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The Packaging Contribution to Patient Adherence
作者:佚名

Contract packagers are multiplying their product offerings to meet marketing and patient-safety concerns

Perhaps catching the hints that the pharma industry is redoubling efforts in patient compliance, the contract packaging industry has announced a flurry of new designs and product-development initiatives on compliance packaging. This is occurring against a backdrop of a greater focus on effective sampling and starter-kit programs, as the importance of product samples in the sales reps’ bags increases. Under new voluntary PhRMA guidelines (and a spate of state-level bans on gifts and office knickknacks), samples have become practically the exclusive item for reps to offer physicians.
But the bigger issue—with implications for both product marketing and for health outcomes—is the potential for better packaging to improve patient compliance. An investment in compliance packaging pays many returns in more consistent drug consumption, more refills and, ultimately, lower overall healthcare costs. Improved packaging also becomes a competitive feature in how drugs are distributed in various channels, as the impact of, for example, the WalMart compliance package (discussed below) is seen as an element of the company’s widely publicized (and copied) $4/month prescription program.
FIG. 1. MCKESSON COMBINES THE BURGOPAK CARTON WITH ITS OWN LOYALTYSCRIPT CARD.

In the past year, several new programs have been initiated by contract packagers:
  • McKesson, drawing on resources in its McKesson Rx Pak repackaging business, along with McKesson Patient Relationship Solutions (see previous story), has partnered with the U.K.’s BurgoPak to introduce the latter’s “slider pack” to the U.S. market.
  • Colbert Packaging (Lake Forest, IL) has introduced two versions—ComplyPak and AlertPak—of a carton with a blister-packaged inner sheet.
  • Catalent Pharma Solutions (Somerset, NJ) has partnered with One World Design (Warren, NJ) to develop a dial-like container with chambers that can be keyed to days of the week or other time periods to improve adherence.
  • Anderson Packaging (Rockford, IL) kicked off 2008 with Compliance in a Bottle (CIAB), a plastic box with a snap cover for making it difficult for children to open the package, yet convenient for adults to open the package and draw out the blister pack. Last month, it announced an “extended dose” form that can contain multiple blister sheets.
Anderson’s (and others’) compliance packaging are required to meet safety standards set by the Consumer Products Safety Commission, which mandates testing for both “child resistance” and “senior-friendliness;” conventional pharmacy-issued bottles of pills generally meet these with a bottle cap that requires two actions to open (nevertheless, many complain of the difficulty of opening such bottles). The highest CPSC rating is F=1.
Notwithstanding the growth of technology offerings, there is no groundswell for adopting significantly more compliance packaging. A May 2008 pharma packaging study published by the Freedonia Group (Cleveland) projected total demand for unit dose containers and accessories to reach $7.2 billion in 2012, up 6.9% from 2007. Efforts to reduce medication dispensing errors in hospitals and nursing homes are expected to favorably impact sales of blister packs, pouches, strip packs, and liquid medication cups.
Getting at patient issues
“Clinical trials show that a primary cause of patient non-compliance is forgetfulness; they simply get too busy and forget to take their medication,” notes Glenn Grosskopf, VP of product development for Colbert Packaging (Lake Forest, IL). “The problem can be compounded if patients simultaneously take multiple missed dosages, which can be life-threatening,”
Unit-dose packaging (UDP) is seen as a key method for improving patient compliance, what with only around half of patients maintaining their treatment regimen and refills. Blister packs, foil strips and other forms of UDP enable tablets to be coded for day of the week or other time periods to provide easy reminders. “The fact that nearly 50% of all consumers do not take their medications properly translates directly into lost sales for pharmaceutical manufacturers and the pharmacy industry,” observes Peter Mayberry, executive director, Healthcare Compliance Packaging Council (HCPC; Falls Church, VA). “It is not a direct correlation, however, because non-compliance takes many forms and the impacts are different.” HCPC attributes an estimated $100 billion in lost drug sales and more than 300 deaths a day to patients failing to take their medications in the proper dosage or on time.
Adherence packaging has been used for years in short-term therapies or oral contraceptives, antibiotics or corticosteroids. But the healthcare industry is changing, and with it, the use of daily-dose blister packaging is becoming more needed and prevalent, observers say. More people are on medication than ever before, and Medicare’s prescription drug benefit has opened medication to more patients treated for chronic conditions, many of whom are older or on multiple medications, making them more likely to need reminders to take their meds.

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