An Ingenious Approach to Drug Compliance

Some ideas are just so great I am left in awe.

Photo: Christopher Harting

As Emily Singer writes in Technology Review that drug-resistant tuberculosis is an important problem, especially in poor countries. After you get TB, you are supposed to take antibiotics for six months to prevent drug-resistant strains of TB from arising. The problem, however, is that the antibiotics have side effects, and there is little private benefit to the person taking the drugs. So there is little incentive to take the full treatment of medication.
So how do you solve this problem? To an economist, the obvious approach is to give the patient strong incentives to take the drugs even after they feel better. The difficulty lies in monitoring whether the patient is actually taking the drugs.
That is where the brilliance of science takes over. Jose Gomez-Marquez, program director for the Innovations in International Health program at M.I.T., along with his colleagues there, came up with an ingenious solution.
They “figured out a simple paper-based test that detects metabolites of the TB drug in urine.” So if you take the drug and pee on a special piece of paper, a secret message appears. If you don’t take the drug, you can pee on it all you want, but it will not reveal the secret message. Every time the drug taker texts the secret message to the people in charge, he earns a prize, like cell phone minutes or cash.
It’s the perfect marriage of science and economics.