Innovative prescription bottle cap helps patients monitor drug use

CVS is now selling a device that may help fight opioid abuse as well as aid other customers in keeping up with their medication schedule. According to the manager of the College Street location in Beaumont, in May, the CVS store began offering TimerCaps, which incorporate an LCD timer that tells a patient how long it has been since they last took their medication.
The device, which is built into a pill bottle cap, counts the hours and minutes since a medication was last taken like a stopwatch. Every time a patient opens and closes the cap to take their medication, the timer automatically resets itself and begins counting anew.
The package CVS sells includes a large cap and two standard sized caps for $10.29. It is also available at Rite Aid. According to the package, there are no buttons to press or alarms to program. The caps can be especially helpful for those who are monitoring meds for pets or parents, and especially when the patient needs to take several prescriptions.
Larry Twersky, CEO of TimerCap, the California manufacturer of the product, told Vital Signs he hopes his product will help fight opioid abuse. Twersky, who mentioned his late mother’s addiction to opioids as an inspiration, said he wants to make caps like TimerCap and other tools mandatory with all opiate prescriptions. Twersky visited the Food and Drug Administration and the Centers for Disease Control in May to discuss the idea with the agencies’ leaders.
“They discussed that it was not even on their radar, but that packaging was an issue,” Twersky said. “Today, opioids are packaged in a child resistant cap, which was created in 1970 to keep children 5 and under out. It was never intended to manage the issue for the 6-26 year olds having prevention issues.”


How can the TimerCap help fight opioid addiction?

“If you’re taking a medication like a painkiller, which you’re supposed to take every four hours, it’s going to count up to every four hours so you know to take it, and taking it any shorter than that could maybe lead to an addiction,” Twersky said. “If you’re taking a chronic med once a day and you forget whether you took it because your travel schedule changed or something, you have the ability to look at it and see whether you took it in the past 24 hours.”
Although Twersky said while he is unsure whether the FDA will require devices such as TimerCap’s on opioid bottles, more attention brought to the subject may pressure the agency to make some much-needed changes.
“We know that certain doctors are overprescribing certain opioids,” he said. “We know that there are opioid naïve patients, and they are not being vigilant in protecting them.”
In addition to the device helping patients monitor their own usage, the TimerCap can also help them tell if someone has been using their medications.
“The timer restarts if somebody has been in your medication,” Twersky said. “You definitely can see the last time somebody has been in it to the exact minute.”
Although the device helps patients monitor their usage, it doesn’t lock them out of the bottle, Twersky points out.
“They just inform as a initial level of safety for the patient and family,” he said. “Most medication, by the design of the pharmacy, is to dispense pills free form in a bottle and (locking) would overly complicate the process. To lock a bottle, it would need to have a pill restrictor, so only one pill at a time could be dispensed, but there would be a problem if the prescription said take one or two at a time. It would need to know what the duration in between would be for locking. It would need to be programed and set up and training would be needed by the pharmacist and patient.”

Twersky suggests three points of safety to help patients prevent opioid abuse:

1. Use a device like TimerCap to
measure usage to avoid accidental
2. Monitor use to avoid DUI fatalities.
3. Manage drugs in their original
He also suggests three points for family and household safety when opioids are in the home:
1. Detect unwanted openings with
a device like TimerCap.
2. Deter theft of medication.
3. Always dispose safely of
unneeded medication.

In addition to selling Twersky’s TimerCap product to help patients monitor their use of opioids, Troyen A. Brennan, M.D., executive vice president and chief medical officer of CVS Health, said the company is working to halt the prescription drug abuse epidemic through advocacy and action at the local, state and national level.
“As the largest U.S. pharmacy company and as an employer of 26,000 pharmacists and nurse practitioners, CVS Health is uniquely positioned to play a role in helping to end the prescription drug epidemic,” Brennan writes on the CVS website. “The size of our customer base, combined with our national computer network, make us ideal partners in efforts to reduce prescription drug abuse.”
CVS Health has also been able to identify physicians and prescribers who have exhibited extreme patterns of prescribing “high risk drugs,” the company reports.
“By studying their volume and share of prescriptions for high-risk drugs versus other providers in the same specialty and geographic region, as well as the ages of patients and their payment methods, the program identified 42 outlying prescribers. Those prescribes were then asked to provide additional information about their prescribing habits. Of these, only six identified legitimate reasons for their unusual prescribing practices,” Brennan said. CVS Health suspended controlled substance dispensing through CVS Pharmacy stores and mail service pharmacies for prescriptions written by the other 36 providers.
The company is also working at the federal and state level to implement policy changes to curb prescription drug abuse. CVS’s recommendations include:
• Mandatory utilization of Prescription Drug Monitoring Program (PDMP) data at the point of prescribing would require prescribers to review the patient’s pharmacy prescription history, showing the prescriber whether the patient is doctor shopping (utilizing more than one prescriber to obtain controlled substance prescriptions). Based on these insights, the prescriber can discuss the issue with the patient and halt inappropriate use. Forty-nine states have operational PDMPs.
• PDMP data pushed directly to the prescriber’s e-prescribing device would make the prescription-writing process more efficient and accurate at the doctor’s office. Prescribers instantly have the patient history before deciding whether the medication is for a legitimate medical purpose.
• PDMP interoperability across state lines would allow prescribers full visibility into patient prescription fill patterns and reduce or eliminate doctor and pharmacy shopping that occurs across state lines. PDMPs can currently share data across state lines in 22 of the 49 programs.
• E-prescribing for controlled substances is a tactic that has proven to be effective in reducing drug diversion and fraud.
• Daily PDMP data submission from pharmacies to the state database will ensure that each database is accurate and encourage use by reducing lag time between updates.
“Prescription drug abuse in this country may be an epidemic, but it doesn’t have to be,” Brennan said. “Government measures, on the local, state and federal levels, may begin to help put an end to this crisis. And the private sector can also do its part. With the help of policymakers and regulators, we’re committed to advancing legislation, promoting technology and creating safer communities.”

Photo courtesy of CVS - The CVS College Street location in Beaumont began selling TimerCaps in May. The device incorporates a built-in LCD timer that tells a patient how long it has been since they last took their medication.