Packaging’s role in adherence

It has been one of the most debated issues for at least as long as I have been writing for PMP News (almost 14 years): Should packaging play a role in encouraging patients to adhere to prescription drug regimens?

At the Healthcare Compliance Packaging Council’s annual symposium, RxAdherence 2011, panelist Jay Carter of AbelsonTaylor, a medical advertising agency, reported interest in using packaging. In March and April, he had surveyed 39 pharmaceutical and biotechnology marketers online about their interest in packaging. Nearly half (46%) represented products that are subcutaneous injectables, compared with 26% who handle tablet or capsule forms.

Forty-one percent had recently turned to packaging to improve patient adherence. Thirty-two percent of those handling injectables chose packaging to support sample or starter packs, but only 16% selected unit-of-use regimen packaging for patient use. Forty percent of those respondents handling other formulations were using packaging for samples; 47% are using packaging for unit-of-use regimens.

But in terms of importance, adherence packaging was ranked behind other tools used to encourage adherence, such as “co-pay coupons, pharmacist time in medication therapy management programs, and closed-loop patient outreach or reminders.” Packaging was ahead of e-vouchers, however. (Respondents were asked to rank those tactical options in order, from first to last place.)

Carter collected some interesting verbatim comments revealing that, if employed, packaging needs to center around the end-user experience: “It should be packaged nicely for the patient and end user, especially if they are paying over $500 per injection. It should look like it comes from Tiffany,” wrote one professional.

“Packaging is a key concern for me and my product,” writes another. “It’s a medical device that needs to be simple to use. Packaging can play several roles, not just adherence. In my case, the packaging needs to aid in starting therapy, more than for adherence.”

There are challenges, and I wonder whether they deter decision-makers from investing in packaging. “Given the ‘learned intermediary’ nature of the business . . .  oftentimes the end-user doesn’t see our packaging,” wrote one. “We have two LIs in between us and the end-user: the doc (who generally doesn’t care about packaging) and the RPh who only cares if it 1) fits on the shelf and 2) comes in increments of 30 days.”

Adds another: “The greatest issue is the concept of finance recognizing the higher cost of the retail package has a payback with patient adherence rather than looking to reduce the retail package cost to improve profitability.”

But despite these challenges, packaging has not been counted out: 87% of respondents have considered packaging for their brands within the last 24 months. So the debate whether to employ packaging hasn’t yet been resolved. There are studies  showing the value of packaging (see Catalent’s Viewpoint in our June 2011 issue); more are sure to come.