Medication Compliance Packaging for Medicare Advantage: An Overview

medical-blister-cardThere was a time when almost all medications in pill form were dispensed the same way. A pharmacist would use a pill counter (or count pills manually), carefully slide them into a translucent, amber-colored vial, apply the child-resistant lid, and then process the transaction.

This process is still practiced today. However, in addition to using traditional prescription containers, pharmacies are increasingly dispensing pills in blister packs — a practice that helps them comply with medication packaging requirements that benefit carriers of Medicare Advantage plans, Medicare Advantage recipients, prescribers, and pharmacies themselves.

The Benefit of Blister Packaging
In 2005, the Centers for Medicare & Medicaid Services (CMS) created a program that established compliance packaging requirements for medications. One of the primary goals was to reduce the number of patients who accounted for medication non-adherence — a term which means that a patient does not comply with his or her physician’s prescribing directions for a medication.

According to recent research, medication non-adherence accounts for roughly $300 billion in avoidable medical spending. Part of the cost is absorbed by pharmacies in the form of patients who hop from medication to medication at their own instigation, and thus require pharmacies to use more pill containers, as well as patients who don’t fill prescriptions, or who fail to request refills.

For Medicare, the goal was to find cost-effective ways to increase medication compliance without implementing complex strategies whose return on investment (ROI) was difficult to predict in the long run. One of the best strategies, the CMS decided, was to use medication packaging that increased medication compliance, and thus reduced associated drug costs. Consequently, the organization implemented compliance packaging guidelines for medication.

Nearly ten years later, Medicare’s compliance packaging requirements are most commonly seen in the use of intuitively designed blister packs. Removing pills from the slim packs would seem to require more effort than retrieving them from a bottle, but blister packs ultimately lower the barrier to using a medication. The packaging shows patients which pills to take on what days, and can provide a variety of information that helps them take medicine responsibly.

CMS’s Five-Star Rating System
Partly to encourage medication compliance, and in turn increase positive “accountable outcomes” for Medicare Advantage providers, the CMS established a one-to-five-star rating system for Medicare Advantage plans, which are offered by commercial insurance companies.

The more stars a plan receives, the greater the percentage of reimbursement a provider receives for medical costs under Medicare Advantage. Providers can also receive bonuses for achieving a high rating. In 2013, providers received nearly $3.1 billion in bonus payments that were established by the Affordable Care Act (ACA) — roughly the same amount of money that was lost on avoidable medical spending in the same year.

The positive impact of high-quality blister packs on medication noncompliance is but one facet of CMS’s original plan to improve accountable outcomes for insurance carriers, but it is an important one that possesses the potential to reduce costs and improve finances for various parties involved in the medication dispensing process: pharmaceutical companies, healthcare providers, pharmacies, patients, and even freight carriers that comprise the delivery chain.

The Future of Blister Packaging
According to a recent news release by PR Newswire, the U.S. blister packaging market is expected to “grow at a [Compound Annual Growth Rate] CAGR of 6.11% over the period 2014-2019.” However, it is important to remember that not just any type of blister packaging will drive great results. The packaging must be designed to reduce medication noncompliance, and this often means designing different types of blister packs or different types of medications.

At Drug Package, we lead the design of best-in-class blister packaging that meets a broad array of compliance packaging requirements and helps to reduce medication noncompliance in the patient population. To learn how we can help your organization by providing the best compliance packaging available, call us today at (800) 325-6137, or email us today at

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