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Prescrire's annual review of drug packaging: choose high-quality packaging for safer health care

A drug's packaging contributes greatly to the quality of care patients receive, to patients' safety, and to the safety of those around them. There were a few signs of progress in 2021, but packaging is still too often neglected by drug companies and regulators.

A drug's primary (or immediate) packaging is the layer in direct contact with the drug, intended to protect the drug from the external environment. Examples include blister packs for tablets, and bottles for oral solutions. The next layer is the box (or secondary or outer packaging). Both layers display information to help patients, carers or healthcare professionals identify and use the drug correctly.

Prescrire examined the packaging quality of 190 medicines in 2021. The results were mixed, including a few glimmers of progress alongside persistent or recurrent flaws. International nonproprietary names (INNs) were too often printed indistinctly, and overshadowed by the brand name, on the boxes of medicines authorised in France through a national procedure.

The boxes of some drugs were printed with the information patients require to take their treatment correctly, helping to inform them from the moment the drug is dispensed.

Pre-cut unit-dose blister packaging was unfortunately rare among recently authorised medicines. In a few welcome but exceptional cases, tablets or capsules previously marketed in bulk bottles had been upgraded to unit-dose blister packaging.

Some new oral liquid medicines marketed in multidose bottles came with a graduated oral syringe, a device suited to measuring doses of such drugs. But many older oral liquid medicines supplied with inaccurate dosing devices had not been improved.

Marketing injectable drugs in a ready-to-use form is helpful for both patients and healthcare professionals.

To make health care safer, drugs must be made available in high-quality packaging from the moment they are introduced on the market. Careful attention to drug packaging should be an imperative for pharmaceutical companies compiling marketing authorisation applications and for regulators who evaluate them.

Full text available for free download below.

©Prescrire 1 September 2022

Source: "Annual review of drug packaging: choose high-quality packaging for safer health care" Prescrire International 2022; 31 (240): 216-219. Free.

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