The Big Question

What if your body could make its own medicine?

The Problem

For people with chronic medical conditions that require continuous management, taking medicine as prescribed can be difficult. Whether the treatment involves self-administered injections or swallowing a pill, patients often struggle to take the correct dose at the correct time – which can lead to serious negative repercussions for their health. For those who live with memory loss, arthritis, or other mobility-limiting conditions, these issues may be compounded.

Failure to properly take prescription drugs – also known as medication non-adherence – is a major problem in the United States. Up to 50% of adults currently fail to take the medicine that they should, causing more than $100 billion in preventable costs per year.^1,2 Many factors lead to low adherence rates, including forgetfulness, cost, fear of side effects due to impersonalized treatments, and complex medication schedules.

The Current State

Despite the increasing prevalence of chronic conditions in the United States, many current treatments remain susceptible to medication non-adherence. For instance, metabolic disorders such as obesity can be effectively treated using GLP-1 agonists, but they can be expensive and require the patient to take medication up to twice a day. Similarly, regular insulin injections can help people with type 1 diabetes manage their condition, but they too are onerous – leading to non-compliance rates as high as 29%.³

The Solution

REACT aims to overcome the problems surrounding medication non-adherence by creating two different—but related—bioelectronic devices capable of treating chronic conditions remotely. These devices will be implanted in patients during minor outpatient surgery and will interface with a simple software platform or app that allows users to track their condition directly.

For the first device, REACT aims to develop an implantable “Living Pharmacy” programmed to deliver therapeutic molecules in the patient on demand. This device will include cells modified to release specific treatments into the body, along with a control system that modulates the dosage. Using this approach, patients can automatically deliver single or combination therapies that are specifically tailored to the individual user by their doctor.

For the second device, REACT aims to create a “Living Sentinel” that measures key biomarkers in the body. This device will use similar components to the Living Pharmacy, but instead of delivering treatments it will detect markers for disease and relay this information to the patient via a software platform or app. In doing so, the Sentinel will provide real-time information that helps patients and doctors track the disease and make appropriate therapy decisions.

The Challenge

ARPA-H seeks to build robust teams of performers to work toward REACT solutions. Interested research partners are invited to read the solicitation and contact us about joining the program. Successful applicants will work with a range of researchers and engineers to address some of the toughest challenges in medical implant technology. If successful, REACT performers will usher in the next generation of bioelectronic devices – and in doing so change the way in which we think about drug delivery as a whole.

References

1. Osterberg, L., & Blaschke, T. (2005). Adherence to medication. The New England Journal of Medicine, 353(5), 487–497.
2. Iuga, A. O., & McGuire, M. J. (2014). Adherence and health care costs. Risk Management and Healthcare Policy, 7, 35–44.
3. Currie, C. J., Peyrot, M., Morgan, C. L., Poole, C. D., Jenkins-Jones, S., Rubin, R. R., Burton, C. M., & Evans, M. (2013). The impact of treatment non-compliance on mortality in people with type 1 diabetes. Journal of Diabetes and Its Complications, 27(3), 219–223.