Image by Jacob Dwyer

The ROI on Design for Healthcare

Pillpack vs. Proteus

Doctor as Designer
4 min readJan 5, 2020


I saw this tweet by


I wholeheartedly agree! This tweet reminds me of a post that I wrote back in 2014 focused on design to support medication adherence. I compared two very different products, Pillpack vs. Proteus.

Proteus Digital Health

Here is the current description of the Proteus product from their website:

In 2019, the Washington Post described how the product finally came to market as an FDA-approved medication called Abilify MyCite, a medication for schizophrenia that has been around for years, but was combined with the Proteus digital health system. Uptake of the product was lukewarm for a number of reasons:

  • It’s expensive! The price of the medication is $1,650 a month, 30 times as the cost of the medication alone without the sensors. I am not sure that it’s really a feasible or affordable solution for individuals who might need to take anywhere from 15–20 pills a day, and those other medications haven’t even been approved yet!
  • It’s inconvenient! Who wants to wear a patch on their torso all the time? What a pain in the neck (or torso)!
  • It’s Big Brother! As described by one psychiatrist: “Patients who have a lot of paranoia might be uncomfortable with the idea of a medicine that is transmitting signals. The patient may be afraid to take it.’’ Besides, as I have pointed out earlier, a missed medication dose noticed after the fact doesn’t really address the core problem of how to help a patient take his/her medications.


Then there’s Pillpack, which fixes the parking sign problem of medication adherence:

Pillpack does the hard work for the user, sorting meds into little plastic packets clearly labeled with the date and time.

It also automatically refills and sends the medication to your house once a month in a really nicely designed box, and it has pharmacists available day or night to answer any concerns or questions.


describes how consumer-focused design is a mission of the company through empathy training embedded into new employee training for Pillpack:

Employees were given a timed test: They had to pack dozens of pills into a box, known as a pillminder, while parsing through complicated and sometimes vague instructions in tiny script, like “take one tablet Monday, Wednesday and Friday night, take two tablets Tuesday and Saturday. Skip Sunday.” To add a further challenge, they wore oversized gloves to restrict their mobility and thick prescription glasses to duplicate poor eyesight.

As described by one of the user researchers leading the training:

“We can’t ship a service that meets the physical and emotional needs of our user if we don’t have the empathy at the root of what we do.”

There is a lot of controversy about the ROI on design, but the ultimate fate of the two companies tells a pretty good story about that ROI.

Epilogue for Pillpack

Pillpack was bought by Amazon for just under 1 billion dollars in 2018.

Why did they make this investment? They hinted at this on an earnings call:

“On the earnings call, Amazon told analysts it liked the way Pillpack built up its personalized approach to e-commerce — a trait Amazon values highly.

The company has a really highly differentiated customer experience, and they’ve done a great job getting to the size and scale that they’re at today. We think that, working together with them we can expand on that in the future”

Epilogue for Proteus

“Proteus has struggled to turn its vision into reality and is now desperate for cash after an expected $100 million funding round recently fell through, according to people familiar with the matter. To preserve enough money to stay afloat, the company furloughed the majority of its employees for about two weeks in November, said the people, who asked not to be named because the information is confidential.”

Which product, Proteus or Pillpack, do you think is a more user-centered solution for supporting medication adherence?

I tweet and blog about design, healthcare, and innovation as “Doctor as Designer”. Follow me on Twitter and sign up for my newsletter.

Disclosures: T1D Exchange, Grant funding from Lenovo.

PS. I had a chance to contribute to this NPR podcast about Pillpack and Amazon!



Doctor as Designer

Joyce Lee, MD, MPH, Physician, Designer, ACMIO, #EHR, #learninghealthsystems, #design, #makehealth