A number of recent surveys, in Italy and around the world, have revealed that a large proportion of patients do not comply with the therapies prescribed by physicians due to difficulty in implementing so-called “polypharmacy,” or due to economic, socio-cutural factors or individual difficulties. This is especially true for elderly or cognitively impaired patients, who are more likely to be subjected to complex therapies, and who are at risk of not following all the recommendations necessary to make treatment effective. Part of these obstacles can be overcome by adopting a “patient-centric” approach that also involves pharmaceutical packaging: new designs, new strategies to improve drug-patient interaction, and use of digital technologies to make packaging more accessible. In this article we will provide some innovative examples of how the pharmaceutical packaging industry, in conjunction with the development of personalized medicine, is investing in smarter solutions to increase therapeutic compliance.

Therapeutic adherence: a growing problem

Therapeutic adherence, or the ability to accurately follow the therapeutic prescriptions that physicians recommend to patients, is a more complex process than it appears. This is because patients do not always, after the first few weeks of therapy, continue correctly with their medication, and as a result the effectiveness of treatment is seriously compromised.

The data, in Italy, capture a growing and perhaps too long underestimated problem. The OSMED 2021 Report states that therapies are followed correctly in only 55 percent of those prescribed an antihypertensive drug or osteoporosis medication. Even lower percentages are found for other conditions, such as in the case of diabetic patients with 45 percent adherence and 15 percent in asthmatics and COPD sufferers. The report indicates that it is particularly people with chronic issues, and therefore more prone to polypharmacy, who have the most difficulty in adhering to prescriptions.

The reasons for this phenomenon are many and are also recognized by the WHO (World Health Organization): from the different types of therapy, which are often multiple and complex to distribute throughout the day, to general social and household dynamics, to which individual health conditions are then added. The elderly or those with cognitive issues, for example, find serious difficulties in carefully following prescriptions when unaccompanied to treatment. Lack of treatment effects also cause serious consequences to the national health care system because of the increased demand for new health interventions and clinical checkups.

For all these reasons, recent times have seen new strategies aimed at increasing therapeutic adherence, which based on the personalized medicine approach and, therefore, the development of solutions on individual patient needs. These innovations also, and especially, affect pharmaceutical packaging.

Customized patient-friendly packaging

Pharmaceutical packaging not only has the purpose of physically protecting the primary packaging, but it also has the purpose of providing clear information to patients while complying with the obligations prescribed by Directive 2001/83/EC, especially with regard to prescription drugs. Despite stringent regulations, many companies today are investing in more accessible solutions for everyone; these, we find packaging with facilitated openings for people with cognitive or joint experiments. In these cases, it is advisable to include, for example, the use of lightweight and flexible materials, easy grip points, or openings that do not require excessive forcing on caps or tabs.

From a design perspective, innovations in the industry allow for compact and manageable packaging that meets the need for more pocket-size packages. Thus, there is talk of the rise of single units of product or prefilled doses to carry with you at all times.
Many companies, for example, create pharmaceutical “wallet” cases for medical device drugs, equipped with two or more internal separators to conveniently divide the various components of the product in case of in case of combination therapies. Often, blisters and cases feature graphic components that indicate the correct dosages, the days of the week or month, and the times of day when the product should be taken. Some packaging also has convenient compartments specifically designed to store the package insert.

The package inserts themselves, which are sometimes difficult to handle and store, have been revamped in their design to have more reading space and, consequently become more usable by patients. Eurpack has developed a new way of designing the package insert through the BiKit, which does not need to be folded several times but can be leafed through with convenience.

“Connected packaging” to improve compliance with therapies

Rethinking the use of packaging puts the patient at the center of new design solutions, but this approach is not just about the manageability of packaging in materials and structure. Digital technologies play a key role in increasing drug accessibility.
The phenomenon of digitization has provided useful tools to improve patient-drug interactions right through the packaging. Consumers, for example, are attracted to the proposition of receiving notifications on their smartphones or viewing product information on their screens. In this sense, companies are using QR code printing on the packaging as well as NFC (Near Field Communication) and RFID (Radio-Frequency Identification) technologies, which are already used in the supply chain to track drugs and combat counterfeiting. Thus, we can talk about connected packaging that uses “smart” sensors to connect people to the product and take advantage of various digital services, with the aim of providing clearer information on drug use and correct dosages. These tools can help improve product communication, customer experience, and treatment adherence.