CHOICE membership

Packaging medications


#1

This might not be one of the top problems in modern civilisation, but I now have 2 ongoing scripts. Inexplicably one is packaged in 30’s meaning in each 365 days there are 12 scripts for 360 tablets. Close enough, and go to the chemist once a month.

The second is packaged in 28’s, for 13 boxes p.a. for 364 days. OK, technically a visit to the chemist every 2 fortnights.

Since I need new scripts annually there is an annual resynch, but.

It makes no sense that different medications that are always prescribed for long term treatment would come in different quantities, but here I am. As the year gets old it is just a chat with the chemist explaining why I want two refills of one or the other a bit early to keep my supply and it is not a problem, but why?

The 28’s is packaged with 4 of these cards. Seems putting 10 on a card would not be a worry. Without saying, the box is commensurately larger than necessary too. One might argue the 28’s are more conducive to keeping track, but then why the 30’s where the same argument should hold?

30’s make sense, 28’s make sense, but 30’s and 28’s make no sense. Why can’t the quantities be standardised, especially since they are ‘forever’ meds?


#2

When I worked in the industry it was glibly referred to as ‘marketing’ - which I always assumed meant a team of people who were experts in the important side of the business - cost reduction, efficiency, shareholder return - sat down over a few boozy lunches and thrashed out the important question of ‘how many tablets in a box’.

I never heard an explanation that made practical sense.

It’s not like the missing tablets on the blister leaf interleave with the next leaf to save packaging space either. In a packaging sense the blister leaf is fairly flexible - easily reconfigured/reduced for sample packs.

It’s understandable when it is ‘a course’ as with antibiotics - maybe 11 is a normal adult course, so the pack comes with 11, as a random example - but not with ongoing.

Maybe the consumer line at one of the big ones could help? Pfizer or Glaxo? I’m sure there’s an official answer, even if it does have some ‘spin’ :wink:


#3

I actually sent the question about packaging of long term sustaining medications to Sandoz since I buy Sandoz generics and the TGA since product-dose packaging is standardised. This is such an ‘important problem’ I suspect few think about it and just accept that is how it is.

I posed the question in my emails and made the Points:

  • all long term medications might be best dispensed in EITHER 30's OR 28's but not both to enable consumers to synchronise purchases
    
  • dispensing with the same number of tablets per card (and box) helps people keep track of what they have taken as well as supply
    

I have a feeling the TGA’s reply will be ‘not our problem’ but Sandoz might provide more, plus Choice health might not have considered this aspect, so here I am. Yes, I’ll add the replies when I get them.


#4

I have a close family member where mobility is limited and unlikely to improve, age, old bones, common story. That person is on a number of medications that will be ongoing, probably for life, and getting to the chemist is becoming more of an issue - as I am regularly told … On the one hand, having an excuse to get out and somewhat active, even just a trip to the chemist, is a good thing - but sometimes it is just too much. I know there are online services, but for people approaching three digit age, sometimes computers and online stuff is all a bit ‘new fangled’ :wink:

The sell ‘the pill’ in monthly batches - so we know they can do it !!


#5

I think, in my cynical nature, that much of the 28 day packaging rather than the 30 comes down to sales/income. While the individual tablet may not have a large price and thus not generate a large income, a packet that sells 13 times in a year rather than 12 means one further sale at whatever price they have on it. This 13th sale generates another 7.7%, compared to 12 monthly sales, in income and as such is no small thing in terms of the large number of national sales made.


#6

Number of Repeats - Maybe Medicare has a role in this? There may be limitations on the number of Repeats or length of treatment eg 12 months.

I am on one medicine unlikely to change, in fact it has been stable for 30+ years, but depending on the doctor, I have to return for a Repeat Script appointment and maybe blood test 3 monthly, 6 monthly or yearly. The current packet is 6 x 30 (6 months), but I have been put on much smaller packets.
I lived in a town of <1,000 people and the doctor charged $70, was a 6+ week wait, would not give results without an appointment, one question only. So I need to book another 3 doctor appointments as I walked out of the last - take blood, results, repeat script. He made his first $million and moved on.

I suspect a number of factors at play.


#7

That is the case that a script expires at 12 months, but that is unrelated to the way doses are packaged. Some medication can affect you, eg an annual blood test when on statins is a liver check, and on ACE inhibitors potassium needs monitoring.

I have a late rellie (USA) who was on a medication that was documented ‘check lungs’ but the doctor did not until some serious symptoms developed after a few years - scar tissue in the lungs. It took another decade but the ramifications finally were his cause of death. In the interim do you think any lawyer or doctor would step in for a malpractice suit? Not in the USA, if anywhere.

Sometimes a doctor might want some ‘supplementary income’ by bringing you back, but sometimes it is due diligence that should be respected. The easiest clue is to read the information sheet for your meds regarding possible side effects.


#8

I mentioned the 30 vs 28 packaging to a group and a comment was that maybe the drug companies also own the companies who make all those wonderful dose boxes and the profits are rolling, no problem, no change required :smiley:


#9

Webster packs are for 4 weeks/28 days…

http://www.webstercare.com.au/


#10

Had to laugh… Here I was thinking that I am the only one frustrated by the disparity in the duration of the foils the prescription medicines are packaged in. The same applies to non-prescription drugs that are just as important.


#11

I’m on multiple scripts and agree. The only sense it makes seems to be to those that gain the most. The one extra trip to the doctor and the chemist to make up the shortfall of the tablets must make a hell of a difference to their respective incomes when multiplied by the many who have to pay.


#12

I may stand corrected, but I do not think it includes an extra trip to the GP, just to the Chemist. Scripts have a 12 months lifetime but I am not aware of a limit to what can be prescribed, eg whether 12x30 or 13x28 boxes.


#13

Mine is a box of 30 - script lasts 12 months before it’s validity expires but there are only 5 repeats on the script before I need another script - can’t remember whether that is original and 5 repeats or 5 dispenses total, but either way its 5 or 6 months worth of tablets …

Edit: my doc does do script renewals at 10 or 15$ a hit, from memory, which is good since a normal appointment here is $80.


#14

Maximum is original Script and 5 repeats thus 6 in total, and as @draughtrider noted this is a maximum of generally 6 months worth. There can be multiple boxes for each dispense but is normally only enough for 1 months worth of the medicine, some such as antibiotics can be only for 7 days or less.

What are termed Authority scripts can be different but each of those require an Authority number/code to be obtained before they can be dispensed.


#15

Apologies you are correct.
Scripts do have a 12 month life and you are limited to 5 repeats plus the original per script.
I suppose it depends on how many of each you have to take per day.


#16

I believe that is not the case. The number of repeats just needs to fit into a 12 month technical dose window.

I have one packaged in 30s with the original dispense + 11 repeats = 12 months worth. The one I have with 28s is still new and we are watching its efficacy. I expect when it goes annual it will be the original + 12 repeats.


#17

From Sandoz, informative and responsive. I’ll add anything further I may receive.

Thank you very much for your email. We appreciate and welcome all queries with regards to our products.

Before therapeutic goods can be lawfully supplied in Australia, they must be entered in the Australian Register of Therapeutic Goods (ARTG). This listing contains details of the product, including pack sizes. Many therapeutic goods are manufactured overseas to international regulatory and quality standards. In many cases the Australian sponsor of the product has limited control on the pack sizes that are available for registration on the ARTG.

We will make enquiries to address your concerns and take this into consideration for chronic medications if the manufacturing process and tooling can make the required allowances.

If you are taking multiple medicines, your pharmacist may be able to assist with solutions to help you to keep track of the medicines that you are taking.

Comparing apples to avocados is irrelevant but teases the question. I am looking at two different generic meds in 28’s, each serendipitously is $5.40 per box, $70.20 p.a… Clearly a trend (/humour1). The one in the 30’s box is $5.99, $71.88 p.a… Equally valid trend (/humour2) The premise about it all being P/L could only be demonstrated by finding the same exact med being supplied in both 28s and 30s, and what are the chances of that. Posting/asking meds and prices for crowd sourced data could be a privacy or personal issue, so not on.


#18

The 5.40 boxes if made up to 30’s would be based on the tablet price $5.78 not a huge difference to $5.99 but still per user over 12 months is $2.52. Considering they may likely sell 1,000’s or 10,000’s or more per year the returns by decreasing the packet size to get the one extra sale per year is enormous.


#19

I think consistency is the key issue, not whether 28 or 30 is better or the value for money of either. Personally 28 suits me better because it fits in with weeks of supply whereas 30 fits in with nothing - but making them all 30 would do.

It is very common for those over 50 (increasing with age) to take multiple ‘forever meds’, one could be on them for 20-30 years. It seems impossible to avoid a mix of 28 and 30 and so inevitably the scripts get out of synchronisation. As memories fail and we grow less competent and less mobile taking them and keeping the scripts filled and up to date reliably becomes more difficult. My doctor tells me he fights a constant battle with some people to get them to regularly take their pills. The way to do it is to establish a routine but the 28-30 problem makes this impossible.

Surely it cannot be too hard to remove this simple problem and for the public health system to therefore get more bangs per buck.


#20

excepting that comparison is against two unlike, non-comparable meds. If we just look at the $5.40 x 28 by itself, that is $5.4/28 = $0.192857 each (got to round or truncate somewhere) so 365 tabs would be $70.39. But there is nothing to compare that with since I do not have pricing for this med in a box of 30. Same in reverse for my box of 30 tabs - without pricing for a box of 28s, nothing to compare against to make a conclusion.