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Why Nemera's e-Novelia is a smarter approach for ophthalmology

Nemera discusses how its e-Novelia system is helping increase adherence for ophthalmology patients.

It’s well known that the quality and success of a treatment can depend on patients’ adherence.

In 2016, the estimation of the revenues lost globally by pharma due to non-adherence was $637bn. In the case of ophthalmic therapy, the quality and safety of eye drop use for patients treated in a healthcare setting play a vital role in the delivery of healthcare.

Underdosing, because of either poor adherence or poor performance, means that patients are not receiving their prescribed medication. Overdosing, as seen in a 2009 American Medical Association’s study, has the potential for several problems, including systemic adverse events, ocular adverse events and a more rapid use of the bottle.

Today there is still a very poor compliance in administering drops into the eyes and a big room for improvement. A study in 2012 showed that nearly 9 of 10 glaucoma patients were unable to instil eye drops correctly, and this may be an important cause of unintentional noncompliance in glaucoma medical therapy.

In order to improve their compliance to treatment, patients really need an innovative system to deliver their drops easily into their eyes and limit negative side effects.

That’s why at Nemera we’ve developed a multidose closing tip system which avoids the need for preservatives in the drug and prevents bacterial contamination over the duration of treatment. The system, called Novelia, limits the distribution of liquid to one drop at a time, with a precise and consistent drop size in order to improve patients’ adherence.

The need for preservative-free medicines in the field of ophthalmology has been outlined by the European Medicines Agency (EMA). For instance, the EMA has stated that preservatives should be avoided in patients who are on long-term treatments, or do not tolerate eye drops. It’s believed that by switching from preserved to preservative-free topical ocular medications can diminish the harmful effects caused by preservative.

Novelia has been tested by patients in user evaluations studies which showed that it was their preferred eyedropper. Eyedropper performance is mainly evaluated by in vitro tests, such as the dose variability against shelf life, the sterility of the content and the delivered drop. Despite these important in vitro tests, the usability aspects of the drug delivery system are not fully considered. Therefore, also conducting a user test evaluation is key because, even if it is successful according to the in vitro tests, an eyedropper may not necessarily be appreciated by patients due to poor usability.

During four user studies conducted between 2009 and 2018 Novelia was shown to be the preferred ophthalmic system. The studies contained a total of 230 people including senior users with chronic eye diseases and showed that 43% of patients thought that Novelia would enhance compliance over their current treatment, and that 76% of patients preferred using Novelia.

A digital world

In response to the digitisation of day to day life and considering the low patient adherence in ophthalmic treatments, we’ve developed an electronic add-on in order to assist patients in administrating their treatments. The e-Novelia add-on has been designed to add new functions to Novelia due to limitations of standard mechanical devices. The add-on includes a range of features to assist patients in administering and tracking their medication. By using the add-on, patients are reminded to take their dose and refill their device, are given digital and interactive instructions and are supplied with information about their drug’s expiry date, dosage and batch number. Importantly, the add-on also offers feedback and guide to patients on how to use their device the right way, and will produce tilts, shakes, and buzzes if it detects it is being used wrong.

This new technology will be useful not only for patients, but for the entire industry: healthcare professionals will benefit from the dose tracking analysis and will be able to adjust the treatment; researchers will perform more efficient clinical studies; pharma companies will also use the data collection to launch better performing drugs while payers will be able to check if the patients comply with their prescriptions.

Nemera’s smart eyedropper showcases several electronic features, which could be transferred across multiple device platforms:

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