• Pharmaceuticals
  • Kenya introduces an ePharmacy app

    MyDawa is an eHealth platform that allows consumers to purchase medications and other health and wellness products via a mobile application.  The platform was launched to the Kenyan market in March 2017 and has already attracted more than 30 000 registered users. 

    After downloading the app from the Play Store or App Store, registered users can simply search medications they require, upload a medial prescription if necessary, add to their cart and proceed to payment.  Once the order is completed, medications and products purchased will be delivered to the consumer at their convenience. Purchases that require a prescription are verified by a pharmacist before dispensing to the consumer’s mobile cart. 

    The MyDawa solution allows customers to gain the advantage of having increased transparency, convenience and affordability.  Products sold on the MyDawa app are 40% below the market price, and even 3rd party products are sold 20% cheaper than usual.  The app’s popularity in Kenya is driven by rising healthcare costs and value conscious consumers.  Payment on the app is made simple and allows consumers to pay via M-Pesa.

    This a great example in Africa that emphasizes the need for healthcare vendors to continue to embrace disruption in the industry, to become more efficient, to lower costs, increase accessibility to healthcare and provide patient-centric care.

  • 3D printing makes a breakthrough in personalised healthcare

    3D printing may open up a whole new chapter of opportunities in the pharmaceutical industry.  There are a number of ways it could be used; drug dosage forms, supporting delivery, or helping to research cures.

    3D printing, also called stereolithography, creates objects by fusing different materials, layer by layer, to form a physical version of a digital 3D image. In the last 15 years, 3D printing has expanded into the healthcare industry, where it’s used to create custom prosthetics and dental implants. 

    Now, there may be an opportunity to use it for personalised healthcare as well.  This was achieved by Aprecia Pharmaceuticals who became the first pharmaceutical company to produce an FDA approved 3D printed pill for epilepsy in 2015.   The drug is made using their proprietary ZipDose Technology platform to produce a high-dose of leviteracetam in a rapidly disintegrating, easy-to-swallow form. 

    Personalised 3D-printed medications, deploying customised dosages, may serve particularly well for patients who respond to the same drugs in different ways.  It may also allow pills to be printed in a complex construct of layers, using a combination of drugs to treat multiple conditions at once.  This could help reduce adverse drug reactions and poor adherence to medications for patients on multiple medications. For Africa, this could be a solution for adherence to ARV and TB medication, especially amongst children and the elderly.

  • Virtual reality better than pain killers?

    So we’ve heard how virtual reality(VR) can enhance our social lives. Now we’re going to discuss the medical benefits of the technology. Particularly in pain management.  VR has is being studied for its potential to ease pain by serving as a distracting force during medical procedures like wound care sessions for burn victims. Already, studies and papers on the subject have provided evidence that VR can lessen the sensation of pain, both chronic and acute. 

    While VR is a promising, drug-free option for pain treatment, existing VR systems are expensive and use unconvincing graphics. However, recent advances can allow the development of more realistic and more cost-effective applications. These include;

    improved realismimmersion using 360-degree 3D technologymore affordable delivery systems

    Applied VR, a company in Los Angeles, is already capitalising on these advances. The company is working with hospitals and doctors to get patients using the technology on Samsung’s Gear VR headset and to study its effectiveness as well.   So far, the company has created three different virtual-reality pain applications, as well as one for reducing anxiety.

    Not so far in the future, your doctor might prescribe VR sessions to ease aches and pains, rather than popping a pill.  The greatest challenge it faces right now is finding software developers who want to make applications that target specific medical problems.  Perhaps this is an opportunity for African start-ups looking to innovate in the eHealth space this year.

  • eHealth could avoid and improve prescribed drugs

    As a concept, eHealth that can improve people’s health as much as a drug can, but without the same cost and side-effects, is good. Andreessen Horowitz, a venture firm, says it’ll work. It predicts digital drugs, will become medicine’s third phase, the successor to chemical and protein drugs we have now, but without the cost of bringing them to market. In the US, digital therapeutics don’t usually need Food and Drug Administration (FDA) approval, especially where they promote low-risk lifestyle or dietary changes.

    It’s part of eTherapies, or digital therapeutics. There are two types, medication augmentation and medication replacement. The report says several peer-reviewed studies show that the outcomes are better than drugs alone. About a dozen start-ups are working on it. The apps are different from wellness apps, such as activity monitors, smart scales and sleep trackers. However, eTherapies can include tracking sensors, coaching material and cognitive behavioural therapy.

    A distinguishing feature’s that eTherapies have big ambitions. An example’s Virta Health, based in San Francisco. It aims to reverse diabetes without drugs or surgery using online coaching to encourage people to adhere to a special diet high in fats and low on carbohydrates. Research in 2011 found that “Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone.”  It took about eight weeks.

    Propeller Health works with GlaxoSmithKline (GSK) to combine GSK’s asthma medications with sensors that patients attach to their inhalers to monitor when they’re used. Patients using the app’s feedback use the medication less often. 

    For Africa, these nascent initiatives are worth watching. It’s too early for the continents health systems to include them in their eHealth plans. As soon as they’re up to scale, Africa can take them.

  • mHealth improves access to essential medicines in Nigeria

    Tracking and stocking essential medication are challenges for many African countries. People living in rural areas often don’t have access to primary health care facilities, and even if they do, facilities frequently run out of essential medicines. To address this problem, Kaduna State Ministry of Health, the third most populous region in Nigeria, Vodacom and Novartis have implemented SMS for Life 2.0, an mHealth programme.

    SMS for Life 2.0 isn't a new concept. It builds on the SMS for Life programme launched by Novartis in 2009, which used cell phones to manage stock-outs of malaria medicines in more than 10,000 healthcare facilities across sub-Saharan countries says an article in eHealthNews.

    Pharmi web has the Novartis press release. It says SMS for Life 2.0 uses smartphones and tablet computers to improve access to medicines and increase disease surveillance, helping to provide better care for patients. It also builds on its success and introduced eLearning for local health workers.

    SMS for Life 2.0 allows healthcare workers to track stock levels for  HIV, TB and leprosy treatments, and antimalarial vaccinations. It also allows them to send notifications to district medical officers when stock levels are low, ensuring adequate and timely supplies of all essential medicines.

    SMS for Life 2.0 will also:

    Monitor disease surveillance parameters of maternal and infants deaths, malaria, yellow fever and choleraImprove stock visibility which will improve supply chain management, by allowing authorities to improve demand forecasts for the treatmentsFacilitate health workers’ training in local facilities using eLearning modulesImprove healthcare by better access to essential medicines so reducing disease prevalence in communities

    Zambia’s Ministry of Health has recently signed a Memorandum of Understanding (MOU) with Novartis to roll out SMS for Life 2.0 to some 2,000 health facilities. It’ll start in 2017.

  • India to register online pharmacies

    Online pharmacies in India could soon be registering on a portal. A report in India’s Economic Times says India’s Drug Consultative Committee (DCC) has recommended the Central Drugs Standard Control Organization (CDSO). It’ll regulate online medicine sales and online pharmacies. The proposed national portal’s a nodal platform to monitor sale of drugs across the internet. Online pharmacies will need to mandatorily display the portal link on their homepage for authenticity verification by patients or consumers.

    The committee, which submitted its report to the central drug regulator recently, stated that only e-prescriptions or electronically generated and digitally signed prescriptions should be considered by online pharmacies to check misuse.

    A significant share of the responsibility for the sale of medicines through online pharmacies will now be on doctors. As per the committee report, doctors will have to create electronic prescriptions or paper prescriptions that can be scanned and uploaded to cloud by the doctor or patient through the intermediary link. These prescriptions may be linked with the Aadhaar card.

    The prescriptions will have a unique identification number, name of the patient, phone number of the patient, name and dosage of the medicine, compounding and drug formularies and information on how many refills can be allowed.

    As part of the broad framework, the committee has outlined that "all e-pharmacies that plan to sell, offer or exhibit for sale of medicines over the internet will need to be registered with Central Drugs Standard Control Organisation (CDSCO) under the Drugs and Cosmetics Rules, 1945." It added: "No unregistered entity shall be permitted to undertake online sale of medicines." The fee for registration of an online pharmacy has been fixed at Rs 1 lakh.

    Besides, it said online sale of drugs may be permitted only on e-prescriptions that are in compliance with the provisions of the I-T Act, 2000, and other rules under the said Act. Electronic prescriptions, the report added, are medical prescriptions generated via the electronic mode, gadgets, devices that are verifiable, printed and transmitted. The authenticity of the prescription will be crucial.

  • Eight technologies are changing healthcare

    There’s no denying that healthcare has undergone dramatic changes in the last ten years. New technology and innovations available to patients enables them monitor and take responsibility for their own health, and improved devices and tools available to doctors and other health professionals can make more informed decisions. Healthcare technology keeps moving along. An article in The Guardian looked at the top eight technologies that’ll keep transforming healthcare. For Africa, the balance and pace of investment in the eight technologies will be different to developed countries.

    The smartphone

    Although not new, it’s clear that the smartphone’s healthcare potential’s yet to be realised. Smartphones can serve as the hub for new diagnostic and treatment technologies. We’ve seen apps developed to support a wide range of healthcare activities, such as healthier life-styles, diabetic patients, treatment adherence and depression. Patients can also use tools like the AliveCOR ECG, embedded in a smartphone case, which helps interpret heart test results via an app and facilitates sharing with clinicians. They’re also ideal for gathering large amounts of data to improve understanding of diseases in populations.

    At-home or portable diagnostics

    Clinicians can now bring hospital-level diagnostics devices to patients’ homes, such as portable x-ray machines, blood-testing kits and other technologies.

    Implantable drug-delivery

    Drug adherence is a big problem, especially for patients with long term conditions. It’s estimated that between a third and a half of all medication prescribed to people with long-term conditions isn’t taken as recommended. Several technologies are already under development to address the problem. There’s sensor technology so small it can be swallowed and combined with drugs in smart pill form. When the pill dissolves in the stomach, the sensor’s activated and transmits data through a wearable patch to a smartphone app. Patients and clinicians can see how well they are adhering to their prescription, though it raises important questions about patients’ privacy and autonomy.

    Digital therapy

    Digital therapeutics are health or social care interventions delivered using a smartphone or a laptop. They embed clinical practice and therapy into a digital form to provide computerised cognitive behavioural therapy (CBT)

    Genome sequencing

    Advances in genome sequencing and the associated field of genomics will give doctors a better understanding of how diseases affect different individuals and populations. These genetic profiles of people’s diseases and knowledge of their response to treatment, it should be possible to predict their response to treatment and prognosis more reliably.

    Artificial intelligence

    Machine learning is a type of artificial intelligence that enables computers to learn without being explicitly programmed, meaning they can teach themselves to change when exposed to new data. Enlitic, IBM’s Watson division and Google’s Deep Mind have started to explore potential applications in healthcare.

    Blockchains

    Blockchains are decentralised databases that keep records of how data’s created and changed over time. They’re trusted as authoritative records without a single, central authority guaranteeing accuracy and security. Electronic health records are widely used, but they are usually centralised, provided by a small number of suppliers. Some commentators have described how records using blockchain technology would bring benefits like resilience and encourage interoperability, with patients and clinicians given encryption keys to control who sees the data.

    Online communities

    Social networks bring together people with interests in healthcare to support each other, share learning and provide platforms for tracking health data, helping people manage their condition and contributing to research. 

    New technologies bring new opportunities for Africa’s health systems. They can help to improve the accuracy, reliability, availability and add value of information gathered, change how and where care’s delivered and offer new ways to prevent, predict, detect and treat illness. The numerous choices makes rigorous strategies, plans and investment decisions challenging, but essential.

  • Diabetic patients have fewer ADEs with ePrescribing

    A study reported in the Journal of the American Medical Informatics Association found that ambulatory diabetic patients had fewer Adverse Drug Events (ADE) when their physicians used ePrescribing. It also results in fewer hospital or ED visits for hypoglycaemia. The gains are mainly attributed to the impact of ePrescribing from sending accurate and legible prescriptions to pharmacies as  decision support and drug interaction alerts.

    There are a few caveats:

    The physicians treated fewer patients from disadvantaged populations Patient’s characteristics, such as comorbidity and low income, affect ePrescribing’s impact on ADEs.

    African countries can use these findings as part of the business case for their ePrescribing initiatives. It sets a direct benefit they can match to other types of patients and other settings. The full range of functionality, such as sending ePrescriptions to local pharmacies, is likely to be more limited than the USA services. This doesn’t prevent African healthcare from matching the scale and cost of ePrescribing to its outcomes.

  • Are big pharmas good at apps?

    Big pharma may not be too good at apps. This is one of the results of the new report “Pharma App Market Benchmarking 2014” released in October 2014. A Mobile Health Economics, a Research2Guidance website, has a blog that says that most pharmaceutical companies  haven’t had  a significant impact on the mHealth app market. Some have published more than 100 apps using iOS and Android, but have generated limited downloads and use.

    The average number for a big pharma company is about 60 apps in Apple App Store and Google Play. It’s hugely above the average for a typical mHealth app publisher, which releases between one and two mHealth apps. The data’s in mHealth App Developer Economics 2014, a free report from Mobile Health Economics, and summarized by eHNA.

    Of twelve pharmas’ apps, three pharmas’ are performing above average. Most of this success seems to come from a small number of apps.

    The pharma app publishers are clustered into three groups:

    Niche players using apps to support their core products, so have a higher share of apps for healthcare professionals and which sometimes require doctor’s identification First Success, which have large app portfolios that have gained above average download numbers, mostly in private users’ mass market of private users Still Trying, which have apps which target large private user segments, but with low download numbers.

    Lessons from the survey are that these apps are:

    Not globally available Built around pharma’s core products, not around market demand Limited by no cross-referencing or common and recognizable design Too many different app publishing entities.

    If you’re considering app development as part of your engagement with patients, carers and communities, it’s worth applying the survey’s findings. They could help you reach you audience.

  • TelePharm helps pharmacists be in two places at once

    Iowa-based TelePharm uses cloud-based mobile apps to connect pharmacists to each other and to patients. It’s raised US$2.5 million to help scale its business.

    TelePharm has several different businesses that enable pharmacists to spread their expertise across multiple pharmacies. This allows local chains to reduce their overheads significantly. One branch under the TelePharm umbrella is TeleCheck. The platform allows remote verification of medications, an important and time-consuming job for pharmacist.

    “They have two different responsibilities: verifying it’s the right drug for that patient and basically making sure the patient will be safe with that drug, and making sure what the technician dispensed was the right drug,” TelePharm CEO Roby Miller said to MobiHealthNew. “What TeleCheck does, is it takes that workflow and puts it in the cloud. So a pharmacist has an image of the drug they’re dispensing, the label on the bottle, and the [prescription] as well. So they can compare those images and make sure the drug is the right prescription for that patient.”

    TeleCounsel is another TelePharm service. This actually allows pharmacists to interact virtually with patients directly.  It’s being used in hospitals which have pharmacists on their staff and supports pharmacists in providing discharge counselling for patients leaving the hospital. The counselling is informal, and talking with patients before they leave hospital leads to better medication adherence. Counselling is often difficult to facilitate because it needs pharmacists to be in many different places simultaneously. TeleCounsel allows pharmacists in one location to talk to many patients and even counsel them when they’re at home.

    TelePharm is relatively new. It was founded in August 2012. Its software is in eight small, regional pharmacy chains in three USA states: Iowa, Illinois, and Texas.

    Similar technology could be used in other parts of the world. It could be especially valuable in countries where there’s a shortage of healthcare professionals. Many African countries could benefit from this or similar technology.