By Sara Miller, NoCamels -
Modern medicine allows people to live longer and better, but with these life-enhancing therapies comes a risk of what clinicians call an adverse drug reaction (ADR) and laymen know as side effects.
This is especially the case with polypharmacy (when patients take five or more drugs at the same time), says Liat Primor, veteran of the pharmaceutical industry and CEO and co-founder of FeelBetter, a startup dedicated to improving outcomes for patients taking multiple medications.
“Sometimes patients have not only one condition, they have plenty – 10 or 15 – and they take so many medications,” Primor tells NoCamels.
“They call them the yellow pills, the blue pills, the purple pills,” she says. “They don’t even know that they have a ‘bad pill’.”
Primor describes a scenario in which a medication causes an unwelcome side effect such as insomnia, which leads a patient’s doctor to prescribe another drug to treat that, which then causes constipation, which again requires another regular course of treatment and so on.
“Instead of changing the first medication, now they have a second medication and a third,” she says.
The situation is exacerbated when a patient sees multiple doctors for multiple conditions, with each physician treating a particular disorder rather than taking a holistic look at a patient’s treatments.
Primor says that 30 percent of elderly people who require hospital treatment do so because of polypharmacy treatments. And the elderly, she explains, make up most of the patients who take multiple medications.
“If you would like [a way] to make sure that a patient is getting better with a combination of medications, it does not exist,” she says.
In fact, a comprehensive, multinational study in 2023 found that 37 percent of the global population are taking five or more medications concurrently, a percentage that rises to 59 percent among those with frail health. The study also warned that clinicians need to take heed of the impact of different medications taken together.
Understanding this need, FeelBetter uses a proprietary AI-powered platform identify patients who will deteriorate due to polypharmacy issues, aiming to help patients respond better to their drug regimen, and, ultimately, stay out of hospital and in their own homes.
When a patient’s data is complex, it is hard for a physician to gain a full picture in the 10 or 15 minutes usually allotted for each person they see, Primor says.
“If someone would actually review their medication and see what happened to them, they could stay safe in their community,” she adds.
Having been placed on her own polypharmacy regimen due to a complicated pregnancy, Primor says that developing the platform became “a quest.”
She wanted to find a way for technology to help physicians and, perhaps more crucially, clinical pharmacists to identify the patients who were in need of this kind of medical attention before they arrived at the ER or were otherwise hospitalized.
Primor left her long-term senior position at Teva, the Israeli multinational pharmaceutical company, to create on FeelBetter’s platform in 2018, alongside a team of clinician and high-tech experts, and with the support of investors including Shoni Health Ventures, Firstime Ventures, and Random Forest VC.
She teamed up with Feelbetter co-founder and COO Yoram Hordan, the former COO of Israeli telecommunications giant Comverse (today known as Xura), who brought the AI and machine learning know-how to the development process.
“We started this journey together, knowing that our dream eventually was to have those Teva and Comverse [skills] in the health domain that we are creating,” she says.
According to Primor, while there are other companies working to reduce ADRs for polypharmacy patients, FeelBetter is the only one both working directly with healthcare providers and examining electronic medical records (EMRs) to uncover potential triggers.
Developing the platform in Israel was more straightforward than in other countries, Primor explains, as Israel has used EMRs for around 20 years. On the other hand, the US, for example, has only had this system in place for the past two or three years.
Furthermore, because Israel has just four health maintenance organizations, patients tend to remain in the same HMO, unlike in the US where a person’s healthcare provider can change regularly, for multiple reasons.
“Israel is a huge advantage for every AI company that needs to have deep data on patients,” she says.
Primor explains that the team started with the concept of identifying adverse drug reactions before they became serious and needed urgent medical attention.
Working with Leumit Healthcare Services, one of the four Israeli HMOs, they examine the current and past medical records of 170,000 anonymous polypharmacy patients to look for signs of deterioration due the combination of drugs that they are taking. When these signs are identified, FeelBetter informs the HMO and it then informs the patients, allowing preventative steps to be taken.
The company has just completed a study with Mass General Brigham, one of the largest medical centers in Boston and the leading US institution for hospital-based research. FeelBetter has offices in Boston, where Primor is based, as well as in Herzliya.
Mass General Brigham validated FeelBetter’s algorithm, Primor says, and even calculated that the platform could save healthcare facilities up to $2,500 per patient by avoiding hospitalization, which would also be down by 24 percent. A peer-reviewed report on the platform is also due to be published next month.
FeelBetter is also expanding its reach, and has just signed an agreement with Atlantic Health System, one of the biggest healthcare providers in New Jersey, with more than 400 locations. Atlantic provides care for more than half of the state as well as parts of New York and Pennsylvania, and FeelBetter’s platform will be available for more than 520,000 beneficiaries via the company’s Accountable Care Organizations.
It has also integrated into one of the largest senior care facilities in the United States, where the American Health Care Association says there are some 30,000 assisted living communities with more than 1 million licensed beds.
Taking a lot of medication requires responsibility, Primor says, on the part of the people and organizations who are trained to prescribe them, to ensure that the regimen is the best possible one for the patient.
“As we all live longer,” she says, “it will become, for each one of us, our responsibility to ask for that.”
