Refills Architecture for AspyreRx
Designing a scaleable prescription refill experience for a first-of-its-kind prescription digital therapeutic
Year: 2023 – 2024
Client: Better Therapeutics
Role: Product Manager
Product: BT-001 / “AspyreRx” — FDA-cleared prescription digital therapeutic (PDT) for Type 2 Diabetes
Scope: Architecture redesign, XFN alignment, phased development, FDA/QMS documentation
This case study demonstrates my ability to lead complex architectural decisions in a regulated environment, drive cross-functional alignment across clinical, engineering, and commercial teams, and translate ambiguous product challenges into a phased, executable plan with real commercial stakes.
BACKGROUND
Better Therapeutics developed BT-001 (commercially branded as “AspyreRx”), an FDA-cleared prescription digital therapeutic (PDT) that delivers a novel form of cognitive behavioral therapy (CBT) to help patients with type 2 diabetes improve glycemic control under physician guidance. Unlike a traditional pill or device, AspyreRx is software — the “prescription” is treatment access delivered through a mobile app.
Ahead of commercial launch, the existing product architecture had a critical limitation: it was purpose-built for clinical trials. Patients received a single, continuous block of treatment days, and once that block expired, access ended with no path to renew.
For a commercialized product that would require ongoing physician prescribing, insurance adjudication, and repeatable 90-day treatment cycles, this architecture was a dead end.
THE CHALLENGE
The core challenge was deceptively complex: the product needed to support an initial prescription dispense and any number of subsequent refills — while delivering a seamless patient experience regardless of when a new prescription was picked up, how long the gap between cycles was, or what state the patient’s data was in.
Core tension
The app’s entire feature logic — progress graphs, content sequencing, goal-setting, behavioral nudges — was architected around a single, uninterrupted, continuous count of treatment days. Refills would break every one of those assumptions.