Cartoning and Labeling: Innovation Tackles the Space Crunch

Cartons, labels, and even wallets are coming to the rescue of space-hungry companies.

By Christina Elston

“Ask your doctor.” As pharmaceutical companies focus more and more on marketing to the consumer, it’s a phrase that has become prevalent in television, radio, and print advertising. After FDA relaxed regulations regarding marketing of prescription drugs in 1997, direct-to-consumer advertising has doubled in each of the following three years, according to a 2003 report from Massachusetts General Hospital and Harvard University.

This drive to build brand recognition with patients isn’t just filling up the airwaves. It also increases the space crunch on product labels, cartons, outserts, and inserts. “The challenge comes with being able to combine patient information with brand information and to make components that are end-user friendly yet still friendly to the pharmaceutical packaging operation,” says Ernest Chaplin, vice president of sales, marketing, and product licensing at Pharmagraphics (Greensboro, NC).

Nosco’s (Gurnee, IL) pharmaceutical clients are equally focused on both brand information and patient information, says director of solutions engineering Kregg Albrecht. “The most innovative are looking at ways to create useful patient information in such a way that it supports brand recognition,” he says. One example of this would be including useful patient information along with a recording chart to support patient compliance. “The patient, who is now taking the medicine properly, benefits from the useful information and the tools provided by the brand owner. This forms the beginnings of brand loyalty,” Albrecht says.


Albrecht says there are two main ways of fitting both branding and compliance information into limited space. The first is using creative graphics to fill existing space as efficiently as possible. “Logically, this is always attempted first, but it is only effective for adding limited amounts of additional copy,” he says. The second is to alter the package to include options for additional panels that can provide substantial amounts of “real estate.” A variety of innovative packaging options for labels, cartons, and printed literature are making this possible.

Companies are offering multiple-panel labels with an expandable number of pages, such as Nosco’s Fix-a-Form. Nosco also recently introduced a multiple-panel carton that includes up to 10 panels for copy space without significantly altering final carton dimensions, meaning it can run on current packaging lines.

The Challenge Printing Co. (Broadway, NC) also offers extended-content labels that can be designed in a variety of ways, reports marketing manager Margaret Polt. “If the additional text can fit in 300% as much space as provided on the front of the label, our customers can use our Multiply design, which provides them with three printable label surfaces,” she says. In the event that more space is needed, the PharmaScript design provides the option of including a foldout brochure under the label. “Our expertise in pharmaceutical printing enables us to use lightweight paper, which contributes to a less bulky packaging component,” Polt says.


Another way for packagers to create more space is to package blister cards into wallets. StoraEnso (Wisconsin Rapids, WI) has recently received an F1 child-resistant rating for its solution for walleting blister-packaged pharmaceuticals, explains Scott Johnsrud, product manager, cartoning systems, North America, for Bosch Packaging Technology (Minneapolis). Working together to provide the child-resistant wallets, Bosch will provide cartoning and blister-infeed systems and StoraEnso will provide packaging materials and design. In addition to blisters, the systems can also handle vials, syringes, and other packages.

Chaplin notes that at Uhlmann Packaging Systems’ recent First Annual Blister Roundtable and House Show in Towaco, NJ, other companies were touting wallet packaging. “You gain a little bit of real estate, and you gain a little more creativity in the package,” Chaplin says.

One such firm was Harro Höfliger, whose product manager, Markus Buchholz, presented machinery options at the event that can be installed at the end of a blister-packaging machine. “Wallets can be made as sophisticated as needed, with as much space and literature as needed,” he explained. “Other elements, such as anticounterfeiting, can be built into the wallet.”

Körber Medipak NA Inc. (Clearwater, FL) offers fully automated systems from Dividella to create NeoWallets. The systems can place one to four blister strips per wallet at a rate up to 80 wallets per minute. Late-Stage Customization (LSC) of the NeoWallets is also possible using Körber Medipak’s BIB-BOB module (blister-in-box, blister-out-of-box) systems. For more on LSC, see “Putting Blister Packaging to the Test” in the September 2005 issue of PMP News.

Fleet uses the Info-sert from Pharmagraphics for added copy space.


Meanwhile, printing technology and new materials are helping companies do more with the space they have. Johnsrud says that Bosch has seen more customers adding ink-jet and laser-printing systems to their packaging lines. These systems allow companies to print more information in less space, to allow for printing of bar codes and product identifiers. The printers have enough resolution and repeatability to be compatible with downstream verification methods. “It’s a more flexible method of getting information across,” Johnsrud says.

This means the supplier of cartoning equipment must be able to integrate a wide variety of printing equipment in their machines. “I’ve got to have several solutions for printing,” says Johnsrud.

Also useful are more conformable label facestocks that allow for extended-content labels (ECLs) that can incorporate more “real estate” for text, says Polt. “Our PharmaScript label is designed so it can accommodate the patient text behind the label, as part of a fold-out piece,” she says.

With inserts and outserts, lighter pharmaceutical-grade paper is making it possible to add significant amounts of copy area without necessitating a change in the finished size or thickness of inserts or outserts. “This is particularly important in the case of our PatientDirect MedGuides,” says Polt. Because the guides can be included as a tear-off within the prescribing information, or attached as a separate outsert to the pharmacists’ outsert, sizes can be cumbersome. “With the lighter paper,” Polt says, “we are capable of maintaining a small fold size despite the increase in the actual dimensions of the outsert.”

Arlington Press (Lake Success, NY) is seeing more color and more coated stock in use by its customers, “pawrticularly on the patient side,” says president Robin Henfling. “Ten years ago, the majority of what we printed was black over black for physician inserts,” he adds. The company can now print coated stock in 18 colors and fold it down to insert size, allowing patient information to be presented in a more patient-friendly format that aids compliance. “If they take the drug properly, and it’s effective, they’re going to keep on taking it,” Henfling says.

Arlington also can attach small pressure-sensitive labels on the outside of patient-information booklets, which can be peeled off and used as calendar reminders. Features such as business reply cards tucked inside the patient insert, which allow companies to get information direct from patients, have also become more popular.


Inserts and outserts offer an additional venue for both regulatory and brand information, and more companies are paying attention to branding on inserts. Stephanie Magill, general manager of Apex Graphics (Mississauga, ON, Canada), says they are often faced with the challenge of fitting insert designs created by customers’ regulatory departments onto the appropriately sized insert paper. “What we see fairly regularly is an insert design that doesn’t allow the logo or product name to show on the outside of the insert once it’s folded,” says Magill. “About 50% of the time the customer will choose to have us redesign the insert to have the product name showing on the outside of the piece.”

As insert sizes have increased, Bosch has seen less demand for C-shaped folds. “Now many customers are going to RTA (right-turn angle) outserts,” says Johnsrud. “That allows you to put so much more print on a piece of paper. You just couldn’t do it with the old wraparounds.”

Folding is a key factor in the crunch to get more information into package inserts. Companies are currently looking for ways to either fit more information onto the same-sized piece of paper, or to find a bigger piece that they can fold and still get into the container. “What they’re asking for now is more and more copy space,” says Magill. If you can fold a large insert correctly, you can fit it into the same space once occupied by a smaller one. So the question now is: “Can the folding technology keep up with what FDA is requiring?” So far, Magill and others say the answer is yes.

“We thought it hit its limit in 2001,” says Chaplin, “but there are equipment manufacturers that are doing some cutting-edge engineering.” There is a collaborative effort between equipment manufacturers, suppliers, and customers to meet these challenges, Chaplin says. In one case, Pharmagraphics was even able to fold an insert large enough to accommodate compliance information, patient information, and a consumer reply card. In another case, the company used folding to help stop the “ripple effect” that would have been created by moving to a larger insert, i.e., the need for a larger carton and larger shipping cases, which would mean fewer cases per pallet and less product fitting into the warehouse. “When you’re talking about 50 million units a year, this adds up,” says Chaplin.

Vijuk Equipment Inc. continues to enhance its folding solutions. Its first system, the MV-81, invented by the late founder and former president Michael Vijuk, changed pharmaceutical-leaflet production. For the first time, claims a company spokesperson, ribbon-style or parallel-folded paper leaflets could be folded inward and glued to form compact “closed” leaflets that would not spring apart during packaging operations.

Years later, Vijuk modified the MV outsert attachment for a leading pharmaceutical company to put more information on leaflets while retaining the same small finished size. The result was the MV-91 RTA outsert attachment, which evolved into the MV-97. It produces 90-panel cross-folded outserts with more than twice the copy space, allowing more information, larger typefaces, and easier-to-follow layouts. When more copy space was needed, the electronically controlled Vijuk 2001 outsert system was developed for producing thicker, 50% larger, and 20% more-compressed outsert leaflets with up to 30% more panels at speeds of up to 10,000 pieces per hour. The latest, the MV-2005 outsert system, produces even larger outserts with more panels and greater thicknesses and compression. It can also be customized according to user needs.


As pharmaceutical companies work to get more information directly into patients’ hands, they often package separate pieces for doctor and patient with each product. Many are also using tear-off pads that go out to the pharmacist or doctor—who tears off one sheet from the pad for each patient. This is another opportunity to get brand information to the consumer. “That’s where I would see the marketing people wanting to get involved,” says Magill, “because that’s going directly to the patient.”

Suppliers are also working to make additional features easy to integrate into the packaging line. “There’s a lot of creative thinking going on in the supplier base,” says Chaplin. Pharmagraphics’ Info-sert is a package insert that is delivered preattached to the folding carton, and its Pouch-sert product is a self-contained package insert that can be applied either into or onto a folding carton. “They provide the customer with essentially two components in one delivery,” Chaplin says, the carton and the insert. According to Chaplin, Fleet uses the Info-sert to meet compliance regulations without adding additional equipment to its line.

Demand for both regulatory and branding information on pharmaceutical products is only likely to increase. Many new technologies on the horizon are poised to help. “The process can be viewed as evolutionary rather than revolutionary as raw-material vendors, equipment manufacturers, and printers are all collaborating to anticipate what industry requirements will be in the future and then to design the most appropriate solutions to meet them,” says Polt. “FDA requirements have fostered a great deal of technological innovation among printers.” This, she says, will place the business advantage on the side of companies that specialize in printing and packaging for the pharmaceutical market, “because to us, this type of innovation is not simply a choice; it’s a necessity for doing business.”

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