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Letters to the Editor
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Packaging
Patient safety should come first
From Mr K. Upadhyaya, MRPharmS
Chris Green’s point (PJ, 1 April, p383) is well made. When I previously
telephoned Pfizer to complain about its packaging policy I drew the conclusion
that it was more interested in its global corporate branding policy than
issues of patient safety.
I would suggest to Bruce Charlesworth (Pfizer UK) that the emphasis on
tablet recognition and counterfeit control is admirable, but it is probably
statistically insignificant compared with the potential for a dispensing
error caused by its packaging.
I also wonder about the appropriateness of cost-cutting exercises, such
as standardising box sizes (as in Lipitor 20mg and 40mg) and embossing,
rather than inking expiry dates. Are dispensing pharmacists ever consulted
before such changes are instigated?
Our primary care trust has run forums to adapt clinical governance to
improve patient safety and reduce potential adverse incidents. Are there
such governance arrangements ongoing in the pharmaceutical industry?
By contrast, it is pleasing to see that for some companies (eg, Almus
and Teva) the emphasis is on clearly distinguishable packaging. For such
companies it seems, patient safety is integral to their corporate branding.
Kamlesh Upadhyaya
Professional Executive Committee Pharmacist
Barnet Primary Care Trust
Patient well-being at stake
From Dr G. L. Stretch, MRPharmS
I was amused to spot not one, but two April fools in last week’s
edition of The Pharmaceutical Journal. The first, regarding the Coat
of Arms, brought a smile to my face, but I was surprised by the second, hidden
away on the letters pages, in the patronising tone of Bruce
Charlesworth’s
reply to Chris Green’s legitimate concerns about patient safety.
I will use two recent near misses that occurred in a dispensary under my
control to support Dr Green’s points. Only at the last check did
a mix-up between Imuran and Imigran come to light: these two GlaxoSmithKline
products not only have similar packaging but also similar names and strengths.
Another near miss occurred with Geigy’s Tegretol and Anafranil. I
think most colleagues will agree that anything that can be done to reduce
the risk of such errors is both common sense as well as good clinical governance.
As for the hypothesis that Pfizer’s blue and white packaging represents
a barrier to counterfeiting, any of my retail colleagues, who have been
on the receiving end of a forged £20 note, infinitely more difficult
to copy, will appreciate that a blue and white box represents little barrier
to a determined criminal, as the recent problems with Lipitor illustrates.
In my view, imaginative packaging from the manufacturers Ivax, Almus and
Teva demonstrates that a strong corporate identity and easily differentiated
packaging are not mutually exclusive, and these manufacturers are to be
commended. I would invite Dr Charlesworth to visit his local pharmacy to
see what a problem look-alike packaging is in the day-to-day running of
a safe dispensary and would urge him to treat the views of experienced
and eminent pharmacists such as Dr Green with more gravity, especially
when the interests of patient well-being are at stake. I would encourage
any readers involved in the packaging of pharmaceutical products to strive
to design easily differentiated and recognisable colour schemes to help
busy colleagues maintain what all of us treat as our primary aim, patient
safety.
Graham Stretch
Hanwell,
London
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The
Pharmaceutical Journal