trend by drug companies and researchers to produce a broad and rapid use of trackable medicines for behaviour modification.