Medthings AS – a break-through innovation with the handling of medication

Master’s in Applied and Commercial Biotechnology. Inland Norway University of Applied Sciences, Faculty of Applied Ecology, Agriculture Sciences and Biotechnology.Patients depend on medicines to maintain health, prevent illness, manage chronic ailments and treat/improve disease conditions. However, there are growing reports indicating the misuse of medicines (not taken on time, skipped dosage, irregular or improper dosage) causing a great deal of challenge to the health sector. The major challenge lies with the elderly people (above 75 years) who often tends to forget their medications or are not adhered to it. At present, changing demography with a high number of elderly people and providing them quality health services is the biggest challenge. People aged 80 years or over use an average of 5.8 prescription drugs per person. The global spending on medicine reached 1.2 trillion U.S. dollars in 2018 and is set to exceed 1.5 trillion dollars by 2023, while the global automatic pill dispenser machine market accounted for 1,755 million dollars in 2016 and is estimated to reach 3,023 million dollars by 2023. Studies suggests that 25% of the emergency rooms are alone filled with patients taking wrong medications making it the cause of majority of the deaths and involving an expenditure of $10.30 billion annually. Several losses of life can be avoided if intake of medicine can be controlled. In addition, there is a huge medicine wastage due to unused/expired or skipped dosage. In 2019, Swedish pharmacies collected over 1,300 tonnes of medicinal residues (Wallêr, 2019), affecting the economy and well and the nature. Medicine management plays a very vital role in order to ensure the correct intake of medicine. Several approaches, from nurses to automated robots have been sought to ensure the correct use of medicines but none of them have been able to turn out completely effective. The variety of automated pill dispensers in the market with multiple functionality and features lack one thing or the other. Although every dispenser is produced with the aim of dispensing the correct medicine at the correct time with accurate dose, it fails to ensure whether the medicine is actually taken or just thrown away. This thesis was written with a purpose to investigate the specific needs for medicine management using Mobili 1) and to suggest a market entry strategy for it in the Swedish market. Several articles and literature reviews were considered to gather background knowledge on this issue and some primary data were collected through personal communications with 10 concerned persons. Furthermore, business analysis tools were also used to study the market and the target customers and to know about the competitors. Overall, an image that despite a hefty number of pill dispensers in the market, the exact number of them used at present and their comparison based on the price was not clear. An important finding was that although not quite great, but still there is possibility of entrance and success for Mobili with the target group of people above 75 years with chronic ailment and multi drugs prescriptions, or young age group with daily supplement intake having a busy schedule requiring reminder. Although there was a conflict of thoughts on the benefits and trustworthiness of the pill dispensers, yet the literature suggested that the elderlies are quite familiar with the technology and the health professionals also praise such automated pill dispensers. 1) An innovative and modern pill dispenser system produced by Medthings AS, Norwa

A framework for development of android mobile electronic prescription transfer applications in compliance with security requirements mandated by the Australian healthcare industry

This thesis investigates mobile electronic transfer of prescription (ETP) in compliance with the security requirements mandated by the Australian healthcare industry and proposes a framework for the development of an Android mobile electronic prescription transfer application. Furthermore, and based upon the findings and knowledge from constructing this framework, another framework is also derived for assessing Android mobile ETP applications for their security compliance. The centralised exchange model-based ETP solution currently used in the Australian healthcare industry is an expensive solution for on-going use. With challenges such as an aging population and the rising burden of chronic disease, the cost of the current ETP solution’s operational infrastructure is certain to rise in the future. In an environment where it is increasingly beneficial for patients to engage in and manage their own information and subsequent care, this current solution fails to offer the patient direct access to their electronic prescription information. The current system also fails to incorporate certain features that would dramatically improve the quality of the patient’s care and safety, i.e. alerts for the patient’s drug allergies, harmful dosage and script expiration. Over a decade old, the current ETP solution was essentially designed and built to meet legislation and regulatory requirements, with change-averting its highest priority. With little, if any, provision for future growth and innovation, it was not designed to cater to the needs of the ETP process. This research identifies the gap within the current ETP implementation (i.e. dependency on infrastructure, significant on-going cost and limited availability of the patient’s medication history) and proposes a framework for building a secure mobile ETP solution on the Android mobile operating system platform which will address the identified gap. The literature review part of this thesis examined the significance of ETP for the nation’s larger initiative to provide an improved and better maintainable healthcare system. The literature review also revealed the stance of each jurisdiction, from legislative and regulatory perspectives, in transitioning to the use of a fully electronic ETP solution. It identified the regulatory mandates of each jurisdiction for ETP as well as the security standards by which the current ETP implementation is iii governed so as to conform to those regulatory mandates. The literature review part of the thesis essentially identified and established how the Australian healthcare industry’s various prescription-related legislations and regulations are constructed, and the complexity of this construction for eTP. The jurisdictional regulatory mandates identified in the literature review translate into a set of security requirements. These requirements establish the basis of the guiding framework for the development of a security-compliant Android mobile ETP application. A number of experimentations were conducted focusing on the native security features of the Android operating system, as well as wireless communication technologies such as NFC and Bluetooth, in order to propose an alternative mobile ETP solution with security assurance comparable to the current ETP implementation. The employment of a proof-of-concept prototype such as this alongside / coupled with a series of iterative experimentations strengthens the validity and practicality of the proposed framework. The first experiment successfully proved that the Android operating system has sufficient encryption capabilities, in compliance with the security mandates, to secure the electronic prescription information from the data at rest perspective. The second experiment indicated that the use of NFC technology to implement the alternative transfer mechanism for exchanging electronic prescription information between ETP participating devices is not practical. The next iteration of the experimentation using Bluetooth technology proved that it can be utilised as an alternative electronic prescription transfer mechanism to the current approach using the Internet. These experiment outcomes concluded the partial but sufficient proofof- concept prototype for this research. Extensive document analysis and iterative experimentations showed that the framework constructed by this research can guide the development of an alternative mobile ETP solution with both comparable security assurance to and better access to the patient’s medication history than the current solution. This alternative solution would present no operational dependence upon infrastructure and its associated, ongoing cost to the nation’s healthcare expenditure. In addition, use of this mobile ETP alternative has the potential to change the public’s perception (i.e. acceptance from regulatory and security perspectives) of mobile healthcare solutions, thereby paving the way for further innovation and future enhancements in eHealth

Dispensador automático de medicação inovador e orientado para o futuro para adultos sénior

The population is getting older due to higher life expectancy and lower birth rates. Medication is becoming a bigger part of older adults’ lives. However, as all people do, it is easy to forget to take medication. This forgetfulness can bring a lot of consequences, specially in older adults. This is because of their more fragile health and the complexities in their medication, resulting in lower quality of life and higher number of hospital visits. Non adherence to medication is cause by 3 main factors: patient factors, medication factors and health care providers factors. These intertwine adding to the complexity of the problem, however they can be fixed. Technological solutions were developed along the years, some academically and some are available in the current market. Nevertheless, as all solution, there is always room for improvement. This document sets out to collect the needs of older adults regarding their medication and review current developed systems, in order to idealize an innovative system capable of meeting the needs of older adults while improving current systems. This took a systematic approach, mixing adequate product development methodologies, linear and more traditional, State-Gate, and cyclical and more innovative, Lean. This resulted in a idealization of a future proof system that tries to tackle the non adherence problem as whole. From this idealization it was possible to develop and build a prototype that demonstrates its main functionalities.A população está a envelhecer devido a um acréscimo na esperança de vida e a um decréscimo nas taxas de natalidade. Assim, a medicação está a tornar-se uma parte cada vez mais prevalente em adultos sénior. No entanto, como acontece com a população em geral, é fácil esquecer-se de tomar a medicação. Este esquecimento pode trazer muitas consequências, especialmente em adultos sénior. Isso se deve à sua saúde fragilizada e às complexidades inerente à sua medicação, resultando numa menor qualidade de vida e um maior número de visitas hospitalares. A não adesão à terapêutica é o resultado de 3 fatores principais: fatores do paciente, fatores da medicação e fatores dos prestadores de cuidados de saúde. Estes entrelaçam-se adicionando à complexidade do problema, porém podem ser corrigidos. Soluções tecnológicas foram desenvolvidas ao longo dos anos, algumas academicamente e outras estão disponíveis no mercado atual. No entanto, como todas as soluções, há sempre margem para melhorias. Este documento recolhe as necessidades dos adultos sérnio, em relação à sua medicação, e revê os sistemas desenvolvidos até ao momento,com o objetivo de idealizar um sistema inovador capaz de reponder às necessidades dos adultos sénior, construindo sobre os sistemas atuais. Para isso tomou-se uma abordagem sistemática, adaptando metodologias adequadas de desenvolvimento de produto, lineares e mais tradicionais, State-Gate, e cíclicas e mais inovadoras, Lean. Isto resultou na idealização de um sistema orientado para o futuro que tenta abordar o problema da não adesão à terapêutica como um todo. A partir desta idealização foi possível desenvolver e construir um protótipo que demonstrasse suas principais funcionalidadesMestrado em Engenharia Mecânic

Entry and Competition in the Pharmaceutical Market following Patent Expiry

This dissertation encompasses three essays on entry and competition in the German generic drug market. The first paper examines the market entry decisions of generic companies and finds that original drug producrs do not create barriers to entry by launching a generic version of the brand drug prior to patent expiry. The second paper examines generic market share dynamics and patients‘ switching behaviors among generic drugs. The analysis shows that generic market shares are little influenced by prices and highly persistent over time, conferring a substantial advantage to first generic entrants. Price differentials likewise have a negligible impact on the likelihood that patients switch to a generic drug offered by a different manufacturer. The third paper investigates generic price differentials and provides evidence of economies of scope and reputation effects

Entry and Competition in the Pharmaceutical Market following Patent Expiry

This dissertation encompasses three essays on entry and competition in the German generic drug market. The first paper examines the market entry decisions of generic companies and finds that original drug producrs do not create barriers to entry by launching a generic version of the brand drug prior to patent expiry. The second paper examines generic market share dynamics and patients‘ switching behaviors among generic drugs. The analysis shows that generic market shares are little influenced by prices and highly persistent over time, conferring a substantial advantage to first generic entrants. Price differentials likewise have a negligible impact on the likelihood that patients switch to a generic drug offered by a different manufacturer. The third paper investigates generic price differentials and provides evidence of economies of scope and reputation effects.Generic Entry; Generic Market Share Dynamics; Patient Switching Behavior; Generic Price Dispersion

The safe administration of medication within the electromagnetic scenarios of the Internet of Things (IoT): looking towards the future

This paper has focused on analyzing the impact of Information and Communication Technologies (ICTs) to prevent or reduce errors during therapeutic drug administration. The methodology used has included scientific literature and marketed appliances reviews and laboratory tests on radiant devices. The role of the patient has been analyzed, both in terms of compliance with the prescribed treatments and user of technical solutions designed for administering medication. In addition, it has taken into account, how a future characterized by multiple technologies designed to support our daily routines, including health care, might affect the current model of relationship between health professionals and patients. Particular attention has been given to safety risks of ICTs in environments characterized by concurrent electromagnetic emissions operating at different frequencies. Implications and new scenarios from Internet of Things or IoT, have been considered, in light of the approach taken jointly by the European Commission and the European Technology Platform on Intelligent Systems Integration – EPoSS, in their 2008 report Internet of Things in 2020: a roadmap for the future, and how the concept has evolved since then.Chapter 1. Adverse drug events. Chapter 2. ICTs in everyday life and healthcare. Chapter 3. the challenge of electromagnetic safety. Chapter 4. ICTs in health care and in the prevention of medication errors: IoT. Chapter 5. A more effective and safer alternative approach. Chapter 6. Technological proposal 7. Conclusions.N

Medicines Reuse

This reprint examines the concept of medicines reuse, the idea that unused medication returned by one patient can be re-dispensed for use by another. Ten papers written by over 20 authors examine a range of issues related to medicines reuse including the circular economy of the pharmaceutical supply chain; the prevalence of unused medicines or medication waste within patients' homes; people's views about the causes of medication waste and the potential for medicines reuse; what might influence people to reuse medicines in the future; how sensing technologies might facilitate medicines reuse; and the effect of including sensing technologies on people's willingness to consider medicines reuse

Prescription packaging design for the impaired : a meta-analysis.

This thesis is a critical analyzation of the state of prescription drug packaging in the United States with respect to unresolved problems for users with visual, physical, and cognitive impairments. It begins with an anecdotal overview inspired by Deborah Adler’s journey of prescription drug packaging for her grandparents and her design solution outlined by a case study. This case study focuses on the need for better prescription packaging for those with the aforementioned and neglected issues. This thesis uses studies in user-centered design, packaging design, and industrial design among others in order to critically assess and question the current state of user experience for those with impairments. The latter part of the thesis argues that a universal standard would be difficult to implement due to logistical challenges of the private sector of pharmaceutical companies

Authorized Generic Entry prior to Patent Expiry: Reassessing Incentives for Independent Generic Entry

Patent holders frequently attempt to mitigate the loss of monopoly power by authorizing generic entry prior to patent expiry (early entry). Competition in off-patent pharmaceutical markets may be adversely affected if early entry substantially impairs the attractiveness of subsequent market entry. I examine generic entry decisions made in the course of recent patent expiries to quantify the impact of early entry on incentives for generic entry. Using unique micro data and accounting for the endogeneity of early entry, I estimate recursive bivariate probit models of entry. Drug markets' pre-entry revenues largely determine both independent generic entry and early entry decisions. Early entry in turn has no significant impact on the likelihood of generic entry. Original drug producers appear to authorize generic entry prior to loss of exclusivity primarily fueled by rent-seeking rather than strategic entry-deterrence motives

Authorized Generic Entry prior to Patent Expiry: Reassessing Incentives for Independent Generic Entry

Patent holders frequently attempt to mitigate the loss of monopoly power by authorizing generic entry prior to patent expiry (early entry). Competition in off-patent pharmaceutical markets may be adversely affected if early entry substantially impairs the attractiveness of subsequent market entry. I examine generic entry decisions made in the course of recent patent expiries to quantify the impact of early entry on incentives for generic entry. Using unique micro data and accounting for the endogeneity of early entry, I estimate recursive bivariate probit models of entry. Drug markets' pre-entry revenues largely determine both independent generic entry and early entry decisions. Early entry in turn has no significant impact on the likelihood of generic entry. Original drug producers appear to authorize generic entry prior to loss of exclusivity primarily fueled by rent-seeking rather than strategic entry-deterrence motives.Generic Entry; Early Entry; Anticompetitive Practices