In a move that signals the pharmaceutical industry’s growing interest in digital therapeutics, Aptar Pharma has partnered with Propeller Health, a pioneer in this burgeoning field. The company, a division of Aptar Group, is one the biggest makers of drug delivery devices. Last year, it generated $800 million in revenue, selling inhalers, injectors and other dispensers to drug companies. Aptar and Propeller will connect those devices via sensors to Propeller’s software to manage respiratory diseases, opioid addiction and pain, among other areas. “[It’s] a great opportunity to industrialize connectivity,” says David Van Sickle, co-founder and CEO of Propeller. Aptar is investing $10 million as part of a $20 million funding round, which includes returning investors Social Capital, Hikma Ventures (the venture arm of Jordan’s Hikma Pharmaceuticals) and SR One (the VC arm of GlaxoSmithKline). This brings the total amount Propeller has raised to $65.5 million. The partnership represents a milestone for the Madison, Wisc.-based company, which focused until now on asthma and other chronic respiratory diseases. App-based digital therapeutics have emerged over the past decade as a potential complement to medications—if not a replacement—to help patients manage symptoms, and follow a drug or treatment regimen. They harness the power of data analytics to monitor patient behavior in real time and facilitate personalized intervention through feedback, coaches or healthcare providers to produce a desired outcome. “We’ve already seen that these digital medicines can deliver meaningful results,” says Salim Haffar, president of Aptar Pharma. “While promising evidence is accumulating, for us to truly understand the benefits, we’ll need to scale this to even larger populations.” A handful of digital therapeutics companies, including Propeller, which has FDA clearance, have embarked on clinical studies to prove their approach works. “Propeller is an early trailblazer in recognizing the importance of generating meaningful clinical studies,” says Andrew Matzkin, a partner at consulting firm Health Advances and an advisor to the Digital Therapeutics Alliance. The company has published results in 14 peer-reviewed publications. In two randomized controlled clinical trials, it showed that tracking drug intake and giving feedback through its app significantly improved medication adherence in asthma patients, and reduced the use of so-called rescue inhalers that relieve symptoms, but can have detrimental long term effects. The evidence helped it build a customer base, which includes health systems, payers and more recently pharmacy benefit manager Express Scripts. Those that offer asthma management programs cover the cost of Propeller. The company says 530 healthcare providers use its system, as well as more than 25,000 patients, who clip the Propeller sensor to their inhaler to link to the app. Patients clip on Propeller's sensor to an inhaler to sync to its app. The company first caught the attention of Haffar in 2013. “Because we’re in drug delivery, we spend a lot of energy on R&D to find ways to deliver drugs better for our customers,” he says. Lack of medication adherence, in particular, is a major issue. “Doctors assume that patients are taking their medications,” says Stanley Szefler, director of pediatric asthma research at Children’s Hospital Colorado. Aptar first signed an agreement with Propeller in 2016 to develop a metered dose inhaler for asthma and respiratory diseases with embedded sensors. The device served as a model to gauge the interest of pharmaceutical customers. The feedback encouraged the two to expand their relationship. Separately, Propeller signed an agreement with Vectura to develop add-on sensors to its inhalers, and received FDA clearance for its sensors and software in combination with GSK’s Ellipta inhaler. It also has similar relationships with Novartis and Boehringer Ingelheim. With Aptar’s clout in manufacturing and sales, Propeller now has the opportunity to potentially reach more patients. It will take its expertise in user interface and data gathering and apply it to other therapeutic areas. The focus will initially be on fastening sensors onto drug delivery devices to sync to Propeller’s software application, as opposed to embedding them, which can require clinical trials for regulatory clearance. “We are working closely with our existing pharma partners and with Propeller to evaluate therapeutic areas, where we think digital medicines may have the potential to make a positive impact,” says Haffar. Other digital therapeutics companies that have partnerships with pharmaceutical companies include Pear Therapeutics, which is collaborating with Novartis to develop digital therapeutics for schizophrenia and multiple sclerosis. It also recently announced a deal with Novartis division Sandoz to market its clinically-validated app for opioid addiction management. Last year, Bayer received FDA approval for its app, which syncs to its Betaseron injector for multiple sclerosis, allowing healthcare providers to monitor their patients outside the clinic.
Following the completion of its $20m funding round, Propeller Health has partnered with Aptar Pharma to expand its digital therapeutics software to a larger range of medical devices. Aptar is one of the largest manufacturers of drug-delivery devices and committed $10m. Propeller has now raised $65.5m and supports 25,000 people with its US regulator-approved digital asthma management programmes. Digital therapies are gaining traction with both healthcare providers and pharmaceutical companies, providing a personalised and cheaper alternative to increasingly expensive drugs.