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Background

Improving Medication Assisted Therapy (MAT) Adherence and Reducing Relapse

Is there an inexpensive technology solution for MAT that scales to:

  • Increase viability of less expensive generic tablet medication regimens
  • Monitor patient symptoms remotely
  • Ensure medication adherence in real-time
  • Verify administration at every dose
  • Track precision dosing for tapering
  • Make diversion transparent to the care team
  • Incent MAT providers and pharmacists to review patient results between encounters
  • Increase affordability by reducing out-of-pocket Rx costs
  • Keep family members informed of progress or misuse?

Challenge

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Increase access and removing barriers to sustained MAT

MAT in concert with counseling and behavioral therapies is considered a standard of care for Opioid Use Disorder patients. Yet, only 20% of all potential patients are enrolled in treatment programs at any time, and MAT medication adherence rates range from ~37 – 41%.

  • Removing barriers to patient cost, insurance coverage and authorizations, social stigma, medication adherence and provider access for MAT and psychosocial services is vital to treatment program enrollment and decreased relapse rates (currently ~40 – 60%). 
  • Prescribing, when appropriate, less expensive generic BUP/Nx tablets during maintenance therapy reduces patient financial hardship.
  • Reducing refill cost with lower dosage prescriptions during tapering also helps reduce patient out of pocket cost.
  • Providers and caregivers/family members also need assurance that patients will be successful in their adherence and will be notified when additional assistance is needed.
  • Helping providers recognize early-on aberrant drug-taking behaviors and helping them distinguish unintentional misuse, pseudo-addiction, or chemical coping with deliberate misuse, abuse, and diversion.
  • Securing MAT medications from accidental access, tampering by making compliance verification for patients, easy, unobtrusive and diversion harder to circumvent. 
  • Addressing non-adherence from patient visit no-shows (travel, transportation, job).
  • Paying MAT providers and pharmacists, outside of visit encounters, to monitor patient adherence, ingestion and dosage data results from a remote sensor, packaging, biometric and smartphone solutions.
 
 

Improving Dosage and Supply Control for Patients in Pain

  • Curb access to the addictive drugs while ensuring that patients with long-term chronic pain who need them can continue treatment.
 

Restricting Dosage for Pain Management Is Challenging

  • Painkiller dosage varies. The CDC’s 90-milligram red flag is for patients in acute pain initiating opioid therapy, not necessarily patients with chronic pain on long-term opioids. The acute pain patient, the guidelines say, should first be offered treatments like acetaminophen or ibuprofen. A short course of a low-dose opioid should be a last resort.
  • Limiting painkiller supply and doses can put older patients into withdrawal or lead them to use deadly street drugs.
  • Prior Authorization hoops. Pharmacists negotiating prior authorizations and insurance rejections eat hours of time between doctors, nurses and insurers. Patients feel stigmatized further. Pain medicine and primary care providers already overwhelmed with time-consuming paperwork will simply throw up their hands and stop prescribing altogether. 
  • Patient hoops. Submitting to random urine tests (UDS) and requiring chronic pain patients to visit pharmacists or providers to count painkiller pills imposes a further burden and unnecessary cost.
 

Solution

CuePath is a smart blister package solution that supports adherence to chronic pain management, and Medication Assisted Therapy (MAT). 

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CuePath uses take-home, standard blister packaging for MAT tablet prescriptions (buprenorphine, naloxone, naltrexone or combinations). Also, CuePath would be used potentially for painkiller medications (Tramadol, etc.) polypharmacy prescriptions (Alzheimer’s, Heart Failure, etc.) and other regimens (Hepatitis C, Tuberculosis).

CuePath analyzes and records location, pills, and dosage taken and when a blister cavity is punched out (date, time taken). CuePath’s pill cavities can be used to track different dosing amounts for tapering. CuePath can also indicate and record the patient’s struggles with cravings or breakthrough pain.


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