Each year, 500 million patients in India living with chronic conditions like diabetes—to name just one—go without medicines they need because they can’t afford them. After witnessing this first-hand as a volunteer two years ago in a private charitable hospital in Bangalore, observing a child with chronic juvenile diabetes walk away without medication, Shivansh Inamdar also saw an opportunity to make an impact.
The idea: leverage pharmacies’ unsold medicines—ones that have not yet reached expiry but have passed their sell-by date—and get them, free of charge, in the hands of people who need them with the help of secure and transparent technology.
Proposing the mission first to Aditya Siroya, a senior in the Wharton School, and later Artemis Panagopoulou, a senior in the School of Engineering and Applied Science and the College of Arts and Sciences, they combined skills and perspectives to tackle the problem in the best way they could, and submitted an application for the President’s Engagement Prize.
Founded by Penn President Amy Gutmann in 2015, the 2020 President’s Engagement Prize is intended to empower students to design and undertake post-graduation projects that make a positive, lasting difference in the world. Each prize-winning project receives $100,000, as well as a $50,000 per-student living stipend.
“This seems like such a natural solution to this problem,” muses Inamdar, a senior in the School of Engineering and Applied Science, discussing their winning project. “But the status quo has really not allowed the pharmaceutical companies to be looking for a second distribution channel for these medicines.”
Three to five percent of medicines are returned to pharmaceutical companies’ warehouses each year in India and later incinerated upon their expiry, all at a cost of millions of dollars to store and eventually destroy. Which, too, comes at a global price of 1.5-2.6 tons of carbon dioxide emissions per year.
Aarogya, which is interpreted to mean “freedom from disease” in Sanskrit, will solve the problem of medicine wastage by using a tailor-made digital redistribution platform, with a decentralized blockchain system set up for traceability, to bridge the divide between pharmaceutical companies and charitable hospitals.
“Of course, this is an inefficiency in a sense that you have these unused medicines lying idle when they should be used for what they were made for, which is to treat people,” Inamdar says. “We thought this was a relatively easy inefficiency for us to come in and solve. Which, on an individual company level, is quite small, but across the [Indian] health care system is quite significant.”
Siroya adds that it’s a financial problem that seems minor across each company, but adds up to a much larger problem when considered together—with no one able to individually “devote bandwidth to the problem,” he says.
Through a four-month pilot in a small village in Karnataka, they’ve already gotten $6,300 worth of medicines to 900 low-income people and proven Aarogya’s concept. They also established partnerships, toured warehouses, and spoke with doctors, administrators, and, really, anyone who would allow them to learn more about the problem. They will now take what they’ve learned from the pilot and flesh out their platform—which, they emphasize, is more timely than ever in the COVID-19 pandemic, and can be completed without interpersonal interactions.
The platform itself, they further explain, is designed to accommodate systems already in place in the health care system to ensure there are no added barriers or burdens for hospital administrators, doctors, or pharmaceutical companies. Hospitals list medicines they need, the pharmaceutical companies list information about what medications they have, and an algorithm built into the platform matches the two. A strip with a QR code is used to track the shipments at checkpoints and notify involved parties.
“What we’re asking them to do is just have a small additional step of entering their stock in our platform,” says Panagopoulou. “And then at the same time, on the other side, the charitable hospitals can again list what they need, and then we can use some optimization algorithms given some aspects like distance, quantity, and other [variables] that are a typical supply chain optimization problem, to deliver the medicines through the best possible way and get it where it’s needed most.
“It’s essentially matching supply and demand.”
Mark Pauly, the Bendheim Professor of Health Care Management and Business Economics and Public Policy at the Wharton School, has been advising the team on their project, pointing out potential concerns from pharmaceutical companies as they’ve continued negotiations, and has largely been delighted by their enthusiasm and research.
“Their knowledge on the ground is of great value, and they came back [from their pilot] even more thoughtful,” says Pauly. “And I like that this team is multinational as well as multi-school. The University’s idea of making [ideas] actually happen in a real-world setting is on display here and I’m excited about it.”
Aarogya will partner with pharmaceutical companies, a charitable institution, and a charitable hospital to provide access to $1.19 million worth of unused medicines and approximately 12,500 low-income patients per day.
“Now more than ever, it is imperative that we find new ways to get life-sustaining and life-saving medicines into the hands of those who need them most,” says Gutmann. “Aditya, Artemis, and Shivansh are harnessing the power of purpose-driven technology to efficiently and ethically ensure that the right medicines reach the right hands in the right place and at the right time.”