PharmExec Blog

Judging a Drug by its Cover: How Packaging Promotes Patient Adherence

Ted Lithgow shot for blogPatient adherence is a chronic issue in healthcare, leading to poor disease management, higher hospitalization rates, and lost revenue for Big Pharma. But one often overlooked facet of the complicated chain of events from R&D to marketing to prescribing may hold the key.

Patient adherence is not a new issue in the industry; still, the statistics are jarring. According to a recent white paper released by the Center for Health Transformation (CHT), the estimated annual cost of patients not taking their medications as prescribed is nearly $290 billion, and “approximately 125,000 Americans die annually (342 people every day) due to poor medication adherence.”

Many factors can contribute to patient adherence, or a lack thereof: ease of use, proper patient education, communication between physicians and patients, refill reminders from pharmacies, co-pay costs—the list goes on and on. But there is one element in the chain from Petri dish to patient—the moment a drug is created until the moment it is administered—that may have more of an impact on adherence than is recognized.

Ted Lithgow, PhD, chief science officer of MeadWestvaco (MWV), a provider of pharmaceutical packaging solutions, makes the case that pharmaceutical packaging can play a role in adherence, and in fact is in a unique position to influence patient behaviors. “Packaging is the only element that we know of that touches every single patient,” he says.

But being in a unique position to exact change is not enough to make it happen. Creative designs, strategies, and ideas must be put in place in order to leverage that power. One common example of packaging that can alter behavior is a blister pack with a calendar, where each pill in a 30-day supply is labeled with a day of the week to help patients remember to take their medications regularly. “The number one reason cited in most studies for why patients don’t take their medication is simple forgetfulness,” says Lithgow.

Packages geared toward specific populations are also key, says Lithgow. For example, senior citizens require packages that are easier to open, without difficult press tabs, while still considering the child-safety element. “We know that ease of access and child safety are critical. A package that is difficult to get into or presents challenges for patients, particularly senior patients, will be an adherence problem,” he explains. “In January of this year, the first baby boomer reached 65 years of age. As more of this grey tsunami hits the healthcare system, we’re going to have to be focused on making certain that those patients can use products easily.”

The result of taking all these issues—and more—into consideration is what Lithgow calls “adherence enhancing packaging,” which can affect adherence not only through ease of use, but also by standing out from the crowd. “We know that the majority of products out there are delivered in amber vials,” says Lithgow. “But amber vials don’t do anything to help patients remember when to take their medication, how much they’ve taken, or that it’s time to renew.”

Though at first glance packaging may seem like a tiny cog in a hugely complicated machine, there is a power and a responsibility that the package manufacturer must learn to accept. “There’s a huge cost element in the industry that never existed before that people really have to attend to,” says Lithgow. “In today’s market, it’s really all about cost management.” Cost concerns come from people living longer and staying on medication longer, new patients coming into the system through healthcare initiatives, and more people taking more medications. And Lithgow recognizes that patient adherence is one extremely effective method of cost containment.

“It’s interesting how brand people and marketers spend so much time thinking about how to reach out and touch the patient directly. Direct mail, advertising, and promotional campaigns are more expensive today than ever.” says Lithgow. “And packaging is one tool in the arsenal that brand managers have, and it’s the one tool that happens to touch every single patient. For my money, I think that’s a great investment.”

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  1. J Hamilton
    Posted February 8, 2011 at 8:50 am | Permalink

    In the “no spin” zone of adherence to prescribed medication regimens, blister or unit dose packaging does have its place. However, to believe that “other” packaging alone can produce improved memory in patients who “simply forget” their med dosings is a rather juvenile “spin” to those in the know. Electronically activated packaging that signals and records a “take” is not catching on quickly (and it has, at least, a positive “spin”. The real problem is a wide spread lack of discipline in self-managing patients who are (A. Sick) and (B. Distracted) from important chores that should be emphasized; like staying healthy. But then, spin is what makes the world go around.

  2. Manfred
    Posted February 10, 2011 at 9:29 am | Permalink

    A well known issue, nicely put in words!
    Packaging is a huge source of additional efficacy, e.g by improved compliance and longer adherence. In times where our molecules still hover around only 20% (oncology) to 75% (analgesics) responder rates we just cannot afford anymore to neglect this topic. However, there is another issue which impacts patient adherence:
    The US has a drug distribution system which was perfectly designed for the nineteenth century but looks like stone age in the twenty first: A patient goes to the pharmacist, drops the prescription. The pharmacist counts individual pills from a bulk into a little box, labels it, packs the box into a paper bag and stores it untill the patient returns. Need less to mention that in many cases the pillcount is wrong, typos are on the label, or the paper bag gets lost. Then the patient returns, picks up the medication and takes it home. Days to weeks later the package inserts arrives by mail, in many cases never! This process is as inefficient as it is prone to serious errors.
    In other countries the patient just drops the prescription and receives the blister pack incuding the package insert immediately, without any waiting time. In the future the prescription will be electronically transferred from the physician to the pharmacy, which will further reduce errors and waiting time. This would be a huge source of efficiency and quality improvement which the US health care system so far has missed to benefit from.

  3. Posted June 3, 2011 at 4:20 am | Permalink

    Give thanks to you information. very easy to guidance am happy I located foundation for a client, and related details.

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