Electronic compliance monitoring (ECM) uses technology embedded in packaging to record patient dosing history electronically. ECM provides more accurate dosing data than patient self-reports. ECM data can help determine who is a non-responder versus a non-complier, and better assess effective and maximum tolerated doses. Planning for ECM should start early to allow for additional logistical and regulatory steps. Major ECM solution providers include Aardex, IMC, MWV, and Stora Enso.