New Zealand-based smart inhaler company Adherium, which up until now has distributed its products via pharma sales channels in Europe and Australia, plans to expand into the United States in the first half of 2018 with a direct-to-consumer (and direct-to-payer) strategy.

“We’ve had a great relationship over the last couple of years with AstraZeneca, we’ve launched in a couple dozen countries now in Europe and Australia, but we don’t want that to be the only channel for our technology to get into the marketplace,” CEO Arik Anderson, who took over the post in June, told MobiHealthNews. “Specifically, we’re opening up a direct-to-consumer channel in the US and we’ll be launching that in the first half of 2018, and a direct-to-payer channel as we work with insurance companies and with pharmacies on being able to go and get our adherence solutions into the hands of patients where it will dramatically improve their lives.”

Adherium makes an adherence platform for asthma and COPD called Smartinhaler, which consists of a sensor on the inhaler and an app that makes data from that sensor available to patients, parents, caregivers, or a clinical team. In addition, the inhaler can be set to remind patients to use it by lighting up, making a sound, or vibrating. The inhaler can also help clinicians pinpoint when and how someone is misusing an inhaler, for instance holding it upside down or inhaling at the wrong time.

Anderson says the company is taking inspiration from successful direct-to-consumer products, both connected (like AliveCor’s smartphone-connected ECG Kardia) and non-connected (Mylan’s EPI-pen).

“As we look at the asthma population or the asthma and COPD population, we recognize that there are key segments of that population that are great candidates for direct to consumer,” Anderson said. “Specifically in the pediatric population, kids between the ages of about 5 and 17 whose parents remember last Saturday when their son or daughter was having an asthma attack, couldn’t breathe, and they put them in the car at 10 p.m. and drove them to the emergency room where they got a breathing treatment. They finally got relief, but it was horrible for the whole family.”

In addition to parents looking for help for their children, Anderson also sees a market for grown children looking for help for their parents.

“On the other end of the patient spectrum we look at the COPD patient, someone like my mother perhaps, still lives independently but needs to use an inhaler to help control her COPD,” he said. “But I’m worried, living a thousand miles away from my mother, that she’s forgetting. And I have no way to help manage that situation, until Adherium provides a solution where now on my smartphone from 1,000 miles away I can look to make sure my mother used her inhaler this afternoon. And if she didn’t, I can call her friend who checks in on her and make sure everything’s ok and that she’s using her inhaler.”

Anderson said the company is looking at a subscription pricing model in the area of $10 per month.

Entry into the US market potentially puts Adherium in direct competition with companies like Propeller Health and Cohero Health. But Anderson isn’t worried about a relatively small number of companies, given the size of the addressable market.

“There are about 25 million asthmatics in the US, another 15 million with severe to moderate COPD that would dramatically benefit from adherence technology,” he said. “We’re talking about 40 million patients that are potential targets. The US market is huge. And we’ve got a handful of companies that are looking at going and demonstrating how adherence can change that outcome. Frankly it’s good for all of us that there are multiple companies involved in that.”

Adherium recently opened up an office in San Mateo, California, and has hired a new head of marketing, Vik Panda, and a new VP of Sales, Tim Houchin. Anderson says in addition to direct-to-consumer efforts by Adherium, AstraZeneca intends to start marketing its respiratory adherence offering, which uses Adherium technology, in the United States some time this year. That leaves one other major channel on the company’s radar.

“We recognize there’s definitely a channel with direct to consumer, but the real economics, when I talk about adherence over all impacting the US healthcare system upwards of $300 billion a year or respiratory nonadherence costing the $34 billion a year, the groups that are paying that money are the insurance companies,” Anderson said. “Economically, they have the most to gain by improving adherence.”