A Drug-Dealing Robot That Upends the Pharmacy Model
BY JOSEPH FLAHERTY02.14.146:30 AM
For $20 a month, PillPack will deliver prescription drugs to patients with the efficiency of Amazon Prime.
PILLPACK
For all the emphasis on design in the business world, there are entire classes of objects and experiences that feel stuck in time. Take a trip to the pharmacy—you wait in line, peruse the latest celebrity scandal in US Weekly, ponder whether peanut M&M’s purchased at the pharmacy count as health food, and pray that no embarrassing instructions accompany your meds.
A startup pharmacy called PillPack hopes to change this archaic process. For $20 a month, PillPack will deliver prescription drugs to patients with the efficiency of Amazon Prime. Pillpack came to life thanks to a new incubator program at the famed design consultancy IDEO and the core of their service is a small blue box that organizes all of your med into “dose packets,” little plastic baggies marked with the date and time they’re to be taken. A jumble of amber bottles are replaced by an efficient to-do list made of drugs.
‘CVS’s iPad app is a 3-D representation of their store. In one fell swoop it shows everything wrong with pharmacy and software.’
This simple innovation makes life easier for seniors who can be a bit forgetful and have difficulty with bottles. Younger patients with active lifestyles and chronic diseases can just pull as many packets as they need and go. The trail of empty packets means there is never any doubt about missed doses, and each order comes with a custom infographic that shows a full color picture of each pill, explains what it does, and clarifies any special instructions. Ointments, inhalers, and other non-pill products are included in the box as well. All told, PillPack means you’ll never have to help your grandma sort pills into a tacky day-of-the-week organizer again.
Despite being a mail-order operation, PillPack is a licensed pharmacy, just like CVS or Walgreens, and serves patients in 31 states. They accept most major insurance plans, as well as Medicare Part D, and customer service is available 24/7. Switching prescriptions only takes a few minutes on their website and patients as young as 12 and as old as 88 have been testing the service for the past few months. Unlike brick and mortar pharmacies, they don’t carry cigarettes or homeopathic “treatments,” but otherwise the experience is just like going to your local drug store.
Meet the Drug-Dealing Robots
The technical backbone of PillPack is a suite of drug-dealing robots. A large, beige machine in PillPack’s New Hampshire office is filled with a cornucopia of curatives which are dispensed into the plastic packets. The strip of dose packs is then fed through another robot that reviews each plastic packet for quality control purposes before a team of pharmacists double check the prescriptions and send them off to patients.
TJ Parker is the co-founder and CEO of PillPack and a second-generation pharmacist who spent his high school years working for his father. His dad used similar robots to deliver drugs to hospitals and assisted living centers, but the younger Parker realized that with a few design modifications the pill packs would be an ideal consumer product.
Big Problems Require New Kinds of Designers
Parker attended the Massachusetts College of Pharmacy, which happened to share a dining hall with MassArt, the state’s art school. “I was sitting in the cafeteria and said, ‘Wait, these are my people; I should be here.’” He registered for as many classes as possible, and like Twitter founder Jack Dorsey even took a class on pattern making for clothes. Despite the creative coursework and his Warby Parker glasses, Parker isn’t your typical designer. His talent is an ability to reorganize the disparate parts of a complex and often dysfunctional system, and less of an ability to create pixel perfect artworks in Photoshop.
The life-saving text is presented in a full-color, large format, easy-to-read infographic.
Take the labeled dose packets at the core of the service. “A lot of pharmacists put everything they can on the labels,” says Parker. “Our design contribution was taking as much off of as possible.” The machine that prints them has serious limitations—pharmacists can select 8 or 16 point fonts, but can’t spec more design-y elements, like a font from Hoefler & Frere-Jones. Instead of squeezing the life-saving text onto a small label, it’s presented in a full-color, large format, easy-to-read infographic.
By focusing on a mail-order model, PillPack only needs to stock the medications its customers are actually buying. Moreover, retail pharmacies often have to repackage drugs if no one has claimed them at the counter after two weeks. It’s a law to prevent fraud, but because PillPack is sending the pills directly to the customer, they can operate more efficiently. “If you go through a retail pharmacy there are 15 active ingredients, and they make two aisles of products from them that everyone thinks are completely different,” says Parker. “It’s totally insane.”
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A jumble of amber bottles are replaced by an efficient to-do list made of drugs. Photo: PillPack
Most designers can kvetch about terrible clients, but most of Parker’s difficulties stem from having to navigate the byzantine system of rules and regulations that govern pharmacies. For instance, in order for PillPack to serve South Carolina, Parker had to appear in-person before the state’s Board of Pharmacy. The process ended up taking all of five minutes, but is evidence of a system created before the advent of the internet.
Parker also believes pharmacists should have personalities. By using robots to pack pills, his team of pharmacists can spend more time on the phone with customers. When he discovered pills to treat Obsessive Compulsive Disorder were packed in a chaotic jumble, he posted the picture to Reddit. Hoping to learn about how people currently manage their pills, he propagated the hashtag #MedGyver to see how doctors, nurses, and patients cleverly deliver care. “Most pharmacists could do a lot more if they were given the tools and regulatory environment to do so,” says Parker.
Enter IDEO
Despite his desire to get his hands dirty designing, Parker knew that his skills weren’t commensurate with the task at hand. In return for equity in the company, IDEO’s Boston office incubated the startup, providing key feedback on everything from the sign up experience on the website to the packaging details while the company was at its formative stage.
According to Parker, the experience of working with the legendary design firm was immensely helpful, but didn’t lead to a dramatic reinvention of the service. The product doesn’t look much different than it did when PillPack first entered IDEO’s studio, but the site has become far better focused. In the original version, the bulk of the content focused on the inventive packaging—a rookie mistake in the world of human-centered design. “People didn’t grok that we were a pharmacy or that we replace your pharmacy, which seems relatively obvious, but took some work to get there,” says Parker. “They also helped reduce the signup process from about 10 screens to three.”
PillPack is designed to serve patients of all ages, but Parker is uncompromising to his commitment to design at all levels. “We got a lot of feedback that said the design doesn’t look like it’s for old people,” says Parker. “Even if people don’t seek out nice things, they still appreciate them, and it would be a travesty if people didn’t get to experience good design in all facets of their life.”
PillPack will surely win a bevy of design awards, but the big question is if anyone will use it.
The Future of Pill-Popping
Despite its size, the pharma industry has seen little innovation in consumer experience over the last few decades. Target shook up the pharmacy in 2007 with the debut of its ClearRX bottle which traded in the cylindrical form for a wedge-shaped design. GlowCaps was an interesting solution that tried to link pill bottles to the internet, but flopped as no one wanted to pay for the product. Parker hopes his product can succeed where others have failed. “In my opinion, for maintenance medications it’s a better experience if they show up automatically and pre-sorted,” he says.
Established giants Walgreen’s and CVS have gotten into the digital realm, but Parker isn’t too worried about them squelching his startup. “CVS’s new iPad app was literally a 3-D representation of their store,” he says. “In one fell swoop it shows everything wrong with pharmacy and software.”
PillPack will surely win a bevy of design awards, but the big question is if anyone will use it. The dose packets look cool, and the service discards the unpleasantness of retail pharmacy like so much wadded up cotton in an aspirin bottle, but will it be enough? It may sound crazy, but nearly a quarter of people who suffer a heart attack never pick up their prescriptions at the pharmacy. The cost of patient’s not using prescribed medications costs more than $290 million a year. Will a modern sensibility and the Amazon-esqe efficiency really be enough to change this suicidal behavior?
Even if patients are non-compliant, PillPack has revealed the massive potential of combining design thinking and the drug market. Big pharma is boring to many, yet the opportunity for designers to make an impact on healthcare and a company’s bottom line is staggering.
For instance, sales of Abilify, a drug used to treat depression, accounts for sales of about $6.4 billion per year versus $5.3 billion spent on digital music downloads. Put another way, one pharma product is bigger than the entire digital music industry. Think of all the energy focused on designing better music experiences—Pandora and Spotify, Beats by Dre and Jawbone, not to mention Apple’s contributions—compared to the underserved world of pharma products.
PillPack is one, but far from the only, possible improvement. Figuring out ways to dispense enemas might not be as glamorous as designing an app to better appreciate Eminem, but it’s a lot more important.
Joseph Flaherty
Joseph Flaherty writes about design, DIY, and the intersection of physical and digital products. He designs award-winning medical devices and apps for smartphones at AgaMatrix, including the first FDA-cleared medical device that connects to the iPhone.