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Patient adherence goals drive Walmart's new compliance pack launch

Walmart and Sam’s 4,600 pharmacies add new sustainable calendar-style packs for select scripts in an effort to improve patient adherence to drug regimens.

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A recognized leader in retail trends and sustainability issues, Walmart is poised to further drive the use of patient-compliant calendarized packaging in the U.S. with its December 2012 launch of paperboard-based ecoslide-RX® packs supplied by Keystone Folding Box Co..


The new portable, calendar-style prescription packs, which aim to increase patient adherence to drug regimens, are now rolling out at nearly 4,600 Walmart retail pharmacies across the U.S., initially for 40 different items, with plans to use the packs for another 35 to 40 items by early 2013. Walmart will employ the ecoslide-RX® packs for prescriptions as an additional package configuration, joining traditional amber vials and caps, as well as other calendar-style packs made of other paperboard and plastics.


The pack measures 6 in. W x nearly 3 in. H x nearly 1⁄2 in. deep. Keystone offset-prints the 18-pt paperboard outer sleeve in five colors. On the front panel is Walmart information, opening instructions, drug details, and photos of the specific drug, as well as the child-resistant release button that instructs the consumer to press and hold a corner tab to slide open the product-containing blister within the paperboard sleeve. The blister materials are supplied separately.


For Bentonville, AR-based Walmart, improved patient adherence will yield economic, supply chain, and sustainability advantages. “The biggest opportunity that we see for consumers in a compliance pack is the ability to help them adhere to a medical regimen,” says Ron Sasine, Walmart’s senior director of packaging for private brands. “So often, what we see in a treatment pattern is that the patient is very diligent at the outset of that regimen. But we start to see a drop-off or a lack of adherence weeks and months later. So the real beauty of this type of a pack is it provides a physical printed reminder and an opportunity for consumers to see whether a dose for a certain day has been taken or not. It really gives—and we have seen the medical literature that supports this—a strong uptick in patient adherence to medical dosage.”


Jodie Cartwright, senior pharmaceutical buyer at Walmart, adds, “Ron speaks about the medical journals and articles that have been published around compliance. Most recently there have been a couple of white paper publications that Walmart had great interest in, one of which was from the manufacturer of the brand Diovan [a Novartis blood pressure medicine] that Walmart partnered with. Results of the initiative far exceeded our expectations, demonstrating if the patient looks every day to see that he or she has taken the medication, he or she ends up getting the prescription refilled on time and taking the medication all year long as prescribed.”


Greater adherence improves patient outcomes and ultimately reduces healthcare costs across the supply chain. That appeals to Walmart on many levels, fitting into what Cartwright refers to as the company’s “one-stop-shop” strategy. “For us, probably the most unique thing that we have for our shoppers is that we are considered a one-stop shop. Customers are able to come into our store, pick up their prescription, get milk and healthy food, and buy fitness and exercise equipment and related apparel.”


The evaluation process


Walmart continually evaluates packaging and supply chain options as part of its internal process to benefit customers and improve internal operations. The move to add the ecoslide-RX® pack stems from that ever-evolving evaluation process.


Says Sasine, “We were approached by Keystone and were interested in their ecoslide-RX® development as a potential alternative to broaden what was being done with calendarized packaging for medications. We began conversations with them about how to make the most effective calendar pack, primarily from child-resistance and cost standpoints. We began a development process with them that has spanned more than a year and a half. We’ve met at pharmaceutical and packaging meetings and watched their product development. They gave us regular updates so we could keep track.”


Sustainability factors


Prescription packaging determinations are made by Walmart based upon what makes sense for a particular drug. The ecoslide-RX® calendar pack is tailor-made for once-a-day, 30-day doses, as opposed to scripts that are taken multiple times per day or in different dosage amounts.


Ecoslide-RX® also fits into Walmart’s sustainability initiatives. Sasine explains: “In any type of carded blister, what we are doing is replacing plastic resin with recyclable paperboard. So for the consumer, there’s a greater possibility of disposing that outer sleeve in a recycle stream rather than in a waste-to-landfill stream. That’s a big benefit from our point of view. Of course, there will be that inner chamber of the blister itself, but that’s a far smaller component than the overall outer shell.”


What the consumer does with the package becomes key in this process. Rigid plastics, too, are recyclable, but if the consumer discards either package in the garbage, the recyclable factor becomes mute. Says Sasine, “It corresponds to the local municipality and the availability of different recycling streams for paperboard and plastics.”

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