Coledy

Markets

Where a verified dispense is worth the most

Who pays for a verified dispense, how drugs are screened, and the markets beyond the pharmacy bottle.

01

Drug selection

01.1

Drug Group Framework: Segment, Qualify, Prioritise

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A Repeatable Screen, Not a Fixed List: 24 Drugs to 28

Three stages — what a missed dose costs, four mechanical gates, then whether it is worth tooling.

  1. 1

    Stage 1 · Segment

    By what a missed dose costs, and who therefore pays: A therapy loss (pharma first), B acute event (pharma on patent, plan once generic), C aggregate cost (plan-funded).

  2. 2

    Stage 2 · Qualify — four gates, all must pass

    Form: a tablet, or a non-gelatin capsule. Container: the patient receives the maker's bottle, not a blister wallet. Geometry: one opening size and one shape as the patient titrates and across suppliers. Regimen: chronic or cyclic with a defined plan — not PRN, not split tablets.

  3. 3

    Stage 3 · Prioritise

    A qualified drug is not automatically worth tooling: avoided cost per patient-year, patients on the molecule, who funds and for how long, moulds × sizes, and who signs.

U.S. patient counts: ClinCalc DrugStats (MEPS 2023) where listed, else Coledy sizing. Packaging: FDA NDC Directory. Shape and size: DailyMed. Running the gates is what removed four widely-prescribed specialty drugs from an earlier version of the tables that follow.

01.2

A Dose Is Not Always One Tablet

All 28 regimens read off FDA labelling — and the three things it changed.

Tablets per dose × doses a day, across the 28 therapies
1 tablet × once a day17 · 61%
1 tablet × twice a day5 · 18%
4 tablets × once a day3 · 11%
2 tablets × twice a day2 · 7%
Mixed strengths × once1 · 4%

Simultaneous — served

Several strengths at once, each bottle stable: one device per strength, each sensed and scored on its own, both in one app. Envarsus XR 0.75 / 1 / 4 mg · Lynparza 150 + 100 mg.

Sequential — out

One bottle whose tablet changes shape as the patient titrates. No number of devices fixes it. Jakafi round → oval → capsule · Cabometyx round → triangle → oval.

What the audit did not change twenty-one once-daily and seven twice-daily, confirmed against all 28 labels — the split already published, so no figure moved. What it did change the geometry gate now routes a split dose to a device per bottle instead of rejecting it, and pPDC caps per bottle.

What has not been measured: a four-tablet dose is four separate tilt-and-release actions. Field use so far has been on one-tablet regimens, so whether patience holds across four tilts is untested on five of the highest-value rows.

Regimen is tablets per dose × doses per day, read off FDA labelling for all 28 rows; shares round to 101%. Loading and ramp-up doses are named separately — Brilinta and Plavix load at two and four tablets, Eliquis opens DVT/PE at two, Venclexta ramps on a wallet.

01.3

The Screen Rejects More Than It Accepts

Every gate is run against FDA labelling — here is what failed, and the line that failed it. A list of drugs is a claim; a list of what failed and why is a method.

Out on geometry — the patient crosses shapes

  • Jakafi: starts at 10 mg twice daily and titrates in 5 mg steps — three shapes in normal use
  • Cabometyx: 60 → 40 → 20 mg reduction is routine, and 40 mg is a triangle
  • Xarelto: the DVT / PE course switches 15 mg to 20 mg and starts on a blister

Out on packaging — no bottle to sit on

  • Trikafta: co-packaged blister wallet
  • Ibrance: monthly box of weekly blisters
  • Imbruvica: folded blister cards
  • Verzenio: stored in the original blister

Out on shell — gelatin goes tacky

  • Revlimid · Gilenya · Tecfidera · Hydrea — the exclusion is the shell, not the shape

Kept, with the limit named

  • Venclexta: maintenance only — the four-week ramp-up is a wallet
  • Tagrisso: 80 mg oval, but 40 mg round on dose reduction
  • Keppra: all strengths are scored, so a half tablet is available

Four of five permanent exclusions fail on form or regimen, not geometry. Geometry decides among generics — and there it is usually recoverable, because what fails is that suppliers disagree on shape. The same lines that reject a molecule are the spec a partner can design to.

02

Target drugs

02.1

28 Priority Therapies, Three Groups

Six therapeutic areas, three entry groups — nine, eleven and eight drugs, screened from U.S. prescription data.

Drugs by therapeutic area
Oncology8
Cardiovascular7
CNS & psychiatry6
Infectious disease3
Immunology & transplant2
Metabolic & diabetes2
GroupWhat a failure costsU.S. patientsAreas
A · Therapy lossA therapy forfeited to resistance~0.83MOncology · HIV · PAH
B · Acute eventRelapse and crisis~3.2MCNS · oncology · transplant
C · Aggregate costSmall per patient, enormous in total~51.4MCardiovascular · metabolic

A · Therapy loss — the manufacturer holds it

Oncology, HIV, pulmonary arterial hypertension. A missed dose costs the therapy itself. The payer buys these drugs at $48,000–$200,000 a patient-year, but a day never dispensed is a day never sold — so the maker carries the loss.

B · Acute event — the payer, twice

CNS and psychiatry, transplant, cardiology. A missed dose becomes an event — a relapse, a rejection, an admission. The payer buys the drug and then the admission that follows.

C · Aggregate cost — the payer, and it is scored

Statins, RAS antagonists, oral diabetes agents. No single missed dose matters; the accumulation does. Cheap generics, yet the payer still loses — all three triple-weighted Medicare adherence measures sit here.

Two funding routes, never zero: a manufacturer whose therapy is lost when a dose is missed, or a payer already scored on the measure. A drug with neither is not on this list — that is what the screen tests for, and why the list is 28 and not 2,800.

Counted per drug — a patient treated for three of these appears three times, and carries three devices. Source: ClinCalc, CDC, FDA.

02.2

Group A — Therapy Loss

High-cost therapies where a missed dose lets resistance or progression in. ~0.83M U.S. patients.

DrugIndicationU.S. patientsDrug cost / yrWhat a missed dose does
BiktarvyHIV-1430K$48,000Resistance mutations emerge
DovatoHIV-1180K$45,000Two drugs, less margin for error
XtandiProstate cancer55K$200,000Androgen blockade lapses
NubeqaProstate cancer25K$130,000Androgen blockade lapses
ErleadaProstate cancer30K$140,000Androgen blockade lapses
LynparzaOvarian & breast cancer35K$180,000Maintenance window closes
VenclextaCLL & AML30K$160,000Remission depth erodes
TagrissoNon-small-cell lung cancer30K$165,000EGFR resistance emerges
OpsumitPulmonary arterial hypertension12K$175,000Clinical worsening, then escalation

Why Xtandi is the only branded addition

The 40 mg film-coated tablet is round and holds one shape across 160, 120 and 80 mg — every reduction the label allows. The 40 mg soft-gel capsule ships in the same bottle size and fails on its shell, so the tablet product has to be specified. It also brings a new drug maker; more HIV rows would add patients, not companies.

Checked and out: CDK4/6

One ships in weekly blisters; the other instructs storage in the original blister. Neither reaches the patient in a bottle.

Patients: ClinCalc, CDC, FDA. U.S. basis — generics at CMS NADAC plus dispensing fees, branded at list price. Avoided cost per failure event, from the sources on the next table.

02.3

Group B — Acute Event

A missed dose ends in relapse, admission or a costlier therapy. Mostly generic — paid for by the plan. ~3.2M U.S. patients.

DrugIndicationU.S. patientsDrug cost / yrAvoided costWhat a missed dose does
Aripiprazole (generic)MDD, adjunctive1.26M$1,270$30KRelapse, then admission
KeppraEpilepsy400K$2,000$12KBreakthrough seizure
Olanzapine (generic)Schizophrenia, bipolar379K$1,518$30KRelapse, then admission
RexultiMDD, adjunctive300K$16,000$30KRelapse, then admission
XeljanzRheumatoid arthritis300K$60,000$70KFlare, then a biologic switch
Latuda (generic)Bipolar depression250K$300$30KRelapse, then a switch to an injectable
VemlidyChronic hepatitis B120K$27,500$80KViral rebound, liver injury
Aubagio (generic)Multiple sclerosis60K$850$21KRelapse and accrued disability
Gleevec (generic)CML50K$700$60KMolecular response lost
Abiraterone (generic)Prostate cancer45K$2,400$70KProgression, then next line
Envarsus XRTransplant immunosuppression35K$30,000$95KRejection, then graft loss

Why three generics, and why they sit here

Every molecule that cleanly passes the four gates turns out to be generic — a branded oncology product is packaged for unit-dose control, a long-marketed generic for a pharmacy to count into a vial. Generic means no brand owner paying, and that means plan-funded — which is what Group B is.

Patients: ClinCalc, CDC, FDA. U.S. basis — generics at CMS NADAC plus dispensing fees, branded at list price. Avoided cost per failure event, from the sources on the next table.

02.4

Group C — Small per Patient, Enormous in Total

Cheap, widely used tablets where adherence drives Medicare Star Ratings. ~51M U.S. patients. ★ = Star Ratings measure drug.

DrugIndicationU.S. patientsDrug cost / yrAvoided costWhat a missed dose does
★ LipitorDyslipidemia29.4M$140$33KLDL rebounds, plaque progresses
★ CrestorDyslipidemia11.8M$150$33KLDL rebounds, plaque progresses
EliquisAtrial fibrillation3.5M$6,500$33KStroke risk returns
PlavixAfter a coronary stent1.8M$140$18KStent thrombosis
★ EntrestoChronic heart failure1.5M$7,300$12KHeart failure decompensates
★ RybelsusType 2 diabetes1.5M$12,000$15KGlycaemic drift to complications
★ JanuviaType 2 diabetes1.4M$4,500$15KGlycaemic drift to complications
BrilintaAcute coronary syndrome0.5M$5,000$18KPlatelets reactivate on a twice-daily gap

★ marks drugs that count toward Medicare Star Ratings adherence measures — the reason a payer pays for a low-cost generic.

Patients: ClinCalc, CDC, FDA. U.S. basis — generics at CMS NADAC plus dispensing fees, branded at list price. Avoided cost per failure event, from the sources on the next table.

02.5

Where Each Avoided-Cost Figure Comes From

Avoided cost is what one failure event costs when a dose is missed. Each figure is a published health-economics result — not a Coledy estimate.

Failure eventDrugsAvoided costPublished source
Ischemic stroke, first yearEliquis · Lipitor · Crestor · Plavix$33KMedicare non-valvular AF cohort — incremental first-year cost $32,900
Graft loss, back to dialysisEnvarsus XR$95KUSRDS 2021 — Medicare dialysis payment $87,000–$99,000 per patient-year
Relapse, then admissionRexulti · Latuda · aripiprazole · olanzapine$30KRelapse admissions reported at $20–40K; schizophrenia ~$14,000 a year excess Medicaid cost
Myocardial infarctionPlavix · Brilinta$18KInside CKD pragmatic review (2022 USD) — mean $18,294 per event
Heart-failure admissionEntresto$12KJ Manag Care Spec Pharm 2022;28:157 — mean $11,552
Diabetic complicationJanuvia · Rybelsus$15KJ Med Econ 2014 (2012 USD) — event-year cost $9,041 to $71,714
Relapse in multiple sclerosisAubagio$21KJ Manag Care Spec Pharm 2023 review — a relapsing year costs $4,390–21,345 more
Advanced liver diseaseVemlidy$80KJ Hepatol 2019;70:24 — decompensated cirrhosis $142,870 a year vs $18,619
Breakthrough seizureKeppra$12KEpilepsy Behav 2015;51:40 — $14,491 vs $3,215 in matched controls, six months
Step-up to a costlier therapyXeljanz$70KAnnual cost of the injectable biologic the patient moves onto

Drug cost on an acquisition basis: CMS NADAC per unit × 365 plus twelve dispensing fees for generics; list price for branded rows. Aubagio uses median generic WAC.

03

Therapy areas

03.1

Real-Time Evidence to Stop Controlled Drug Diversion

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Legacy tracking stops at the pharmacy counter. Coledy verifies the dose after it — at the dose level.

14.4Mpeople misuse controlled drugs in the U.S. each year
8.9Mopioid misuse — 62% of the total
80,000+opioid overdose deaths a year
StepLegacy trackingWith a verified dispense record
1 · PrescriptionCovered (EMR)Covered
2 · PickupCovered (claims)Covered
3 · Dose eventBlind spotVerified in real time

Coledy layer: GPS verification + single-tablet log turn the untraceable dose event into settlement-grade evidence.

Regulatory A top-priority issue for the DEA; FDA imposes REMS obligations on pharma — a clear, mandated payer.

Traction: early interest from government / regulators at U.S. expos (pre-pilot, not yet executed). Source: CDC WONDER & SAMHSA (2024–2025 basis).

03.2

Obesity Therapy: Capturing the Oral GLP-1 Market

Two approved pills in fifteen months and a phase 3 field behind them. Every one of them is a tablet in a bottle.

Approved

  • Novo · Wegovy pill — oral semaglutide, Dec 2025
  • Lilly · Foundayo — orforglipron, Apr 2026

Phase 3

  • AstraZeneca · elecoglipron — phase 2b met, phase 3 from 2026
  • Viking · VK2735 oral — phase 3 planned Q4 2026

Phase 2

  • Structure · aleniglipron — phase 3 planned 2H 2026
  • Roche, Novo amycretin and others — oral programmes in trials

Tablet, not capsule

Compressed tablets carry the dose and the absorption enhancer in a smaller pill.

Daily, at home, for years

No clinic visit records the dose. Persistence is the whole variable.

Qualified by form, not brand

An oral obesity drug is screened the same way as any other.

The moisture cap is a part, not a barrier. Oral semaglutide keeps its drying agent in the cap. On a round bottle the Coledy build is an add-on closed by a single child-resistant cap of Coledy's design — so the desiccant and the seal are part of that design. Not yet demonstrated: equivalent moisture performance.

Approvals: FDA. Phase status as most recently reported by each company. Not in the financial model — this widens an existing route, it does not add a forecast line.

04

Data & AI

04.1

Healthcare AI: Ground-Truth Adherence Data

A predictor measured with error drags its own coefficient toward zero — and adherence is measured with error everywhere.

The same relationship, measured without error (left) and with error (right). Simulated at λ = 0.60, fixed seed — the fitted slope falls to 0.61.
The same relationship, measured without error (left) and with error (right). Simulated at λ = 0.60, fixed seed — the fitted slope falls to 0.61.
Reliability λ0.90.80.70.60.5
True effect ÷ published1.11×1.25×1.43×1.67×2.00×

β_obs = λ · β_true, λ = σ²ₓ / (σ²ₓ + σ²ᵤ) < 1 always. Sensitivity, not a point estimate — no published λ exists for claims-based PDC.

Statistics room

Cite attenuation — the effect is understated.

Data-science room

Cite label noise — a lower ceiling and a bigger data bill.

Either room

The fix is a better label, not a better model.

A verified dispense raises λ on the adherence variable toward 1. That does not make a model smarter — it removes the attenuation that was hiding the effect. This holds for non-differential error; the systematic over-reporting in self-report shifts the mean and needs separate treatment.

Spearman, Am J Psychol 1904 (correction for attenuation); Carroll, Ruppert, Stefanski & Crainiceanu, Measurement Error in Nonlinear Models, 2nd ed., 2006; Frénay & Verleysen, IEEE Trans Neural Netw Learn Syst 25(5), 2014.

04.2

Healthcare AI Trains on Inferred Adherence, Not Verified

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A fill, an opening and a memory are all inferences — a verified dose never reaches the model.

Labelled dose observations — one patient, one year, once daily
Pharmacy claims — one record per fill12
Patient self-report12
Cap sensor — an opening, not a tablet365 · 0 verified tablets
Coledy STPV — a tablet leaving the bottle365 verified

Claims record a purchase, cap sensors record an opening, apps record a memory. The valve records a tablet leaving the bottle, at a timestamp.

Classical attenuation: a predictor measured with error biases its own coefficient toward zero. Every published adherence–outcome estimate is therefore a floor, not a ceiling.

Value Every adherence model in the field trains on an estimate of the variable it is trying to predict. Coledy produces the measured value — for Coledy's models and for a partner’s.

04.3

Predictive Value from Adherence Data

Precision dispense data fused with partners' lifelog signals is designed to train models that predict risk and generate real-world evidence.

  1. 1

    Data fusion

    Fuse verified pPDC with partners' lifelog data — fill the clinical-data gap with high-resolution behaviour.

  2. 2

    Model development

    Learn individual patterns to flag adherence drop-off risk; use adherence–biomarker correlations to predict complications.

  3. 3

    AI on adherence

    Analysis on measured adherence strengthens clinical development and regulatory readiness.

Not in the forecast — no data-licensing contract exists.

04.4

Digital Health Networks: Daily Social Network Engagement

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Platforms Bring Reach; Coledy Brings a Verified Dispense Record

A scheduled, device-triggered event every day — engagement the platform does not have to manufacture.

  • A daily reason to open the app
  • A care circle worth subscribing for
  • Health content it can stand behind

Consent first Anything shared beyond the patient — a carer, a circle, a feed — is opt-in per recipient and revocable. Adherence is health data, not a status post.

Illustrative partner-app mock — the 95% and the battery level are not measured.
Illustrative partner-app mock — the 95% and the battery level are not measured.

04.5

Supplements Claim Efficacy With No Proof of Dosing

Four categories sold on a dosing regimen — and none can show the regimen was followed.

Blood pressure

Daily · same time

Consistent dosing maximises the reduction; irregular dosing raises cardiovascular risk.

Glucose

Twice daily · with meals

Strict pre- or post-meal timing; irregular dosing causes spikes and control failure.

Weight management

Daily · steady level

A steady blood level is required; missed doses cut the effect.

NAD+ / longevity

Daily · no gaps

Long-term use maintains levels; stopping erases the gains.

Regimens are the manufacturers' own label directions. A verified record that the regimen was dispensed is the missing half.

05

Channels

05.1

The Channel That Needs No Market Entry

An interventional trial supplies its own bottles — so the dispensing format of the country the patient lives in does not apply.

$180Bof the $300B+ a year is direct trial cash waste — Phase II/III programmes abandoned to statistical noise and adherence failure

Non-adherence inflates σ, not the effect

A subject who misses doses does not weaken the drug — they widen the variance around it. The trial then needs more subjects, or reports a false negative.

The expensive failure is finding out late

A non-adherent subject identified in week two can be replaced. The same subject identified at database lock has consumed a full arm of cost and cannot be replaced at all.

The container gate is a retail constraint

Around 85% of oral solids dispensed in Europe are blistered, and press-through packs are standard in Japan. A drug maker running a trial ships investigational supply in whatever container the protocol specifies.

The buyer is clinical development

A different budget, decision-maker and contract from the commercial channel. One signature at headquarters covers every site in the study.

Korean and Japanese drug makers are a near market

In a retail argument Korea is small. Here the contract is signed at a headquarters within reach, and the sites can be anywhere.

R&D waste figures: Tufts CSDD and Watanabe (2018). A post-authorisation study on a marketed drug is different — the patient collects an ordinary pack, so that half needs the valve-less Universal build and a bottle market. No clinical contract has been signed.

05.2

Connected-Care Infrastructure for B2B & B2G

The dose-data layer scales — from the individual to community care to smart cities.

Government (B2G)

Chronic-disease management reimbursement

Municipal (B2G)

Senior-living safety-care programmes

Payers

Value-based health-data payments

Providers

Adherence-monitoring protocols

Pharma

Clinical and RWE data services

Construction (B2B)

Healthcare wall-pad systems

Data flow: individual › community › urban infrastructure › policy. Multi-sector B2B & B2G value creation across pharma R&D, clinical data, and global platform expansion.

Illustrative — no counterparty approached.

05.3

Seven B2B Channels, and How Each One Signs

The go-to-market plan targets seven B2B channels across pharmacies, hospitals, distributors and digital platforms.

These are target channels for the go-to-market plan. None is contracted today — Coledy intends to sell into them; it does not already operate them.

Inquiries

For licensing, partnership or investment inquiries, please write to the address for your area.

Partnering & licensing
partnering at coledy dot com
Investment & strategic
investors at coledy dot com