Patients fail to take medicine correctly at an alarming rate. It’s part of a packaging scientist’s job to improve compliance.
When Jim Regan announced to his father one Christmas that he was going to major in packaging science at the Rochester Institute of Technology, his father quipped, “What? Are you going to wrap presents or something?”
Packaging science turns out to be a far more complex, and serious, endeavor than Regan’s dad imagined, requiring knowledge of materials science, manufacturing, behavioral psychology, industrial and graphic design, and marketing. Regan, now Senior Director of Package Design and Development at Pfizer, sees his primary duty as “protecting the product from the environment and the environment from the product and insure our customers and patients can properly use our products.” Medications must remain chemically stable and be inaccessible to children—to name just two salient packaging goals.
And the medicines must be easy to take: Americans fail to fill prescriptions and take their medications correctly at an alarming rate. It’s estimated that a lack of compliance costs anywhere from $100 billion to $289 billion a year (due to the resulting health effects and waste). Twenty to 30 percent of prescriptions are not filled, while up to 50 percent aren’t taken as prescribed, according to a 2012 study. Most concerning is how a lack of adherence causes approximately 125,000 deaths a year, and up to 10 percent of all hospitalizations.
Having pharmacists more actively oversee a patient’s regimen has been shown to increase adherence, as have phone calls and mailings reminding people to take their medicines. Electronic prescriptions are projected to save $140 billion in health-care spending in the next decade, because patients fill them more often than paper ones. And digital reminders could also play an important role. At least 75 medication reminder apps, especially useful for those who must take multiple prescriptions a day, are on the market.
Packaging is a crucial piece of the compliance puzzle that links how people perceive design with how they behave, in the hopes of making sure they get optimal care.
Regan, who leads a global team located at sites in North America, India and China, encourages compliance by designing packages that are intuitive and easy to store. Unit dose packaging, where pills reside in separate “cavities,” makes it more difficult to accidentally take more than one at a time. “We are also investigating bottles with orifice reducers, which make it hard to dump out five pills from a bottle at once in your hand,” Regan adds. “For liquid medicines, the days of teaspoons are over. We include nice dosing devices instead.”
Visual cues on packages can indicate days of the week, or remind patients to take medicine at night rather than in the morning (or vice versa). “Based on literacy rates in developing countries, we’ve designed packages with icons to instruct patients how to take malaria drugs,” he says.
Packaging as an Integral Part of Drug Development
The pathway to the ideal packaging starts during clinical trials, where Regan and his team can assess how important compliance is for a particular drug. “Certain products are titrated, that is, the dosage must be adjusted, so it’s crucial to make it clear which dose should be taken when,” Regan says. Prototypes are shown to focus groups and market research studies inform strategies for creating each package.
Among the more pie-in-the-sky ideas in the field of packaging are “smart” bottles that sense when medication hasn’t been removed at the right time and then light up and beep to grab a patient’s attention. The designer in Regan is intrigued, but his pragmatic side is less impressed: “The light-up bottles cost a fortune.” There are certain products where this might make sense but on a broad scale, not practical.
For Regan, the perfect packaging isn’t necessary about flashing objects, but ingenious, pragmatic solutions to an everyday task for many that is crucial to their health.