Opportunities in pharmaceutical RFID and smart packaging
By Dr Peter
Harrop, IDTechEx RFID in healthcare is growing rapidly and is forecast to become a $2.1
billion global business by 2016. Smart packaging for healthcare has
multiple applications, including recording patient use in drug trials, stock
tracking, tamper recording, anti-counterfeiting, preventing medical errors,
and child-resistant packaging.
Patient compliance When two equally
efficacious drugs enter the market, the one with better compliance by
patients is likely
to be more widely used as non-compliance is costly and risky. Medication non-compliance costs the US alone about $100 billion and 125,000 deaths yearly.
It is responsible for 10% of hospital admissions — $31 billion yearly and
380,000 patients. It is responsible for 23% of nursing home admissions — $15
billion yearly and 3.5 million patients. Non-compliance also costs the
drug industry over $8 billion annually in unfilled new and refill
prescriptions. This can be caused by patients being confused over the reason
for the medication and not being fully
convinced that their treatment is necessary.
Some patients not get their
medication in the first case. If they do, then 30-50% is not taken
correctly, according to MeadWestvaco. Many patients fail to get refills
where prescribed and 28% of over 45 year olds admit to discontinuing the
prescribed medication prematurely. Antidepressants are particularly bad in
this respect. Drug companies have come to realize that spending heavily on
creating new blockbuster drugs is risky and less and less cost-effective,
whereas encouraging patients to take medication correctly benefits the
patient, reduces load on physicians and hospitals and sell more of existing,
non-contentious drugs. One company, Aardex, has a
plastic bottle of pills that is continuously weighed by a load cell in the
base, thus recording when a pill is removed. These packages are used in drug
trials and they incorporate RFID so that the record can be linked to the
patient. Widespread use will
follow cost reduction by use of new finer electronic and electric inks such
as the Parelec Parmod silver conducting ink used in litho, flexo and
gravure printing. Indeed, even semiconducting and dielectric inks are being
developed by Merck and some of these will be suitable for high-speed
printing of replacement for the silicon chip in a talking or RFID laminate.
The printed alternative is cheaper, more damage tolerant and thinner.
Packaging companies Dai Nippon Printing and Mreal are among those developing
printed electronics for packaging. An
example of a six-month drug trial involving smart blisterpacks is the
National Institutes of Health trial of its antibiotic Azithromycin, using
30,000 smart packages that record which tablet was taken when. Fischer
Clinical Services is carrying out the trial using smart blister packs from
Information Mediary of Canada. Novartis is also carrying out a drug trial,
in this case using smart blister packs from Cypak of Sweden, a company that
uses packager MeadWestvaco for some of its marketing. Compliance through
packaging:
- assists the medical provider in explaining the optimal prescribed
regime
- enrolls the patient as a participant in their own therapy
- simplifies medication administration for the patient
- provides
interaction and prompting, reinforcement and cueing
- creates a permanent
and continuous intervention that demands little involvement by the physician
or pharmacist
- supports the brand message all the way to the medicine
cabinet
- builds efficacy and integrity
- reduces medication errors
- reduces the development of antibiotic resistant bacteria.
The
smart blister pack and plastic bottle reduce the amount of false data
recorded in drug trials and eventually such packs will appear in the home,
probable enhanced by self-adjusting electronic use-by dates (you overheated
it for so long, therefore dispose of it at this earlier date) and electronic
monitoring of degradation in storage and transport. Tamper recording and supply chain
efficiency Sometimes printing — or at least partial printing — has been
used to make packages that record when tampering is attempted or achieved.
This permits investigators to calculate where, in the supply chain, attacks
typically occur and arrests have been made using this technology. Cypak is a
leader here, incorporating RFID. Indeed RFID, particularly at item level can
help to tackle the recall of pharmaceuticals where well over 1000 recalls
occur every year and they are less than perfect. The cost is significant,
not just the safety aspect. For example the retail and pharmaceutical
markets must absorb $2 billion yearly from return of outdated and
overstocked products. Anti-counterfeiting The World Health Organisation
estimates that counterfeit drugs cost the pharmaceutical industry $40
billion yearly. To combat this, RFID on each small package, with unique
identification of that precise package ("mass serialization" under EPCglobal
numbering and network) permits reverse audit, called "pedigree" by the
pharmaceutical industry.
Pedigree, combined with sophisticated software,
permits the origin and destination of even the smallest package to be known at
all times. The Food and Drug Administration in the US is expected to
legislate on this within the next year or so as the best frequency to use
and other aspects are resolved.
Meanwhile, Pfizer, who will speak at the
above conference, is RFID tagging at item level all Viagra for the US,
GlaxoSmithKline is tagging Trizivir and AstraZeneca and others are rapidly
following. Cardinal Health, TAGSYS and others have developed smart shelves
in cabinets, refrigerators and trolleys that can read such tags for error
prevention, automatic reordering and theft prevention. Wal-Mart has taken
delivery of about three million tagged drugs at item level for improving
automation of stocktaking and customer service and theft prevention in its
pharmacies. Omron and Avery Dennison use gravure printing to create the
antennas on these packages. Talking packages Another technology
receiving the attention of the printing and packaging industry is the
EnvisionAmerica system by which an RFID label under the regular label of
patient information electronically records a duplicate of that information.
A device held near then speaks out loud the information to assist the blind,
partially sighted, illiterate, dyslexic and those shaking from an affliction
or in a dark place when they need to read instructions. That is about one
third of all patients, according to studies. Indeed, a study by City
University in London even found that 25% of fully sighted consumers can not
read or have difficulty reading instructions, the figure being 73% for
partially sighted people.
The US Institute of Opthalmology reports that
nearly 50% of people over the age of 65 develop one of three chronic eye
diseases, the figure rising because of the ageing of the population. The
EnvisionAmerica talking label system is now being rolled out across the USA
following years of trials in the Chicago region. Lithographic and other
printing techniques will be used to print sensors, antennas and eventually
the complete electronic circuits in these and other forms of smart packaging
for pharmaceuticals, including packs that speak to give prompts and
instructions. Meanwhile, for the small runs currently involved, screen
printing usually suffices, with rotary screen printing sometimes in use as
with antennas on ASK RFID labels. Preventable medical errors The US
Institute of Medicine estimates that preventable medical errors in the US
cost $17 billion yearly. A study in the UK National Health Service showed
10% of patients suffer an "adverse event". While a report by the UK
National Patient Safety Agency says, "No single technology can solve the NHS's unfortunate habit of giving patients treatments that were intended for
other people, and NHS study has shown that unclear packaging and labelling is
a contributory factor in 25% of reported medication errors." The demographic
time bomb by which patients nurses and physicians are, on average, getting
older, cannot help this situation.
The Aventura Hospital Group reports that
2% of administered doses in hospitals in the US are incorrect already.
AstraZeneca has been a pioneer in using an electronic handshake based on an
innovative form of "chipless" RFID for error prevention and recording
procedures with Diprivan anaesthetic, over 30 million RFID enabled syringes
having been delivered so far. New solutions Packaging that flashes light
and even speaks when the patient should take the medication will help. So
will packaging with large scrolling instructions in glowing images.
Experimentally, we have electrically operated packages that lock, go rough (electroactive
polymers) or go black when the contents have expired. There are already
packages that call you back if you have taken one pill and should have taken
two and one experimental pack shouts "not now" if you touch it at the wrong
time. This may seem humorous to a healthy person but it is a lifesaver to
the confused elderly and sick, who will increasingly have to self medicate
as the population ages. Child resistant packaging Another aspect is
child resistant packaging where smarter mechanical and electrical
technologies are being explored for the packaging. The Child Accident
Prevention Trust finds that 20% of under fives can open safety tops and the
move to blisterpacks has made things much worse, with most babies
penetrating them — they use their teeth. Now that batteries can be printed
on packages or at least applied as very low cost laminates, there is
interest in electrical baby proofing technologies and "active" RFID where
there is a battery in the tag to give longer range and manage sensors.
Indeed, talking packages and compliance monitoring packages all need
batteries and the coin cells currently used are expensive and, with their
spring contacts, unreliable compared to printed versions which also have the
advantage of being thin and environmental as well. Thin Battery Technologies
and Graphic Solutions are among the leading low-cost battery printers.
More information For more information on RFID applications,
attend RFID Smart Labels Europe,
London 19-20 September www.smartlabelsEurope.com and read Electronic Smart
Packaging www.idtechex.com To top
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