PDA 2023
Summary and Conclusions
Summary (with ARF from Team Consulting)
Patients deserve better. This was, overall, the key theme emerging from the PDA ‘Future of Drug Delivery’ workshop
Innovative drug delivery devices can provide many tangible benefits to the patient, but also add commercial value to the product itself. To achieve this there is, in effect, a ’toolkit’, comprising the shared experience, design options and development opportunities of the Pharmacos and device developers/manufacturers, that should be utilised to provide better solutions for the patient.
Being first to market with a new product is generally a distinct advantage, and second to market products are always playing ‘catch-up’. However, it is often a fine judgment as to when the performance and features of the overall drug/device product are “good enough” for launch. Delaying launch to achieve perfection may not only lead to a loss of market share but may deny benefit to patients who need better devices to manage their conditions.
Although we pride ourselves on delivering products to patients which improve their healthcare outcomes, clearly not all solutions work optimally for every patient. Patient conditions and circumstances vary enormously, and one size simply doesn’t fit all; fiddly devices that patients with loss of sensation in their fingers can’t use, insulin pen displays that diabetic patients with retinopathy can’t read, even life-critical connected devices that stop working when a mobile phone has a software update are all examples. We must acknowledge that actual, physical, experience of use is often lacking amongst devise developers. How many of us have experienced inserting a pen or auto injector needle into our own skin?
We should also consider whether the patient’s needs may be satisfied with something other than a pre-filled syringe or an auto injector? Could a nasal spray, or a needle-free device or an on-body device be a more practical, less challenging, or more convenient alternative?
When the patient’s quality of life, or indeed their very life itself, depends on the delivery of drugs from the devices we develop and manufacture, we need to deliver solutions that work for them.
Patients want devices they can use readily, without difficulty and with confidence. There will always be technical, regulatory, or cost implications, but our objective remains to provide solutions designed to make sick people better.
Our patients deserve better.
Kestrel Summary
Our patients deserve better
Patient Perspectives:
Imperatives for patients are:
- Safety
- Reduced burden of drug
- Ease of use
- Reduce pain and intimidation suffered by patients experiencing and anticipating
Important aspects of design for users are:
- Size
- Comfort
- Position
- Dexterity required
- Sensory inputs, e.g. colour
Overall, devices need to be designed for the patients who use them – all types of patients – and in all situations.
Reliability is paramount, as in the ability of a user to know they can get their treatment when they need it. Devices can be life-critical and so they MUST work. Frequently they do not. Users do not feel they can trust flimsy lightweight devices so the PERCEPTION of quality is vital.
Devices must work for people with the illnesses they treat. Users with diabetes cannot see displays clearly – backlights would be useful – and they can’t feel or hear the clicks when a dose is increased so they can’t be certain how much drug they are getting.
Connected dosing devices lose their connection when automated software updates take place. As a result, users frequently feel they need to carry a backup device they KNOW they can trust. Unfortunately, there is not the range of devices needed to cover the range of patients. Children, the elderly, the unwell and those with co-morbidities or exacerbating conditions all have different needs. One size does NOT fit all, but one size is frequently all that’s available.
Users need to take their medicine regularly, but they regularly forget. Devices should feature reminders.
Key points for user compliance:
- Chronic therapies depend on patient compliance
- Patient compliance is improved if you can address patient reluctance and anxieties and improve the patient experience.
- Better patient experience = better patient outcomes
- New technologies can enable new therapies and enhance existing therapies
- Patients – up to 30% – suffer from needle phobia or needle anxiety to a degree that it can prevent them getting their medicine