Superpills Will Usher in a New Era of High-Tech Medicine
Pills are such a common part of everyday life that we barely think about them. Yet they might be one of the greatest developments in the history of medical technology.
Consider some of the alternative ways of delivering medicine. You could mix it in a solution, but the patient may not measure the dosage correctly. You can offer it as a nasal spray, but the patient’s sinuses may impact delivery. You might provide an injection, but that is painful, messy and impractical.
A pill is a precisely measured dose, delivered along an extremely predictable route. Pills are also portable and long-lasting – most pills have a shelf-life of years, without a need for refrigeration.
But pills are old tech. While manufacturing techniques have improved, the basic properties of a tablet haven’t changed in centuries. This can only mean one thing: it’s an area ripe for disruption.
Get ready for the next generation of medication: the superpill.
5 technologies that will change the way we think about pills
In a few years, you might find yourself at the pharmacy picking up a prescription for a pill designed to suit your taste, or a pill with wi-fi connectivity, or a tablet that sits in your stomach for a month. Here are five features that are coming to a medicine cabinet near you.
Bespoke pills from 3D printers
Drug production is an extremely efficient process, with pharmaceutical plants producing millions of units each hour. This approach works on the basis that all pills are going to be identical. Manufacturers might produce a small selection of variations, such as 5mg and 10mg versions of one tablet, but there is little variation apart from that.
So, what happens when you need an 8mg dose? Or if the tablet is too big for the patient to swallow? What if you could add flavor to the pills so they’re more attractive to children?
This is where 3D printing can help. At Alder Hey hospital in the UK, researchers are conducting experiments to see how children respond to custom-made pills. The tablets are placebos, but researchers are gathering data on how to optimize shapes, sizes and flavors to suit younger patients.
3D pill printing may not be suitable in all cases. Researchers have discovered that some drugs, such as the heart medication amlodipine, aren’t released in a clinically acceptable way during the 3D printing process. But for patients who struggle with medication, bespoke pills might be a lifeline.
Polypills deliver everything at once
Half of Americans take two prescription drugs, and 20% are on five or more. Every time a doctor prescribes another new medication, they introduce an element of risk. The patient could forget to take one of their pills, or mix up the dosages, or take things in the wrong order.
But what if doctors could prescribe each patient a single pill? That pill could contain multiple drugs, delivered as a single dose. Even complex drug regimes could be administered in this way.
This is the polypill, and they’re already available for certain conditions. The first polypill was developed in 1999, containing a mix of statins, aspirin and blood pressure regulators. The typical polypill has multiple layers, so each section of the pill dissolves at a different time.
3D printing opens up a whole new world for polypills. If a patient is taking compatible medications, their entire regime could be combined in a single tablet. Instead of keeping their pillbox organized, patients would just take their polypill two or three times a day.
Smart pills send data to your GP
Internet of Things (IoT) technology involves lots of single-purpose devices, such as cameras and thermometers, that wirelessly feed data back to a central server. Often, these gadgets are tiny. So, what if you could put an IoT device in a pill?
An American company, etectRx, received FDA approval in 2019 for one of the first devices of this kind. Their smart pill contains an adherence monitor – a sensor that rests inside your stomach and reports when you take your medication. Your doctor can look at this data and see if you’ve been adhering to your medication schedule.
There are endless possibilities for this kind of technology. Patients could swallow a smart pill with a micro camera that explores their gut. This would allow doctors to perform a detailed colonoscopy with no discomfort for the patient.
Other sensors could monitor temperature, blood pressure, insulin levels, or other critical markers. A single smart pill might last for years, providing a reliable stream of patient data.
Long-lasting pills that can release over the course of a month
Most drugs are issued on a multi-pill prescription. For example, your doctor might treat an infection with a seven-day course of antibiotics to be taken three times per day, or twenty-one pills in total. If you forget to take one, you’re in good company. Anywhere up to 60% of people fail to finish prescriptions.
So, what if you could just take one big pill instead? This is the concept behind the long-lasting pill, under development at MIT. Initial trials have focused on anti-malarial treatment that requires 3-4 pills per day for several weeks.
The goal here is to create a long-lasting pill that slowly releases over the course of two weeks. Patients swallow the pill, and it gradually dissolves in their digestive tract, which has the same effect as a regular course of treatment.
There are long-release alternatives, such as sub-dermal implants. However, these can be painful and intrusive. Long-lasting pills have all the simplicity of pills, with no chance that the patient will forget a dose. One potential application is female contraceptive pills, where missing one dose can cause serious disruption.
Digital pill controlled by an app
Ultimately, pills might contain some combination of all the above technology. A fully digital pill could contain some IoT functionality, plus medication that can be released by a command from an app.
For example, consider a pill with camera functionality. Your doctor could use this to study the progress of an ulcer within your bowel. Based on this visual information, your GP could help set a schedule for releases of medication from the digital pill.
This schedule would be controlled by an app on your phone, so you could set it to release at fixed times, or you could manually release the medication after meals. Either way, you don’t need to remember to take a pill.
The vision of a digital pill is still a long way off. But much of the technology required already exists. All that remains now is…
Managing the risks of superpills
Technology solves problems, but it also creates new problems. The rise of the internet has been the dawn of a new age of theft, fraud, piracy, and unregulated surveillance.
And these problems can be a matter of life and death when medicine is involved. Industry watchers have already pointed out some pitfalls that may lie ahead:
3D medicine printing will make it easy for anyone to produce their own pills. This could create a boom in unlicensed medical products, from recreational drugs to untested treatments. Police will struggle to track down and stop these backroom operations.
3D printing will also make it easy to produce counterfeit versions of licensed medicines. This is already an issue, with millions of fake pills being traded on the internet every day. New technology will help these pirates to create even more convincing knock-offs. This is bad for drug companies, who own the IP for the treatment. It’s also bad for patients, who may end up taking a poor-quality version of their vital medication.
IoT-enabled smart pills might improve the quality of your care, but they’re still broadcasting sensitive data about your body. This kind of device raises several privacy questions, like whether data can be intercepted by a third party. There’s also the issue of whether the IoT signal could, in some way, be used to identify you without your permission.
With any kind of connected device, there’s the risk of hackers. Most smart pills have a limited range, only reaching as far as a lanyard that the patient wears around their neck. However, this lanyard will retransmit the data to the patient’s smartphone, and both of these devices are vulnerable points. As well as stealing data, hackers could potentially disrupt the operation of a smart device, such as interfering with the dosage schedule. Any system of this kind would need a high level of security measures.
The new wave of medical technology will help most people live longer, healthier lives. But we shouldn’t assume that all advances are inherently benevolent. Technology is a tool, and we can use those tools for ill or for good.
Whatever advances lie ahead, they have to be supported by a strong system of medical ethics. More importantly, doctors and patients need to have open conversations about all available treatment options.