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PACKAGING
FORUM

Improved Blister Packaging
Benefits Consumers, Caregivers,
and Drug Makers

Hallie Forcinio
nhanced blister packaging that adds a pa- acute, enhanced blister packaging is considered perboard or plastic component to standard “pass-through” because it minimizes the need for Eformed film–lidstock blisters is familiar in pill counting and handling and reduces labor re- hospital settings and clinical trials. Such struc- quirements. Miscounting errors also are less likely tures, which can provide a unit dose, help ensure to occur because packages contain the amount re- patient compliance, or make a package more child- quired for a specific dosage regimen.
resistant (CR), are used for a growing number of Commercial products in enhanced blister pack- physician samples and animal healthcare prod- aging include many of the packages recognized in the annual Compliance Package of the Year com- petition sponsored by the Healthcare Compliance New blister
Packaging Council (HCPC) (Falls Church, VA).
packaging offers
Winner of the top award for 2002 is a physician sample pack for the anti-epileptic drug Lamictal patient compliance
(lamotrigine) from GlaxoSmithKline (Research Triangle Park, NC). The wallet-pack design aids, child-resistant
arranges a five-week regimen in a single foldover card. Previous packaging consisted of four sepa- mechanisms, and
rate cards. GlaxoSmithKline outsources the heat- seal carding and final assembly (Caraustar In- space to include
dustries, Clifton Primary Contract Packaging brand information.
Runners-up in the 2002 competition include a bifold carded blister pack for Fosamax Once Weekly (alendronate sodium) from Merck & Co.
scribed as blister cards, heat-seal cards, foldover (Whitehouse Station, NJ) and a physician sample blisters, wallet packs, blister wallets, or compli- ance packs. What most of the variations have in from Astra Zeneca PLC (London, UK). The Fos- common is a paperboard or plastic component amax package includes a patented CR zipper back that provides space for printing brand informa- for the one-dose-per-week osteoporosis drug and tion, patient education, and compliance aids such is contract packaged (Contract Packaging, Sharp as days of the week or times of day. In many cases, a CR mechanism also is incorporated.
The Nexium package provides 14 days of treat- Patients who take their medicine on schedule ment in a cold-formed foil blister pack. Unlike tend to experience more positive outcomes with many enhanced blisters, which print label and quicker recoveries from acute conditions, better compliance information on a die-cut paperboard control of chronic maladies, fewer hospitaliza- overlay, printing is done directly on the foil (Jones tions, and lower healthcare costs. Study results Packaging, London, ON, Canada). The Nexium Hallie Forcinio
is Pharmaceutical
published in various journals indicate that pack- design also features a tamper-evident carton.
aging with built-in compliance aids significantly improves patient compliance rates. This increased from a growing array of enhanced blister designs.
degree of compliance induces the prompt refill of One pioneering application, the winner of the prescriptions or restocking an OTC drug in the medicine chest, which then generates higher sales award is designed to run on existing cartoning for pharmacies and drug makers. In addition, at and heat-sealing equipment integrates a foldover the pharmacy level, where staffing shortages are blister card and CR carton (Dosepak, Mead- 38
Pharmaceutical Technology SEPTEMBER 2003
Packaging Forum
Carton space can
initial opening until it is discarded, full la- hold additional
beling information remains with the drug.
patient information
the outer carton relies on cognitive abil- serve brand equity. Finally, a space created literature such as a
ity rather than strength to open. To boost CR characteristics, a tear-resistant paper- carton can hold additional patient infor- CD or insert.
mation literature such as an insert or CD.
These materials can be preinserted dur-ing the conversion process, thereby elim-inating that step on the filling line.
ical trials but with potential for broaderuse features a tear-resistant paperboardcover wrapped around a high-strengthpolypropylene frame. A proprietary lock-ing mechanism on one side of the framesnaps closed over the cover and holds itsecurely in place. When the lock is disen-gaged and the cover is lifted, an inner blis-ter card attached to the underside of thecover lifts with it. When the cover is closed,the blister card nests back inside the frame,leaving sufficient space for CDs, brochures,safety and compliance guidelines, andother product information. The design isparticularly well-suited for fragile prod-ucts because it places full CR and rigidprotection on the exterior of the package,allowing peel-drop, peel-push, and othereasy-open style blisters to be housed in-side (Surepak, MeadWestvaco HealthcarePackaging).
format trays capable of holding р24tablets, capsules, or full-format trays,which can accommodate р60 pills. Tostrengthen brand identity, trays can carrya debossed logo or be produced in a par-ticular color. To cut costs, trays can beproduced in volume in advance and assembled as needed with the printed paperboard overlay.
pharmaceutical manufacturers often out-source the design and production ofcarded blisters. One contract packagerwith pharmaceutical expertise offers a tri-fold wallet design with a variety of fea-tures, including closure tabs, pockets forpatient information booklets, coupons,labels and business cards, a patient recordlog, and a patented tablet storage com-partment for regimens that require frac-tional doses (Carded Blisters, Sharp Corp., Circle/eINFO 31
40
Pharmaceutical Technology SEPTEMBER 2003
Packaging Forum
half for the next dosage time. Without the innovation dates back to 1996 when it was Carded blister packs
Squibb for a BuSpar Starter Kit, one of the have the potential to
first commercial applications of the tri- ter packs have the potential to record when record when a dose is
MHz radio frequency identification (RFID) removed.
first week. This dosage necessitates break- ing tablets in half and saving the second sors in the blister wallet structure (Med-ic ECM Electronic Compliance Monitor,Information Mediary Corp., Ottawa, ON,Canada). These additional features can beinserted into packaging by using existingequipment and add virtually no bulk orweight to the package. The state-of-the-art electronics also can be tailored to mon-itor other conditions such as temperature,vibration, humidity, radiation, light, orshock. The electronics also can be pro-grammed to provide patients with visualor auditory reminders.
ing how compliant patients are can meanthe difference between a successful mar-ket introduction and a costly failure, the By extending the forming web beyond the
foil lidstock, Toren Consulting creates a
foldable blister pack with a CR feature.

card is read by a handheld scanner at re-fill points or follow-up visits to retrievedata on dosage times (Med-ic CertiScanElectronic Compliance Monitoring Soft-ware). This action eliminates the need fortime-consuming pill counting, medica-tion diary preparation, and manual dataentry. It also simplifies the organizationof data and report formatting and enablesstudy leaders to identify noncompliantclinical-trial participants so their data donot skew results.
based packs are expected to launch beforethe end of 2003. RFID tags used in thepackaging currently are manufactured off- Circle/eINFO 33
42
Pharmaceutical Technology SEPTEMBER 2003
Packaging Forum
(Top) Dosepak’s
design integrates a
folded blister card
with a carton.
(Middle) Surepak cradles a blister pack and patient
information in a polypropylene frame with a
paperboard cover.
(Bottom) A proprietary CR device on Surepak keeps
kids out and eases elderly access.

Circle/eINFO 35
44
Pharmaceutical Technology SEPTEMBER 2003
Increasing compliance just a
few percent for a $1-billion drug
can have a multimillion-dollar
effect on revenue.
shore, and converting the blister wallets is outsourced to an ex-clusive partner (International Paper’s Shorewood Packaging,Stamford, CT).
Another design results in a foldover pack that not only pro- tects the blister lidstock but also imparts CR qualities (CR Fold-ing Blister Pack, Toren Consulting Engineers, Sydney, Australia).
The CR locking feature is created by extending the film portionof the blister beyond the foil on two opposite sides and ther-moforming a press-stud mechanism along the edges so thatwhen it is folded over, the male and female parts snap together.
To unlock, a patient or caregiver pushes the tapered end of apencil or pen into the conical shape formed at the outer cor-ners of the pack and along a small sloped section to push thetwo halves apart.
Available for licensing, the design is reported to be cost- competitive with existing CR blister packs, compliant with Circle/eINFO 36
British Standard BS 8404 for nonreclosable pharmaceuticalpackages, can be produced on existing blister packaging linesby adding a folding station to the cartoning machine, andadaptable to customized blister layouts. To enhance CR qual-ities, an opaque forming web is recommended so that the prod-uct is not readily visible through the package.
As usage of carded blister packs has increased, equipment makers have developed automated equipment to attach the paperboard overlays. One example is a machine that integrateswith thermoform–fill–seal equipment or is fed by manuallyloaded blister hoppers. Capable of producing Ͻ80 wallets/minwith as many as four blister cards each, the unit is compatiblewith a wide range of card sizes and dose counts as well as CR andnon-CR formats (NewWallet, Dividella AG, Wareham, MA).
Enhanced blister structures typically carry a $0.10–$0.15 per piece premium. However, increasing compliance just a few per-
cent for a $1-billion drug can have a multimillion-dollar effect
on revenue. Considering the well-documented evidence that
health benefits are related to improved compliance, enhanced blis-
ter structures can be a quadruple win—benefiting patient, care-
giver, retailer, and manufacturer. PT
Circle/eINFO 37
Pharmaceutical Technology SEPTEMBER 2003
45

Source: http://ecm.cachefly.net/pdf/BlisterPackagingBenefits.pdf

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