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Take care of your dose

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Adherence to medicines is a must for people suffering from chronic diseases, and Caredose is helping them in doing so, informs Gauri Angrish, CEO, Caredose, to Akanki Sharma in an exclusive interview

What led to the formation of Caredose? What prompted you to come up with such an idea — any incident or personal experience?
I’ve always had an inclination towards creating something that would positively impact multiple people and understood at an early age that healthcare was the only avenue to do so. Keeping this in mind, I studied biotechnology from the University of Nottingham with a focus on stem cells. However, after moving back to India, I saw that research opportunities in stem cells were limited here. Thus, I wanted to understand the business side of healthcare and therefore joined McKinsey & Company’s pharmaceutical and medical device vertical. My role there involved interacting with and working on projects for large pharmaceutical manufacturers. That is how I got exposure to the concept of medicine non-adherence and more importantly understood the huge negative impact of medicine non-adherence — not just on patients, but also on each and every stakeholder in the healthcare spectrum. I knew I had found a problem worth working on but lack of experience and in-depth knowledge of how things work in healthcare prompted me to quit McKinsey and start a physical pharmacy store in Delhi. I spent two years just running the pharmacy and understanding how the supply chain works. Post this, I started my research in existing solutions for improving adherence and saw that the only options were app alerts or reminder services, which, in my opinion, were not comprehensive at all. So, I recruited 50 patients from our pharmacy network across multiple chronic ailment and devised our initial offering with them, modifying it each month based on their feedback.

Which cities are you currently active in and how many patients have benefitted through your services till date? Do you provide your services for every disease or are these specific to some major diseases?
Currently, Caredose operates in cities across Delhi, Haryana and Uttar Pradesh. Our next target is to expand the footprint in five new cities including Hyderabad, Mumbai, Pune, Chennai and Bengaluru. We will also be looking at global expansion next year. Our target countries include Indonesia, Qatar, the UAE, the UK, Nigeria and South Africa, where we will be focussing on both private and public sectors. Our service is primarily focussed towards patients with chronic ailments like diabetes, hypertension, cancer, kidney diseases, neuro diseases and so on. Managing medicines for such users can be difficult and overwhelming. Our aim is to provide these patients with the easiest way to buy and manage their regular medicines. After launching our services, we realised that several post surgery, pre/post-natal and tuberculosis patients were also subscribing to Caredose and benefiting from it.

You were in talks with the central government for providing your services to tuberculosis patients via TB health facilities run by the RNTCP. What is the current development in this regard? Are you working with any specific state government too?
Yes, we have partnered with the RNTCP, Ministry of Health, World Health Organisation and Clinton Health Access Initiative to provide our proprietary smart dispensers to ensure and track real-time non-adherence in tuberculosis patients and link them up with actionable alerts to optimise patient care and treatment outcomes. We have carried out successful feasibility tests, and have been approved for a grant by United States Agency for International Development (USAID) as well. Additionally, we were invited by the University of Harvard, at their annual global health symposium, to speak about our technology and plans to impact global health. Post this they are now assessing us for a grant for a large trial, across multiple cities. With respect to state governments, as of now, we are only working with the Delhi State TB office but are already in talks with other states.

What progress/advancem-ents in technology have you noticed in India among medtech providers? What more is needed for eradicating TB?
Technology has advanced by leaps and bounds amongst the medtech providers in India. Improved data penetration, voice-learning modules, robotics, machine learning and artificial intelligence are helping the patient-provider models of care. Increasingly, medtech providers are acknowledging and appreciating the need for multi stakeholder alignment to be able to make an impact. Last-mile delivery in healthcare and personalisation of medicines/treatment are growing segments in the industry given the needs of the users. With regard to TB, there is a need for optimising public resources and aligning the supply chain to be able to deliver care to the patients within the stipulated timelines. Unfortunately, in our society, strong stigma attached to TB and gender inequality make it even tougher to achieve effective treatment outcomes. Substantial efforts towards women empowerment and spreading awareness around TB need to be made across all socioeconomic classes. Innovative technologies and targeted education, on the back of a collaborative effort between the private and public health sectors can help us eradicate TB in India.

The central government has plans to eradicate TB by 2025. Do you think this target is achievable? What is the role of Caredose in it?
The goal set by the Government of India is definitely not an easy one but when one sees the steps that are being taken towards eradicating TB, it is easy to say that this goal is achievable. Eradicating TB is not simple and requires inputs and efforts from various stakeholders. It is great to see that they have been extremely proactive in this regard and are promoting a “cafeteria approach” which involves getting multiple stakeholders together and providing patients with end-to-end care, from diagnosis to treatment to cure, to ensure positive patient outcomes. Caredose fits into the treatment aspect of the patient’s journey, and as adherence is important for successful completion of treatment, it will play an essential role in not only ensuring adherence, but also tracking and communicating it in real-time, without any input from the patient.

How should our healthcare ecosystem respond to a TB patient’s needs? Give 4-7 key steps leveraging innovative technology/ies.
A lot is already happening resulting in increase in understanding a TB patient’s needs and provision of solutions accordingly. A few things I can think of are: increasing focus on diagnosis of TB along with latent TB, integrating all technologies on a single platform to allow for seamless end-to-end care, focussing on creating awareness about TB to negate the social stigma, especially around women with TB and collecting and analysing relevant data to keep improving the treatments and technologies based on real-world data.

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