\Viewpoint: Branding through Packaging: An Analysis of Counterfeiting and Patient Compliance

Drug companies are challenged to maintain and create powerful brands that inspire, inform, and protect patients.








By Hector E. Estevez, Director, U.S. Innovative Solutions, Bilcare Research
Maria Esther Barros, Director, Mexico Innovative Solutions, Bilcare Research


Bilcare�s innovative package design program is intended to promote patient compliance by simplifying dosage regimens.

Over the past decade, the pharmaceutical industry has been rocked by a counterfeiting epidemic and wide-ranging compliance issues. This article will analyze the current situation within the pharmaceutical industry and propose potential solutions to combat the issues.


New blockbuster drugs are introduced to the market faster than authorities can regulate the production of counterfeits, which are often produced efficiently and distributed widely. Counterfeiting has become a phenomenon with a ripple effect. The absence of legislative deterrents and the presence of widely available technology mean that counterfeiting can easily proliferate. Unlike product processes at large pharmaceutical companies, counterfeiting does not require a large infrastructure or multiple facilities. Counterfeiting is relatively easy to do and hard to uncover. In addition, globalization provides an increased number of distribution channels for counterfeit drugs.

In Mexico, for instance, one drug manufacturer estimates a loss of between $50 million and $90 million dollars a year owing to counterfeit drugs. Of that amount, it is estimated that roughly $10 million is related to the sale of counterfeit versions of its blockbuster erectile dysfunction drug.

Counterfeiters take full advantage of the extensive research and development expenses of the original manufacturer, leaving the manufacturer with a highly significant number of lost sales. However, even though drug companies suffer great losses in revenues owing to counterfeit drugs, drug consumers often suffer the most. Because a counterfeit drug does not follow established standards of safety, quality, and efficacy, the effect can be a negative one for patient health. Not only are consumers cheated out of the product they paid for, but they unknowingly—or knowingly, if purchasing directly from a suspicious source—put themselves at great risk.


In addition to counterfeiting, patient compliance is a deep-seeded issue in the industry that also causes lost revenues for pharmaceutical companies. Patients who must follow a strict dosage and drug schedule are the most likely to become noncompliant. Often, nonadherence is not intentional, but rather the result of patients’ forgetting whether they took their medication or when they need to take their next dosage. Some patients either double up on a dosage to be sure or skip a dosage to be safe. Coprescriptions further aggravate this problem.

Many elderly patients forget where their medications are kept or when they need to refill prescriptions. Patients with arthritis frequently leave bottles uncapped to ease access, often putting children at risk and potentially affecting drug stability given exposure to moisture and light. Finally, compliance instructions are often printed on secondary packaging or pharmacy-generated labeling, which are usually discarded upon opening. For all of these reasons, patient compliance issues are on the rise in the United States.


In an effort to resolve both of these problems Bilcare Research, a global pharmaceutical research and packaging company, began to test a program in India called Innovative Solutions. Its basic idea is to look at how a specific pharmaceutical company is marketing a given drug, including an analysis of any potential issues with counterfeiting and patient compliance. After a thorough analysis, Bilcare creates a unique packaging program for that drug to address the issues at hand and effectively brand and market the drug.

After three successful years in India, Bilcare has now introduced the program in the United States. With backgrounds in the pharmaceutical industry, Bilcare’s packaging specialists have begun researching the U.S. pharmaceutical market. Given its counterfeiting and patient compliance issues, a perfect storm is brewing.

However, there is also a tremendous opportunity to market drugs, especially as generics are flooding the marketplace, and a need to differentiate within the market.

Most pharmaceutical companies spend the bulk of their time and money researching and testing their drugs. All too often, packaging is an afterthought; after package testing is complete, the drug is hastily given to a marketing department to brand it and get it to the marketplace. The time crunch is understandable, considering the relatively short time a drug actually enjoys in the market before generics arrive. However, packaging is a major factor in what sets a company apart from competition.

Packaging acts as the first form of communication between a pharmaceutical company and a potential consumer. It differentiates products, such as name brands and generics. In addition, packaging can offer a consumer more than just information; it can offer an experience. For a patient who is suffering, the sight of a drug that could ease pain produces a positive effect and affiliation with the package design.

Secondary packaging is an obvious opportunity to market a drug, but most companies fail to take full advantage of the primary package, which is often the piece that is retained for a longer period of time by the patient. Primary packaging can communicate with a patient through printed compliance instructions and reflect the brand of the drug.

Effective packaging may also be the best defense against counterfeiting. With discernible features that evoke a strong recall or recognition component by patients and physicians, a complex packaging solution should be extremely difficult to reproduce by counterfeiters. Packaging companies can use several techniques such as overt technologies like color-shifting inks, holograms, fingerprints, tags, or chemical markers and anticounterfeiting blister films. More complex techniques like RFID tagging allow companies to track and trace the product once it leaves the manufacturer.

Strategic packaging can also assist in mitigating patient compliance issues. Innovative systems, like blister packaging, allow patients to easily track how many pills they’ve taken and if necessary, what days of the week, or even what time of the day they need to take their dosage. Effective packaging can inform and educate a patient. Blister packaging allows patients to gauge when their prescriptions are getting low and helps them remember to call in refills. Primary packaging can include specific instructions for dosage, refill information, or drug interactions. Unit-dose packaging can allow patients to open or discard primary packaging without compromising drug integrity.


Recently, a major retail pharmacy chain conducted an extensive study and determined that its pharmacists spent less time per prescription refill by handing a patient a drug in blister packaging, as opposed to taking the time to count out pills into bottles. Additionally, there is far less room for error when dispensing in blisters.

With 3000 pharmacies dispensing approximately 250 prescriptions per day, per pharmacy, this chain was able to realize savings of approximately $50 million annually. Moreover, they were able to address the current shortage of pharmacists. With the realized savings in time, the chain no longer has to ask its employees to work overtime to reduce the wait time for prescription refills. And by shortening the time that some customers have to wait for prescriptions, the pharmacy chain can cater to the needs of more patients per day and worry less about turning customers away because of long delays.

New packaging is not something that can be implemented swiftly within a large company. But the benefits for a company that endures an in-depth evaluation process to determine the most-effective packaging for its drugs will be tenfold.

Even though higher-level counterfeiting operations will emerge, so will many more technologies for security. The challenge for drug companies is to create powerful brands that inspire, inform, and protect patients. This challenge can only be met with innovation.


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