Pharmaceutical Commerce - May/June 2013 - (Page 26)

Manufacturing & Packaging Compliance prompting packaging: ‘The light bulbs are coming on’ continued from page 1 MeadWestvaco’s (MWV; Richmond, VA) new Shellpak Renew, which features a tearresistant, recyclable outer carton, an easy-slide blister, an integrated calendar for patients to track their medications, and billboard space for patient education. The package is available at more than 5,500 major retail pharmacies nationwide, including Walmart. MWV says Shellpak Renew was developed based on feedback from pharmacists and patients. “Medications prepackaged in Shellpak Renew make dispensing medications quicker and easier so that our pharmacists can spend more time counseling our patients, including providing instructions on how to take their medications,” says Sandy Kinsey, VP, pharmacy merchandising at Walmart. “In addition, the calendared packaging helps reinforce to our customers how to take their medications safely and effectively for the best outcome.” Walmart’s increased adoption of unit dose compliance prompting formats served as a major endorsement of UDP and reportedly helped create an uptake in the use of these packaging solutions. “Certainly, Walmart’s adoption of this style of packaging has fueled this momentum, and you are seeing that now with other major chain pharmacies,” observes Justin Schroeder, a senior director at AndersonBrecon (Rockford, IL), a contract packager. “The light bulbs are coming on.” The proof is in the pudding, as recently published research reaffirms what UDP suppliers have been preaching to the pharma community for years: Increasing patients’ adherence to their medications through the use of compliance prompting packaging can positively impact patient health outcomes. Case in point: a first-of-its kind study published in the May 2011 issue of peer-reviewed journal Clinical Therapeutics conducted by Venebio and funded by MWV found that when used alone, MWV’s Shellpak calendar blister packaging demonstrated a statistically significant impact over vials, improving adherence and persistence for long-term daily medications. The study reportedly involved more than three million Walmart pharmacy patients. Additional studies revealed similar results, proof positive that packaging pills in blister packs are far more likely to enable patients to take their medications. In a 2012 study, published in the journal Patient Preference and Adherence, researchers from Novartis Pharmaceuticals (Basel, Switzerland) and consulting firm Xcenda (Charlotte, NC) examined pharmacy claims from more than 9,000 patients taking hypertension drug Diovan HCT over the course of one year. Approximately half the patients received their medication in MWV’s Shellpak, a calendared blister pack, says Hung Le, senior director, innovation, at MWV Healthcare; the other patients received their medication in a traditional pill vial. The study found patients using Shellpak refilled their prescriptions five days sooner and stayed on their medication 22 days longer. While such new developments are promising, several hurdles stand in the way of greater adoption of compliance packaging for pharma products. One of the biggest relates to cost, as production, shipping and storage expenses may be viewed as unnecessary. And there remains resistance in the pharmacy community, observers say, which is reluctant to change traditional practices. While additional evidence needs to be gathered to ascertain whether it is more cost-effective to utilize blister packs in drugregiment adherence, some industry members believe this is negligible when you consider the annual cost of nonadherence. This figure in the US alone is estimated at nearly $300 billion, or roughly 13% of total healthcare expenditures per year. A 2012 study by Capgemini and HealthPrize Technologies, a medication adherence technology developer, saw a $188-billion gap between current US pharma revenue and the revenue level assuming full compliance (Pharmaceutical Commerce, Jan/Feb, 2013, p. 10). Drug makers can reap financial benefits from greater refill adherence. “We foresee a trend that pharmaceutical companies who utilize MeadWestvaco wins Healthcare Compliance Package of the Year award Avive package changes pharmacy-dispensing practices; MWV also places with second runner-up The annual competition for the Compliance Package of the Year, held by the Healthcare Compliance Packaging Council ( witnessed a strong showing by MeadWestvaco (Richmond, VA) with the winning entry as well as the second runner-up. Information Mediary (Ottowa) was the first runner-up, with a compliance package designed for a clinical trial that features electronic interactivity. The winning design, branded as the Avive multiple-medication patient adherence solution, isn’t meant to be used by pharma packagers, but rather in the central fill operations of chain pharmacies and drug distributors. The core of the product, according to Tom Grinnan, MWV senior director, is an IT system that helps a pharmacist match the collection of meds 26 Visit our website at May | June 2013 a patient is receiving with the schedule for taking those meds, packaged into a 30-day course of therapy. The dosages are packed into pouches (up to four oral-solid meds per pouch), and the pouches marked (both with instructions and with symbology) to guide the patient in the appropriate regimen. At the end of the 30-day therapy, the meds are refilled (or adjusted per doctor’s instruction) and a new 30-day course begins. The pouches—a continuous, cellophanetype strip—are produced in pharmacy automation systems that can handle pouches (rather than pill bottles); these are available from several manufacturers that MWV worked with, says Grinnan. MWV provides the software, the carton and the pouches, along with training for pharmacists and central-fill operators. “Any part of the adherence packaging solutions during clinical trials will see the benefit in continuing to use similar packaging for the commercialized drug,” MWV’s Le says. “It’s important that adherence is encouraged from the very first time a patient interacts with a medication and its packaging—whether it’s in a clinical trial, a physician sample or a commercialized drug.” The core function of complianceprompting packaging is to ensure a patient takes their medication as prescribed by their healthcare provider. This includes dosing, frequency, timing and conditions. But approximately one-third to one-half of all patients do not adhere to their prescribed treatment plan and almost one-fifth of new prescriptions go unfilled, according to industry studies. Poor medication adherence can lead to worsening of disease, serious and avoidable health risks, increased hospitalizations and even death. An estimated 10–25% of hospital and nursing home admissions are a direct result of medication non-adherence and 23% of long-term elder care admissions in the US healthcare system, including manufacturers, pharmacies and health systems, concerned with patient wellness programs and medication adherence will be interested in this technology,” he says. “Wellness is the tide that will raise all ships in healthcare.” MWV has worked with a local pharmacy, LTCPCMS, to commercialize the technology with pharmacies. Its ideal application is for senior patients who tend to have multiple meds to take daily—by providing the meds in pouches labeled with the specific day and time of administration, patients can more easily follow their regimens. Grinnan says that MWV, which has a comprehensive patient-adherence advisory program, worked closely with pharmacies to essentially turn multiple prescriptions into one delivery package. “The healthcare system is geared toward writing individual prescriptions; there are many issues of administration and adjudication to work through which we have automated,” he says. MWV’s second runner-up award was for an implementation of its Dosepak carton for the titration sample package of Eli Lilly’s

Table of Contents for the Digital Edition of Pharmaceutical Commerce - May/June 2013

Pharmaceutical Commerce - May/June 2013
Table of Contents
Top News
Brand Marketing & Communications
Supply Chain/ Logistics
Information Technology
Manufacturing & Packaging
Legal & Regulatory
Meetings and Editorial Index

Pharmaceutical Commerce - May/June 2013