Companies support appropriate use through brochure and packaging adaptations

• Various factors offer challenges to patients' appropriate use of medicines

• Innovative solutions being offered across the industry

Challenges and solutions

The risk of resistance is lowered when patients understand the risks and adhere to their courses of treatment until they are completed. 

When patients are prescribed medicines, the packaging as well as materials such as informational brochures can help them to understand AMR, and how they can minimise these risks to themselves and their communities. 

Pharmaceutical companies can adapt packaging materials to ensure information is clear, for example by presenting it in a local language, or by supporting it by pictograms in areas with low levels of literacy.

Eleven companies out of 17 report taking steps to minimise AMR and facilitate appropriate use through brochure and packaging adaptations. Since the last Benchmark, Abbott and Aurobindo now report making adaptations.

Challenge: Language needs

Patients may not be able to read the included instructions on how to use the
product appropriately if they are not written in the local language.

Solution: Eight companies have made language adaptations

• Cipla adapted its patient education leaflets for itraconazole, oxiconazole and fosfomycin trometamol in India. These leaflets contain QR codes that redirect to information in eight to ten regional languages in India: Assamese, Bengali, Gujarati, Kannada, Malayalam, Marathi, Odia, Punjabi, Tamil, and Telugu.

• Teva’s packaging for azithromycin and linezolid contains information that is translated into English, Spanish, French and Portuguese. The multilingual packaging was adapted for the receiving country.

Challenge: Adherence facilitation

Patients may not be aware they need to finish the full course of treatment even if they start feeling better.

Solution: Six companies have made adaptations to facilitate adherence

• Cipla created leaflets for itraconazole and amorolfine that contain information about things to be considered while taking antifungal medication, e.g. to complete the course of treatment even if symptoms improve earlier.

• Johnson & Johnson packaged a six-month treatment regimen (188 tablets) of bedaquiline (Sirturo) in a single bottle. This was designed to enable patients to follow a full course of treatment without needing to make multiple visits to a pharmacy or clinic.

Challenge: Paediatric use

For paediatric patients there may be different requirements for the administration or dosing of the product.

Solution: Five companies have made adaptations for paediatric use

• Abbott adapts packaging of eight antibacterial paediatric suspensions by including a QR code on the packaging that directs to a video explaining how to use them appropriately.

• Pfizer has adapted packaging of azithromycin (Zithromax) as an oral suspension to include a QR code that directs patients to a video explaining how to administer the oral suspension properly for adults and children. This is applied in Vietnam and the Philippines and the video is played in the local language.

Challenge: Literacy levels

For illiterate patients it is difficult to understand written instructions on how to use the product appropriately. 

Solution: Two companies have made literacy-related adaptations

• Abbott adapts packaging for antibacterial medicines in India by including pictograms to illustrate the recommended usage regimen.

Challenge: Environmental conditions

Local environmental conditions can decrease the effectiveness of the product.

Solution: One company has made an environmental adaptation

• GSK designed blister packaging for amoxicillin/clavulanic acid (Augmentin™) with a specific lidding foil that is sensitive to moisture ingress for high humidity environments. This technology also received the Alufoil Trophy Award for its innovation in technical packaging.

More than half of companies support patient education on the risks of AMR

Ten companies are involved in general patient education on AMR through awareness campaigns, brochures, posters, articles, videos, games, comic booklets and a TV drama series.