Blockchain use cases in medication adherence

There are various powerful blockchain use cases in healthcare. In this article, lets look at one specific niche use case ie. Medication Non-Adherence. Let understand the problem in detail and check out the solution blockchain can offer.
What is Medication Non-Adherence?
Patients faithfully following to medication schedule as per the prescription is Medication Adherence. In case the patient does not follow or stick to the prescription schedule, it becomes a case of Medication Non-Adherence.
Why does Medication Non-Adherence occur?
There are a variety of reasons for this non-capacitance.

• Majority of patients medical non-compliance is due to forgetfulness( 63% ).
• The cost of the drugs/ medicines can de-motivate the patients to not renew the prescription ( 10.1% )
• The Regimen complexity counts for a wide reason as well ( 2.9% )
• Quite a number of people also mention side effects of the drugs as a reason for non-adherence ( 5.3% )
• and many doubt the drug itself or the need to take the medicine which leads to not sticking to it ( 4.8% )

Why is this such a big issue?
The healthcare industry as such is burdened by chronic diseases affecting mankind. Beyond a certain limit there is huge pressure on the industry to solve this issue without increase in budgets. This is raising to become an important issue in the Healthcare and Insurance industry. Reports say that by 2020, three-Fourth of death globally will be caused due to chronic illness. As of date a lot many countries lack even the basic healthcare requirements or budget to tackle this growing problem. By 2035, Experts expect a shortage of at-least 12 Million healthcare providers globally.
Having said that, medication non-adherence by patients makes the problem all the more serious. It results in huge financial loss, drug shortage and scarcity of data to determine the effectiveness of drugs for the respective illness. This will also put pressure on public budgets and tax payers money. By 2021 healthcare budget of the United States of America alone is expected to reach $4.8 Trillion!
Who are all affected due to Medication Non-Adherence?
There are many parties that get affected due to Non-compliance or Non-Adherence by the patient.

• Medication Non-Compliance can cost the economy more than you can think. The wastage of drugs can cost the country several billions every year. In the U.S alone non-adherence cost is a staggering $289 billion yearly!
• Resources used to hospitalize patients simply due to the reason of not following medication prescription is sky high. The Australian government spends tax payers money of nearly $380 Million yearly on hospitalizing people due to their non-compliance. The united states spends on an average $26 billion per decade on re-admission for medicare patients.
• Stats point that personally its a huge loss for patients. Medication Non-compliance costs an extra $4100 per year for Hypertension patients alone ( $9000 for Heart Failure patients & $4200 for Diabetes patients ).
• It costs near $637 Billion for all the pharmaceutical companies each year.
• Above all Medical non-adherence costs a LOT of lives globally. In the U.S alone it results in 125,000+ pre-mature deaths each year ( this does not count the death rates for each of the other chronic diseases )

What are the steps taken so far to stop Medication non-adherence?
Medication non-compliance is growing to become a big threat. It has made the entire world wake-up to find solutions immediately.

• Healthcare companies are looking to implement more innovative approaches to solve this issue. They have started allocating significant budgets on Proof-of-concepts to tackle this problem.
• More adoption of smart phone technology is encouraging healthcare players to urge patients to use required apps that can help them in timely adherence of prescription drugs. By 2018 end nearly every patient in the U.S will be using a healthcare app.
• A lot many startups are coming up with innovative ideas and products that can reduce medication non-adherence. There is also huge V.C interest in this sector, as there is a clear big market.
• Many I.O.T devices are already there in the market and are being used by a wide range of people. These devices remind patients to take medicine on time and also stores the adherence data for future analysis. Eg: Pillsy, Hero Health etc.
• The most recent and upcoming solution is via. the power of the Blockchain technology.

What are the Medication non-adherence solutions that can be built on Block chain?
Incentive approach: Instead of involving complicated practices that require the patient to change their lifestyle, simple solutions an make a huge change. Timely consumption of medicines can be tied to an incentive based program that becomes a reward to the customer if only he takes his pills on time and updates the system. This approach can be reversed and made into incentive based reminders from near-and-dear ones. Eg: If any one of the friends or family members of the patient reminds the patient to take his medicine on time > Coins will be mined and credited to the family account > That can be used for a month end party etc.
API’s to existing systems: The above discussed ‘Incentive approach’ can also be made into a SAAS model. The API’s can be used by any IOT device or App that is built for Medical Adherence( Ex: Reminder apps, Drug dispensing devices, Fitness trackers etc. ). Upon successful timely intake of drugs, the API generates coins that can be strategically used by the product company for variety of reasons.
Drug inventory management: If the above approach can be achived, the API can easily collect, maintain and track the daily usage of drugs by storing in a secure hyper-ledger. Upon the medicine regime nearing the end, notification can be triggered to medical shops nearby to refill the dispensers. This can help in continual adherence and save time for the patient. Also pharmaceutical companies can anticipate the global usage and calculate the production of drugs.
Decentralized patient records: As every adherence information is stored on the block chain, physicians can easily pull out the medical history of patients for counselling. They can get the entire knowledge of duration of entire medication cycles, in which pharmacy what medicine was bought etc. This can overall improve the service the doctors can offer to patients and lead to a speedy recovery of the illness. All these goodness can happen in a very permission’d manner. The patient can have access to who he can share his details with or not.
Drug effectiveness analysis: If the above data an be shared with the pharma companies, it will help them to a great extent on analyzing the defectiveness of each drug on respective disease. Since data cannot be tampered on block chains, the adherence data can save a lot of money for companies on research and finalization of results.