TB Adherence Survey and Fact Base Development
We developed a comprehensive adherence fact base regarding TB and TB/HIV co-infection in India, China, and Sub-Saharan Africa. Using structured, insights-oriented interviews with patients, providers, disease state experts, and other key stakeholders, we assembled at a practical and actionable level of detail the key facts around five questions:
- How relatively important is adherence in TB– what level of non-adherence affects health outcomes?
- What is baseline adherence?
- What are the causes of poor adherence?
- What adherence interventions are available or needed? What is their demonstrated/comparative effectiveness? What is their scalability?
- What would be the impact (health outcomes and cost-effectiveness) of a systematic, scalable way to positively impact TB medication adherence?
This fact base served as critical input in our client’s development of a comprehensive strategy to modernize TB delivery in resource-limited settings.
TB Medication Adherence Devices
Under a grant from the Bill & Melinda Gates Foundation, we serve as global project lead for the development, manufacture, testing, and deployment at scale of a highly accurate, highly affordable, TB blister compatible medication adherence device to improve patient medication self-administration and to enable and inform differentiated care for TB and TB/HIV patients in India, sub-Saharan Africa, and China. Our work includes working with other grantees and public health organizations to plan and implement pragmatic trials and demonstrations of these medication adherence devices in China, India, and South Africa to support global scale up of these devices and thus support the broad implementation of proven effective adherence interventions based on detailed, patient-specific dosing histories.
Global Supply Chain Assistance
Leveraging our extensive experience in pharmaceutical supply chain and in printing and packaging, we assisted grantees of the Bill & Melinda Gates Foundation in their efforts to develop and manufacture using existing equipment and processes highly cost-effective “dose instructive” blisters to address at scale the challenge of patient confusion regarding dosing of TB medications. We also worked with this grantee to identify sources of supply for pharmaceutical “envelopes” requiring unique digital printing and die-cutting capability and expertise.
We serve as advisers to Novartis’ newly formed global initiative, The Digital Acceleration Lab. In this capacity, we help (i) identify unmet patient and health system needs on a disease state specific basis, and (ii) identify technologies or digital solutions that can address these needs, enhance patient care, and improve health outcomes.