A low-cost digital adherence engagement tool


99DOTS is a low-cost digital adherence technology built into the Everwell Hub that uses inexpensive packaging (envelopes or stickers) with medication that enables people taking medication to engage with their treatment daily. Providers distribute medication with custom packaging to people taking medications. When someone dispenses a dose, they reveal a hidden number behind perforated flaps on the external envelope; in some cases, the number may be fixed on the outside of the medication blister or pill bottle. This number can be a toll-free number that can be called to register daily adherence, or a code that can be sent by SMS, USSD, or other communication channel. Calling or messaging the number is free! For those taking medication, the Everwell Hub sends reminders and alerts based on engagement, and providers can view daily reported adherence so they can provide differentiated care to those under their care.

Benefits of 99DOTS

  • Affordable - 99DOTS is designed for cost-effectiveness at scale, and only requires access to a basic mobile phone (no smartphone required for users)

  • Scalable - 99DOTS has been scaled to over 250,000 TB-affected people in India, and deployed in 9 other countries

  • Adaptable - 99DOTS is customizable based on disease and context. In some environments we use toll free calling, while in others we leverage SMS. We have deployed with both blister-wrapped envelopes, or stickers affixed to blisters or pill bottles.

  • Accessible - where other prerequisites are met (users daily access to phones living under mobile coverage, staff capacity and training to follow up with non-adherence signals, and appropriate packaging/ supply chain to add the 99DOTS packaging), 99DOTS is acceptable to users across demographics

Please do contact us to support you in getting 99DOTS envelopes. These can be use in conjunction with the Everwell Hub to run an adherence program in your context.