How pharma packaging can improve

Despite decades of effort to design pharmaceutical packaging that helps people take the right dose of the right medication at the right time, non-adherence remains a serious and far-reaching problem. Rich Quelch, Global Head of Marketing of Origin, a global pharma packaging and supply chain specialist, explains how the latest technologies and methods are being employed to help solve this pressing issue.

hoW PhaRma PaCKaGInG Can ImPRovE PaTIEnT ComPLIanCE

Research suggests around half of patients who are prescribed medication don’t comply with recommended adherence advice in some way.

Non-compliance can take many forms. It could be forgetting to take a dose, refusing medicine due to off-putting side effects, taking incorrect amounts or not requesting a repeat prescription. Whatever the circumstance, patients are suffering because they’re not taking a prescribed medicine correctly or at all and, in the process, excessive amounts of medicine are being wasted.

In the EU, 200,000 people die each year as a result of failing to follow medication advice properly. In economic terms, this costs the EU €1.25 billion and the NHS £500 million every year, putting additional financial strain on healthcare systems. Pharma packaging innovation plays an important role in boosting patient compliance and improving health outcomes.

Intelligent blister packs

The use of blister packaging for solid dose medication is widespread, and this form of delivery system is a core focus for innovators looking to boost compliance and enable adherence monitoring.

‘Smart’ blister packs are becoming increasingly popular, featuring an incorporated microchip which captures use-related data to monitor when a medicine is being taken and remind patients when the next dose is due. They can also provide warnings when the expiry date is nearing, if storage conditions aren’t safe or the packaging has been tampered with.

Intelligent blister packs empower pharmacists and healthcare professionals caring for the patient by giving them access to the patients’ medicine-taking behaviours at home. This valuable information can then be used to get to the root cause of non-adherence and address any behavioural issues head-on in a way that hasn’t been possible before.

Another good example of innovation in this area is smart wireless pill bottles used primarily for the treatment of cancer. Each bottle incorporates a wireless cellular chip and sensors which collect real-time adherence data such as when the bottle is opened and reclosed. In

the case of a missed dose, the system sends an automated alert via text to the patient, caregiver or pharmacist.

Despite the promise of smart packaging in boosting patient compliance, there’s still a lower market adoption than you’d expect due to the initial cost of developing such technologies which is ultimately pinching heavily-guarded profit margins.

Part of the answer to lowering costs and promoting accurate data collection could be to use smart packaging during clinical trials, in turn increasing commercial application and ROI by adding value to stakeholders, patients and pharma manufacturers.

eliminating contaminants

Big pharma is investing heavily in biologics to have prime mover advantage in a market forecast to be worth nearly $480bn by 2024.

This all sounds extremely promising, but the rapid rise of biologics and biosimilars has thrown up huge challenges for the delivery of safe and effective products.

By their nature, therapeutic proteins are very different from traditional small-molecule medicines because their function depends on their molecular shape and structure. They’re also very sensitive to contaminants such as metal ions found in tradition packaging materials like glass, plastics and rubber.

There is a growing interest in wearable injectors (or on-body delivery devices) to meet the challenge of reducing contamination and improving patient experience. The most advanced on-body systems are helping to improve compliance by administering larges doses of medicine over a preset delivery period, helping to avoid site leakage, local intolerability and injection pain.

Patient self-administration of subcutaneous injections is a much cheaper method than intra-veneous (IV) infusion in a hospital. In addition, the patient’s quality of life is greatly improved as they can receive their life-saving treatments with ease and comfort at home.

Protecting children

In the UK alone, medicines are the cause of over 70 per cent of hospital admissions for poisoning in under-fives.

Alongside this, the global average lifespan is steadily increasing, applying pressure on the pharma industry to develop innovative seniorfriendly solutions which promote adherence. However, the very features which improve child-resistance can also make medicine packaging more difficult for older people to use.

Traditionally, child-resistant packaging (CRP) comprised of bottles with the familiar ‘press to turn’ closure. However, more prescription drugs are now distributed in blister packs, which provide a perfect seal and can be issued in retail environments without any risk of contamination.

At Origin, we are currently working on a new CR Smart technology, which comprises a ‘twin child-resistant design’ to create an even stronger preventative barrier. The design is at a concept stage and has been purposely left to allow interested parties to take the design and adapt it to their given application.

Several packaging firms have also developed innovative CRP options beyond traditional bottles. These include ‘press-to-engage’ resealable sliders that are difficult for young children but easy for adults of all ages.

Expectations are also increasing when it comes to child protection; acceptable extraction levels for solid dose medication are being challenged and rightly so. If some are achieving results of F4 to F1, then why should F8 be considered acceptable? Brands have much to gain – ethically and commercially – by blazing the trail when it comes to CRP.

The future

No one solution exists to solving the nonadherence problem. What’s certainly clear is a more holistic approach is needed that integrates packaging and delivery systems with ‘smart’ devices, software and personalised support. Unlocking the potential of big data will continue to be a top priority for the industry and healthcare stakeholders over the coming years to use the valuable insights gained to develop patient-centered adherence interventions tailored to individual needs.

Only through an ongoing collaboration and investment in R&D will we succeed in improving optimal use of evidence-based treatment and adherence to medicines. n