Openability: Solving an old-age problem

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Speak to anyone in the pharmaceutical industry and they will tell you the US favours bottles and Europe prefers blister packs. However, at the start of this year, Wal-Mart named MeadWestvaco's (MWV) Shellpak blister pack as a top finalist at its Supplier of the Year Conference.

Shellpak is a blister pack that features a rigid outer shell to protect pills and a senior-friendly and child-resistant push-button system that houses a calendarised blister card inside. The pack has been used by Wal-Mart on some of its drug ranges. It could mark a major change in the type of packaging used for pharmaceuticals in the US, as the retailer drives more of its suppliers to adopt this type of packaging.

MWV's European sales director of adherence and delivery systems, David Spackman, believes that patients are more likely to take the correct dosage of a drug in a blister pack, as the remaining pills are visible. The pack can also be labelled to indicate which pill should be taken when. "Bottles tend to offer poor patient adherence. This could mean an extra script a year," he says.

A common problem patients, particularly the elderly, experience with medicines is difficulty opening the packs. The ageing population means that senior-friendly packaging is a major issue. "There are more pensioners now than teenagers," says David Sinclair, spokesman for the newly combined charities Age Concern and Help the Aged. "There's a lot more that can be done in user tests and making sure older people are part of that," he says. Sinclair points to the organisation's Age OK scheme launched in April. The Age OK logo will appear on age-friendly products and services. "It would be fantastic to have some pharmaceutical packs on the list."

Balancing act
Pharmaceutical company AstraZeneca (AZ) recognises the importance of both child-proof and senior-friendly packaging. "The greatest challenge to AZ and all pharmaceutical companies is getting the design of packs correct, so they provide the required level of child resistance while not introducing barriers to easy access," says global packaging demand manager John Phillipson. 

Legislation, adherence and the role of child-safety and senior-friendly packaging are key factors for AZ when it designs a new pack. "We want patients to get the best value from our products in terms of health outcomes and safety use. The way our products are presented can affect this, and we know packaging design has a key contribution here," says Phillipson.

Burgopak has adopted this philosophy in the design of its new sliding blister pack, which has child-proof and senior-friendly features. The company investigated folding carton-based packaging in the pharmaceutical sector and discovered that these packs can become dog-eared and weaken over time or consumers dispose of the carton altogether. This means that important safety and dosage information on the pack is lost.

As a result of its research, Burgopak created a pack comprising a plastic inner tray of blisters that locks into a cartonboard outer sleeve. In order to release the tray, the consumer has to press two release points on the packaging - these are easy enough for an elderly person to release and far enough apart for a child's hand not to reach both at once.

Burgopak has decided to focus the push for its new packaging in the US, where there are strict child-safety regulations. "The biggest challenge in the American market is that the blister materials that are available and accepted in Europe, in terms of child resistance, do not meet some of the difficult criteria in the US," says Burgopak's automation director Mark Symonds.

Burgopak has an order to install one of its machines, developed with Bosch SIG Pack, at US contract packer RXPak, a division of healthcare services company McKessen, in Memphis. The machine will be installed next year and will create the child-proof and senior-friendly Burgopak. Brecon Pharmaceuticals in Hereford houses the first Bosch SIG Pack machine to automate the production of Burgopaks.

So where does this leave the traditional pill bottle? Despite MWV and Burgopak's inroads into the US market with their blister packs, the bottle still reigns supreme in the US pharmaceutical market. "Blisters are less flexible for a pharmacist as they are already pre-welded," says Dallas Stiles, vice president of sales and marketing at Rexam Primary Packaging and Healthcare Closures. "Blisters are also a multi-material structure, which can be difficult, if not impossible, to recover."

Rexam offers both the push-and-turn and squeeze-and-turn forms of bottle caps for pharmaceuticals. The long-established push-and-turn closure has traditionally been made from two pieces and is child proof. However, Rexam is about to put a one-piece closure into production with a major pharmaceutical company.

Small risks
Child-proofing bottle caps throws up a series of new issues for the manufacturer. "You get into a lot of challenges with smaller-diameter closures as children try to bite them," explains Stiles. Potential dangers could arise if there are inconsistencies in manufacture or tamper evidence devices on the closure that could override a child-resistant closure. On push-and-turn closures, the application of a shrink band for tamper evidence could pull down the closure onto the neck of the bottle so that a child only has to turn the cap.

Rexam pharmaceutical marketing director Patrice Lewko says: "The market is not always ready to accept child-resistant features, because it may be a lot more expensive." Rexam, for example, does not include child-proofing on all of its packaging. However, if it is required in one country, where the product will be distributed, then it will be used across the range. All Rexam's new packaging will be designed to be senior friendly.

The ageing population means it is increasingly important for companies, and particularly pharmaceutical firms, to ensure their packaging is accessible for older people. The amount of money lost through people not taking their medicine properly means that compliance features, that make it easier for patients to take the correct dosage, are also on the wish list of many customers, as proved by the popularity of MWV's Shellpak.

Wal-Mart's use of the Shellpak suggests that the landscape of pharmaceutical packaging could be about to change in the US. A more European preference for blister packaging may be on the horizon, especially if Wal-Mart continues to push the Shellpak to its suppliers. Meaning there is likely to be more innovation around ensuring blister packs are child-proof and senior friendly.

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PRO PLUS
Caffeine tablets sit in an awkward place somewhere between pharmaceuticals and energy sweets. Chemists have typically stocked them next to the paracetamol and so the product is limited to people who actively seek them out. "They can languish in category ghettos unless you've a reason to go there and find them," says Ian Webb, managing partner of Webb Scarlett deVlam (WSdV), the design agency tasked with redesigning the packaging for Pro Plus.

The new pack consists of a 16-tablet pack that is stored in a plastic protective outer case embossed with the Pro Plus name. WSdV designed the pack to be carried around and fit discreetly into pockets or handbags. It also needed to be manufactured using existing machinery.

Each pack had to include a product information leaflet. WSdV had to create a pack that was pocket-sized, but could also accommodate all the necessary information. In the end the company "folded the leaflet up as small as possible" using its existing machinery, says Webb.

A cartonboard sleeve includes a eurohook, which means that the pack can now be hung at checkouts and in new areas around a store. "I think one of the interesting things is that being in a new format, it could be listed in different sitings," says Webb. The resulting packs could be located in different parts of a store, other than the pharma aisle.