Will an in-home electronic pillbox solve this country's medication error problem?
Maybe the only two entities that think so are the company that invented the machine and the FDA.
"The device can be programmed to dispense individual doses of up to a month's worth of 10 different drugs, according to its manufacturer, INRange Systems Inc. The Web-connected medication box allows pharmacists, doctors and nurses to tweak both the dosing schedules and dosages of drugs loaded into the device in special blister cards. The company-described 'electronic nurse' alerts patients when it's time to take a drug with visual and audible alerts.
"The bread-box-sized device may reduce drug identification and dosing errors, the FDA said. Expected users include aging and forgetful patients, as well as those with HIV who must adhere to complex treatment regimens." (See: "Computerized Pillbox Is Cleared").
Here are some problems I foresee that will limit the adoption of this contraption:
- The cost! $200 per month! (See "Drug-Dispensing Machine Wins Approval From U.S. FDA".) Sure, maybe Medicare will pay that, but I think the money is better spent eliminating the infamous Medicare Part D "donut hole."
- The company and the FDA claim that the device will help prevent medication errors that "harm at least 1.5 million people in the United States annually." While INRange claims that "the greatest rise in prescription medication errors occurred in the ambulatory setting," the vast majority of medication errors still occur IN HOSPITALS, not in homes. Also, if physicians prescribe the wrong medication in the first place, this device will continue to dispense the wrong medication unless someone tells it differently.
- The device dispenses pills in blister packs, which many seniors have trouble opening! Not only that, but pharmacists have to load the pills in these packs instead of simply putting them in bottles. I'm sure that's more work for the pharmacist.
- The cost! Did I mention the cost? Not only the $200 per month per patient, but to Medicare if it had to pay for millions of these devices. Do the math.
- Doctors and pharmacists are expected to remotely monitor and manage the devices to alter dosing and make sure the patient is compliant. Sure, that'll happen!
- Imagine a HAL computer scenario if you will. Or just plain hackers. Or software bugs. Or power outages! Imagine the havoc these electronic bogey men would cause. Oh, the humanity!
- Did I mention the cost?
And the drug industry -- including the FDA -- must do more to address the problem through patient/physician education and promotion of ePrescribing at least, instead of worrying so much about counterfeit drugs, which kill far fewer Americans than medication errors!
That's my opinion, and I'm sticking to it!