Espoo, Finland-based Popit, maker of a smart pill tracker, has revealed this month that it is teaming up with Swiss pharma giant Novartis in an initiative aiming to improve patients' adherence to medication. The announcement follows the startup's work with Pfizer to support patients receiving treatment for rheumatoid arthritis.

Last week, at Slush, MobiHealthNews sat down with Popit cofounder and chief operating officer Timo Heikkilä to find out more about the new projects.

This interview has been edited for length and clarity.

MobiHealthNews: After working for Samsung Electronics as a technology scout, and also for Nokia, why did you decide to make the move to health tech with the founding of Popit?

Heikkilä: I’ve always been interested in health tech, I don’t exactly know why, but I find it really fascinating that you’re able to track your body and then what you do, you’re able to quantify yourself, so that has always been really, really interesting for me. But why I moved from the mobile companies to a startup is that I wanted to first of all do something that has an impact, and something that I can say that I have created. But, also, with Samsung and Nokia we were looking quite a lot into health technologies at the time, so I have been following it quite closely and looking at the trends and the technologies from a vantage point I guess you could say. I had a pretty good idea about what is happening in the health space, and we came up with this idea, so we figured that this is actually the right time to start executing it and here we are.

MobiHealthNews: And how did the idea come about, how did you meet your cofounders?

Heikkilä: We are actually friends from past, and we sat down one time when we were just kind of having like a get-together. One of our cofounders, he is an orthopaedic surgeon, and he was complaining that patients are coming back after surgery and they have not healed properly, so he has to do another operation, and it looks like they didn’t take the anticoagulants, they didn’t take the antibiotics that he had prescribed, and, as a result, they didn’t heal properly, and then he had to do another operation. And of course, in Finland, as in many European countries, healthcare is provided by the government to a large degree, so that is a very expensive operation when they again come for surgery and the outcome of that surgery is going to be worse than if they would have been compliant in the first place.

So we started to think about how it would be possible to then somehow monitor if the patient has taken the medication. We figured that a majority of solid drugs come in the ubiquitous blister pack, and we came up with a way to quantify that, so measurable variables from the blister, if you so will, so that if you move it around, you touch the blister, all of these can be measured and then [there is] also a variable you can measure when taking out the medication.

That was the birth of the innovation and then we built a prototype and then we got quite quickly traction from pharma. One of the reasons is because we don’t require any changes to the packaging. But it is not really actually about a piece of hardware, it is not even about the app, going forward it is about having an understanding of how the patient has been taking medications, having a real-time understanding of that and then being able to also intervene and really just about moving the medication into the digital era.

MobiHealthNews: You say that you got quite quickly traction with pharma. What can you tell us about that?

Heikkilä: When we had a product, we were already contacting some pharma companies and we, I don’t want to name any companies, but we had some contacts in the Nordics, so we were able to gauge their feedback and see how they responded and there was a lot of interest, I think one of the areas is in clinical trials. A lot of interest grew from that perspective that you would be able to use the solution for clinical trials, because the golden standard, as I hear, is pen and paper right now, so it is a really nascent area where you can actually provide new technologies for the benefit of the patient, but then also for the company that is doing the study.

MobiHealthNews: On your website, you mention findings from a pilot study that you carried out with a university hospital in Finland, which showed a significant improvement in adherence to medication by using the Popit device, was it 80%? [Clarification: The Popit device and app were used in a study of 24 women taking birth control pills, conducted in collaboration with Kuopio University Hospital. In the first month, the device was used to track pill consumption. It found that 11 women forgot to take one or more pills during this time. In the second month, when participants started receiving reminders through the app, only two forgot to take one or more pills. The study can be found here.]

Heikkilä: So, we were actually able to reduce missed pills by over 80%. Adherence calculation is always a bit of a minefield, I would say, because it’s not necessarily that straightforward, but we were able to reduce missed pills and also get the patient to become more consistent with their medication taking, so the time window [during which participants took the pills] became smaller. This was a study that we did together with one of the university hospitals here in Finland, but now we are recruiting for two additional studies at the same time. One is for oral anticoagulants and the other one is for Type 2 diabetes medication. We are looking to now do longer-term studies.

MobiHealthNews: And is this only in Finland?

Heikkilä: There is interest actually globally right now, so we have been in discussions from Australia all the way to the US, certain organisations. Right now we have ongoing only our own studies, but we have had discussions about starting a few studies in the, not the clinical trial space, [but] in researching adherence.

MobiHealthNews: Let’s turn to the collaboration with Novartis, which you recently announced. What does it involve, and what does it mean for Popit?

Heikkilä: We are supporting Novartis medications in the neurology space, and we already have some collaborations ongoing in certain European countries. For Popit, it obviously means that we signed yet another agreement with a major pharma company. We already had an existing collaboration with Pfizer, and now with Novartis it’s a global agreement, and we will be also then expanding together with Novartis within the neurology space in 2020. For us, as a small startup, that’s a huge advancement, and I think we have several interesting customers also in the pipeline, so [we] hope to be able to release those in Q1 and Q2 of 2020.

MobiHealthNews: This is interesting because pharma is known to be a heavily-regulated industry that moves at a slow pace, particularly compared to the world of technology. With more and more partnerships like the ones you have with Novartis and Pfizer emerging, do you think signs point to changes?

Heikkilä: Our thesis is that the pharmaceutical product will become the centre of a service ecosystem. So, that pharmaceutical companies going forward will increasingly be providing services to complement their drugs. And I think one of the reasons is of course that patients are starting to expect such services. It’s starting to become unacceptable that you just get a product and that’s it, so I think also the pharmaceutical industry is moving in that direction, in our opinion, that the actual product will need to be complemented by supportive services. I think there is quite a lot of innovation in the pharma space, so they are looking into adding innovative tools for patients. I would say, even though it’s a traditional industry, there’s a lot of innovation, but of course there’s a lot of inertia also in the industry. But I think we are on the brink of a new era.

MobiHealthNews: Speaking about your collaboration with Pfizer, could you give us an update on how that has been developing since the announcement in June?

Heikkilä: We have been rolling out in several markets together with Pfizer now, and we are also looking into expanding geographically and also to possibly, how should I say, we are looking into expanding. Nothing official yet.

MobiHealthNews: Now, what is next for Popit?

Heikkilä: We are raising €3m to grow so that we are able to expand and scale up and also to be able to start collaborations with new pharmaceutical companies. As a company, we are looking to make medication connected. Our key focus right now is to be able to secure the investment so that we are also able to be serve our customers better.

Editor's note, 27 November: A change in wording has been made to this piece post-publication to clarify the speaker's intent.