Express Scripts rolls out smart inhalers in digital health push 

Propeller Health's technology (Courtesy of Propeller Health)

Express Scripts is making smart inhalers available to its members who suffer from asthma or COPD. The move potentially represents a big win for Propeller Health, which now has a chance to provide its sensor-enabled inhaler and companion app to a large population of patients. 

Starting from early next year, Express Scripts will make Propeller’s technology available to patients who are enrolled in its pulmonary care value program. That could lead to as many as 750,000 people using the devices, CNBC reports, making the alliance Propeller’s biggest respiratory digital health deployment with a pharmacy benefit manager.

Patients who take up the option will receive inhalers incorporating digital sensors that track when the device is used and send the data to their smartphones via Bluetooth. The system will loop in Express Scripts pulmonary pharmacists, enabling the pharmacy benefit manager to see when a patient uses their controller and rescue medications.

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The value of the technology to Express Scripts lies in those data. If the pharmacists see a patient is using their rescue medication too often or is nonadherent to their controller therapy, they will “engage and perform counseling using patient-specific data.” The goal is to make more people use their inhalers as intended, improving their health while controlling the cost of treating their conditions.

In a pilot study, Express Scripts saw an 80% drop in average daily rescue events, plus improved compliance to controller medications. Scaled across Express Scripts’ members, such improvements could bring down the cost of treating asthma and COPD. 

The economic costs of these conditions mean even small improvements could translate into sizable sums of money. In 2014, the CDC estimated U.S. medical costs attributable to COPD to be $32 billion a year. With other studies suggesting adherence is a major problem in COPD, there is an opportunity to chip away at that figure by ensuring patients use their drugs as intended. 

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Propeller has laid the groundwork for the deal over the past few years by landing a string of FDA approvals for asthma and COPD treatments delivered using its technology. The FDA first signed off on a Propeller product in 2012 when it cleared the then-two-year-old startup to market its system with pressurized metered-dose inhalers, such as those used to deliver asthma drug albuterol.

Madison, WI-based Propeller followed up that regulatory nod with approvals covering the use of its technology with Boehringer Ingelheim and GlaxoSmithKline inhalers. Those inhalers administer widely used asthma and COPD therapies including Advair and Spiriva. Patients use the treatments proactively to manage their conditions without needing to resort to rescue medications, which is the type of behavior Express Scripts hopes to encourage by monitoring the use of inhalers.