Would you like a micro chip with your prescription?

By AMY MAXMEN | NATURE | AUGUST 2, 2012

Digestible microchips embedded in drugs may soon tell doctors whether a patient is taking their medications as prescribed.  These sensors are the first ingestible devices approved by the US Food and Drug Administration (FDA). To some, they signify the beginning of an era in digital medicine.

“About half of all people don’t take medications like they’re supposed to,” says Eric Topol, director of the Scripps Translational Science Institute in La Jolla,California. “This device could be a solution to that problem, so that doctors can know when to rev up a patient’s medication adherence.” Topol is not affiliated with the company that manufactures the device, Proteus Digital Health in Redwood City,California, but he embraces the sensor’s futuristic appeal, saying, “It’s like big brother watching you take your medicine.”

The sand-particle sized sensor consists of a minute silicon chip containing trace amounts of magnesium and copper. When swallowed, it generates a slight voltage in response to digestive juices, which conveys a signal to the surface of a person’s skin where a patch then relays the information to a mobile phone belonging to a healthcare-provider.

Currently, the FDA, and the analogous regulatory agency in Europe have only approved the device based on studies showing its safety and efficacy when implanted in placebo pills. But Proteus hopes to have the device approved within other drugs in the near future. Medicines that must be taken for years, such as those for drug resistant tuberculosis, diabetes, and for the elderly with chronic diseases, are top candidates, says George Savage, co-founder and chief medical officer at the company.

“The point is not for doctors to castigate people, but to understand how people are responding to their treatments,” Savage says. “This way doctors can prescribe a different dose or a different medicine if they learn that it’s not being taken appropriately.”

Proponents of digital medical devices predict that they will provide alternatives to doctor visits, blood tests, MRIs and CAT scans. Other gadgets in the pipeline include implantable devices that wirelessly inject drugs at pre-specified times, and sensors that deliver a person’s electrocardiogram to their smartphone.

In his book published in January, The Creative Destruction of Medicine, Topol says that the 2010s will be known as the era of digital medical devices. “There are so many of these new technologies coming along,” Topol says, “it’s going to be a new frontier for rendering care.”

Obama Machine Preparing for Healthcare Defeat

By LUIS MIRANDA | THE REAL AGENDA | JUNE 8, 2012

The Obama administration recognizes that it may actually be handed a defeat later this month if the Supreme Court strikes down the individual mandate that obligates Americans to buy health insurance from a government program or worse, if the judges find Obamacare unconstitutional as a whole. While a decision is made by the Supreme Court justices, the administration is taking steps to cope with a defeat that could be decisive during an election year both politically and in the economic realm.

Secretary of Health and Human Services, Kathleen Sebelius officially announced what she called contingency plans should Obamacare be rejected as unlawful by the US Supreme Court. The Court does not need to declare Obamacare illegal in order to cause chaos for the administration. A declaration that the controversial individual mandate violates individual rights, would basically and automatically defund Obamacare, because it is based on the use of government force that the Obama administration intends to finance its program.

The prospect of defeat raised awareness in the Federal Government and all responsible parties are now working extra time to mitigate the impact of a decision not to uphold Obamacare. While she was speaking at a women’s health town hall meeting held at the White House, Kathleen Sebelius said that although the government remained optimistic, they were also preparing for the worst. “We are confident and optimistic that this change within the law was well within the purview of Congress. Having said that, we’ll be ready for court contingencies,” she said. Sebelius made sure to use scare tactics in order to seek support and to put pressure on the Court’s decision. She added that if Obamacare is stroke down such a decision would have a “pretty cataclysmic impact”. Her explanation went on to say that such outcome would indeed undo what she called the “incredible changes and improvements to Medicare.

The Obama administration’s hopes are now riding on a positive decision by the Court that ratifies the healthcare law based on the premise that the judges will consider the large number of people who will allegedly benefit from socialized medicine, many of whom, Obama himself has said, cannot afford to pay for healthcare themselves. This is often added to other measures included in the legislation which allow children to remain under their parents’ health coverage and a mandate for insurance companies not to deny coverage to those with pre-existing conditions.

The parts of the law that the Obama administration does not want the justices or the public to remember is that constitutionally, government cannot obligate an individual to buy insurance. It must be a decision made by each person. But since the success of the law depends on the financing provided by all participants, a declaration that the individual mandate is unconstitutional would effectively defund Obamacare. “What we’re doing right now is just working as hard as we possibly can to get ready for 2014,” Sebelius said, referring to the time when most of the law will actually take effect.