Creating patient-friendly medicines with new dosage forms and innovative packaging

Posted by Akums Drugs & Pharmaceuticals Ltd on October 1st, 2022

Compliance and adherence to medication are a serious problem across the world with impact on multiple fronts. Medication noncompliance often leads to worsening conditions for the patient and even death in some cases. On the other hand, the financial implication of patient noncompliance is enormous, amounting to yearly costs of more than 0 billion globally, as at 2017. According to a New York Times 2017 report, up to 30% of prescriptions in the United States are never filled, resulting in 10% of hospitalisations, 125,000 avoidable deaths, and between 0 to 0 billion in costs annually.

There are many reasons for medication noncompliance and much of that have to do with lack of access and affordability, lack of understanding, cultural biases, forgetfulness, and physical impairments. However, there is also a growing concern around the unpalatability of medications. A situation known as dysphagia describes a patient's inability to swallow conventional capsules and tablets. Hence, even oral administration, which is the most popular mode of medication, is a problem for many people, especially among geriatric, pediatric, and mentally ill patients.

In India, and indeed the rest of the world, patient noncompliance to medication also stems from several safety concerns to even ephemeral issues of convenience. For instance, choking hazard is a concern among children, whereas dosage accuracy, additives and preservatives are concerns associated with liquid medications. At the level of convenience, unpleasant tastes, smells and dosing requirements are some of the factors deterring patients from complying with medications.

Growing trends in pharmaceutical innovations

Pharmaceutical companies and consultants in India need to take the issue of noncompliance as a global priority and come up with medications that are easier for people to take. Beyond improving the health outcomes of patients and reducing costs, reducing noncompliance by as little as 10 percent can result in revenue opportunities up to 4 billion for the global pharmaceutical industry, according to international consulting firm, Capgemini. This potential has led to the introduction of new innovations in dosage forms and packaging in recent years.

This evolution is evident across the entire pharmaceutical sector, covering injectable, oral solid dosage (OSD), and so on. There's no surprise, therefore, the sudden spike in demand and preference for orally disintegrating tablets (ODTs), multiparticulates, modified release products, and fixed-dose combinations. The push for more orally dispersible powders to replace large, difficult-to-swallow tablets and capsules is one way this is being done. Using orally disintegrating technologies, these powders are produced to offer a pleasant effect in the mouth and are made to be relatively sweet, so it is not merely easily dissolved in the mouth, but also easy to ingest because of its relatively sweeter taste.

The rise in inhalation formulations by converting conventional molecules to inhalable forms is impressive as we have seen in recent years. Not only are sufficient levels of the drug delivered to the target organ, specifically the lungs, the issues of dysphagia and side effects are also addressed significantly. It is quite easy to inhale and because the dosage is relatively low, side effects of conventional drugs are largely prevented. Added to this is extensive work done on protein concentration, co-formulation, and dispersion enhancement of large active pharmaceutical ingredients (API) molecules, often with the use of hyaluronidase.

Soft gel dosage forms have also become popular today, which is considered not just convenient for patients, but also economically beneficial for pharma companies if the coating technology is properly managed with the use of gelatin and pectin. There are others like medicated gums, jellies, and sweets which are extremely easy to take, but dosage must also be adhered to strictly to avoid misuse due to their pleasant taste. Polymorphs, lipid-based technologies, size reductions, cosolvents, surfactants, and amorphous solid dispersions are some of the new design strategies being adopted by producers to ensure the bioavailability of drugs.

Beyond OSD and ODTs, there are also noteworthy innovations in other segments. Painless and needleless syringes, wearable injectors and prefilled syringes have also all become more popular in the last 10 years. Drug product design is increasingly patient-centric and the solubility of APIs is an important factor to consider, and as pharmaceutical companies and contract producers continue to adopt these new trends, there's bound to be improved healthcare and growth in the sector. The goal is to achieve efficiency, efficacy, and competence in dosage forms.

Does packaging count?

Packaging does matter, and can make a difference in creating patient-friendly medicines. In fact, the right packaging can help to prevent contamination and reduce cost significantly, making drugs more affordable and accessible. 3D visualisation tools are increasingly getting the attention of pharma product design engineers, to help prevent the practice of producing prototypes at every stage of the design process, thereby saving cost of packaging and reducing the final cost of the product.

Also gaining popularity are smart blister packs which help to remind patients of their next due date or time of medication using microchips. This will serve populations that have an issue remembering when their next dose is required. More frequent doses arrived also more likely to be missed, and pharmaceutical companies are seeing the need to invest in adherence packaging which increased compliance. This includes the use of single-dose blister packs by producers.