Increasing Sales with Blisters
Say the words noncompliance with drug therapy and generic-drug competition and watch the chief financial officers of brand-name drug manufacturers cover their ears. Such realities of today's healthcare marketplace threaten the long-term profitability of nearly all brand-name drug companies. In fact, last year alone, Warner-Lambert lost nearly $1 billion in sales of its cholesterol-lowering drug Lipitor, a lot of which can be attributed to noncompliance, according to Thomas McMurray, Warner-Lambert's director of new packaging technology. And in 2000 alone, patent expiry will reduce ethical drug revenue by approximately $10 billion industrywide, he said. McMurray spoke to attendees of the eighth annual national symposium on patient compliance, "Compliance Packaging: Promise and Performance." The symposium was organized by the Healthcare Compliance Packaging Council and held in Philadelphia during May.
Unit-dose packaging, however, may be able to turn such losses into gains, he explained. "Sixty percent of patients stop taking Lipitor after six months, and such noncompliance is common with other drugs," he explained. If drugs were to be packaged in unit-dose packaging such as blister packs, patients would have a daily reminder and record of their regimens and therefore a greater chance of adhering to them.
However, the same CFOs who fear noncompliance and generics may cringe at the thought of placing all of their firm's drugs into unit-dose packaging. Material, equipment, tooling, and labor costs associated with unit-dose blister packaging are often high enough to deter companies that are accustomed to using bottles or to supplying their products in bulk to pharmacists for dispensing. But using blisters, even electronically enhanced blisters, may cost less than manufacturers think and may actually increase profits, claimed two other symposium speakers, Peter A. Basile and Mark D. Burrows, cofounders of the Greenbrier Group (Villanova, PA). Drug makers may be able to drive up the value of their products enough so that volume increases actually lead to a break-even point in costs between bottles and blisters.
The key is to find "the knee in the price/volume curve, which is the point at which the cost floor of high-volume production is in sight," explained Basile. At the beginning of the curve, manufacturers must pay for development, tooling, and production costs, whereas at the end, manufacturers only pay for materials. (Drug manufacturers may also want to consider hiring contract packagers to handle blister operations, because these firms are already equipped with the necessary machinery and expertise.) The point is that to be able to reach the end of this price/volume curve, manufacturers must "get volume up to get cost down," said Burrows. The key to increased volume is to convince patients, practitioners, and payers of the value of unit-dose packaging.
Electronic blisters can add value to drug products in a number of ways that directly benefit patients. First, they can help improve treatment outcomes by reminding patients to follow their regimens. Secondly, electronic packages can provide patients with comprehensive educational information. Finally, the electronic chips that can be incorporated into the blister packages can store compliance data for retrieval by practitioners, manufacturers, or suppliers; such data can either alert doctors and pharmacists about forgetful patients or can signal the need for a prescription refill.
As drug compliance increases and refill prescriptions are generated electronically, drug makers will be able to maintain or increase current sales figures. Also, makers whose drugs have gone off-patent can use electronic blisters to create distinct new products that compete effectively with generic versions. Electronic blisters can also help practitioners and payers verify drug authenticity and reduce liability exposure.
However, Basile and Burrows pointed out that for patients, practitioners, and payers to value such capabilities of the electronic blister, they all need to view packaging in a new way. "Today, users are expected to be aware, motivated, and disciplined about their regimens—they are expected to know when to dose, how many tablets to take, what and what not to ingest, and when to refill," said Basile. "Packaging is merely used to protect drugs from the environment and to impede unintended access, like by children."
Instead, packaging should take on most of the expectations that are currently placed onto patients. "Users should only be expected to be aware of the need to take the medication and to be motivated to follow a regimen. Packaging should provide the discipline," said Basile.
"Many things that need to be done for altruistic reasons aren't done if there aren't economic reasons to do them," said Burrows. If drug makers can convince users of the value of packaging that encourages regimen compliance, more manufacturers may be able to afford—let alone profit from—a packaging technology that could help save lives.
Daphne Allen, Editor