We’ve all been talking about poor patient compliance for years. Why is it still a lingering issue? PMP News asked Phill Marley, Packaging Intelligence Manager for AstraZeneca and Chair of the Healthcare Compliance Packaging Council Europe (HCPC Europe), this question and more.
Marley will be speaking about patient-friendly packaging at Pharmapack Europe on February 11 in Paris, where he will discuss HCPC Europe’s new white paper, “Patient Friendly Pharmaceutical Pack Design.”
Why is patient compliance still an issue?
Marley: Patient compliance is still an issue because observed compliance rates for many therapeutic areas are poor. This leads to reduced efficacy of medicines, poorer outcomes for patients, and increased costs for payers in healthcare.
Many packs on the market today provide little assistance to the patient—in some cases they prevent the patient from having a good experience and therefore have an adverse effect on compliance. The ethical pharmaceutical market is one of the few areas where the patient has no choice in the type of pack received as products are prescribed by a healthcare provider. It is therefore imperative that pharma packs are designed from a patient perspective, to provide the best possible pack for the patient.
AstraZeneca is actively working in this area and recognizes that there is a strong shift towards patient-centricity. The assessment of new product pack requirements comes at a very early stage, immediately after the packaging materials have been selected. Where appropriate, prototypes of proposed packs can then be tested for functionality and understanding with patients and other players in the supply chain like physicians and pharmacists. In this way, we aim to ensure that we will produce a pack that is patient focused and supports favourable outcomes.
What role should packaging play in promoting compliance?
Marley: Packaging has a key role to play in promoting compliance—in many cases the packaging is the last (and in some cases, only) contact that the patient has following diagnosis and visit to their physician. The packaging provides a strong communication link directly to the patient and should be used to enhance the compliance, adherence, and persistence aspects that the patient has with their medication regimen. The use of optimized packaging supports the patient and increases their confidence on the journey through acceptance, control, and ultimately to an optimal quality of life.
In some cases, dosing regimens can be difficult to comply with, for example, taking multiple tablet strengths, or intermittent dosing, e.g., every other day, and special attention in the design of the packaging for products of this nature should be taken.
What will you discuss during your presentation?
Marley: Patient-friendly packaging versus regulations, the opportunity out there to use packaging to contribute to increased compliance, the Healthcare Compliance Packaging Council of Europe (HCPC), the HCPC White Paper, key aspects of packs required for patients, factors to include to design good packs, and some examples of [what] award-winning packs look like.
How will emerging technologies outside of pharma, such as digital and smart technologies, impact patient compliance and pharma packaging?
Marley: Emerging technologies are already providing benefits in the field of improved compliance for example in the areas of Smartphone Apps, QR codes, and reminder aids. We are also seeing the emergence of exciting technologies like 3-D printing and printed electronics, which are also likely to provide additional benefits within the compliance arena.
What future pharmaceutical packaging and drug-delivery innovations do you predict? Hope for?
Marley: At AstraZeneca and HCPC, and indeed across the pharma industry, we are all seeking to provide medications that are easy to take, coupled with an effective way of prompting patients to take their medication on time, in full, because the best drug in the world is not effective if not taken correctly.
My hope is that effective medicines will continue to be developed, along with presentational packs and devices that by their nature add to the ritual of dosing in such a way that they greatly enhance the patient experience, making compliance become more like second nature. This will increase the effectiveness of good drugs and provide better patient outcomes. AstraZeneca has a number of smart devices and packs in the development phase, so it promises to be an exciting future!
What do you need more from packaging material suppliers? Container or device suppliers? Machinery suppliers? Service providers? Regulators? Standards bodies?
- From material/component suppliers – an openness and willingness to work collaboratively with pharma and discuss new ideas, materials, and technologies to meet patient friendly pack requirements going forwards.
- From machinery suppliers – an understanding that pharma packs are becoming more and more complex and that their machinery offerings need to take this into account and respond accordingly…
- From regulators and standards bodies – a broader acceptance of features that will provide patients with a better experience when taking medication and therefore an increased likelihood of attaining compliance and adherence. This one is critical—more flexibility from regulatory authorities like the FDA, EMA, etc. will ultimately facilitate the design of better packs by pharma companies, which will assist in the quest for better patient outcomes.
Do you see traditional pharmaceutical packaging intersecting at all with functional medical devices, such as with drug-delivery devices? If so, will this help compliance? What are the challenges?
Marley: There is an indistinct line between packaging and device delivery system already, and both should be designed to assist wherever possible with the patients overall experience and improving compliance, adherence, and persistence. For devices, Instructions for Use (IFUs) for the device are of critical importance, and we foresee the use of QR codes with links to instructional materials also becoming more widespread.
What is the first thing pharmaceutical professionals should do after listening to your presentation to encourage patient compliance?
Marley: Download and read the HCPC White Paper (at www.HCPC-Europe.org ). This gives some excellent examples of how and what to design into a pharmaceutical pack to make it patient friendly and assist in the desire for good compliance and adherence.
And after that, adopt a patient-centric mentality and use their influence in wherever they work to ensure that patients are getting the best pack possible—we are all patients!!!
Don't miss Marley's presentation on patient-friendly packaging at Pharmapack Europe on February 11. The conference and exhibition will take place in Paris February 11-12.