The oral route is a simple and cost-efficient way of delivering medicine, typically as tablets or capsules. However, recent data suggest that these solid dosage forms are often far from optimal. Commissioned by HERMES PHARMA, the market research company SPIEGEL INSTITUT Mannheim surveyed 2000 people in the US and Germany to explore the acceptance of conventional dosage forms such as tablets and capsules as well as user-friendly forms including effervescent and chewable tablets, lozenges, orally disintegrating granules (ODGs) and instant drinks. The goal of the study was also to estimate the proportion of the population having difficulties taking tablets/capsules, as well learn how people overcome these challenges. The researchers assessed people's awareness, experiences and preferences when using tablets/capsules and other dosage forms.
DETAILS OF THE SURVEY

DETAILS OF THE SURVEY

This impartial quantitative survey was commissioned by dosage form specialist HERMES PHARMA and carried out by SPIEGEL INSTITUT Mannheim, a renowned international third party provider with 110 employees and over 60 years of experience. It targeted 1000 people in Germany and the United States (over 2000 people in total), tailored to reflect overall population demographics in terms of age, gender and ethnicity to generate statistically reliable data.

The study was executed via a web-based online questionnaire. Participants were recruited using panels in Germany and the US based upon pre-assigned quotas so that the final samples represented the population demographics within each country. The selected participants received an invitation via email with a link to the questionnaire. SPIEGEL INSTITUT designed and executed the entire study and statistically analyzed all of the data captured.
  • Memberships:
PARTICIPANT
DEMOGRAPHICS

 PARTICIPANT DEMOGRAPHICS US STUDY

Below you will find more information on the background of the 1002 participants that took part in the US study. The sample was designed to mirror the population demographics of the US in terms of age, gender and ethnicity to ensure that the results of the study would be representative of the overall US population.
 
PARTICIPANT
DEMOGRAPHICS

 PARTICIPANT DEMOGRAPHICS GERMAN STUDY

Below you will find more information on the background of the 1012 participants that took part in the German study. The sample was designed to mirror the population demographics of Germany in terms of age and gender to ensure that the results of the study would be representative of the overall German population.
 

MAIN STUDY FINDINGS

Difficulties swallowing tablets/capsules are a widespread issue that may influence treatment success
  • 0%
  • IN THE US
  • MORE THAN
  • 0%
  • IN GERMANY
Over half of the people reported difficulties swallowing tablets/capsules, and around a third reported the issue as serious. The most frequent reasons cited were the tablets/ capsules being too big, becoming stuck in the throat and having an unpleasant taste/odor. People did not report similar problems with foodstuffs or fluids.
Please see graph 1 below



Many people reported using much more water to overcome these difficulties. Others tried breaking tablets (32%), crushing and dissolving them in water (17%) or chewing them (9%). All of these approaches can negatively affect API release profile, bioavailability and medical efficacy. Most worryingly, 8% had resorted to not taking their medication at all.
Please see graph 2 below
QUESTION
Do you have or have you had problems or discomfort prior to or while swallowing tablets/capsules? If so, how do/did they occur?
(Multiple responses were possible.)
CLICK AND HOVER
FOR MORE DETAILS
USA N=1002, Germany N=1012
QUESTION
What did you do to resolve your problems when swallowing tablets/capsules or to relieve the discomfort?
(Multiple responses were possible.)
USA N=500, Germany N=625
MARKET OPPORTUNITY
Difficulties swallowing tablets/capsules affect more than half of the population, representing a huge and relatively untapped market segment. Bringing medicines to market that are easier to swallow would not only open up new revenue opportunities for Pharma, but also improve patient experience, increase compliance and reduce healthcare costs.
Difficulties swallowing tablets/capsules are not only a problem for the elderly
  • 0%
  • OF THE YOUNGER GENERATION
    REPORTED DIFFICULTIES
    SWALLOWING TABLETS/
    CAPSULES
  • 0%
  • OF THE OLDER GENERATION
    HAD THE SAME PROBLEM
Perhaps counterintuitively, a greater number of young people (aged 16–34) reported swallowing difficulties when using tablets/capsules compared to other age groups, especially those over 65. Tablet size was an issue across all age groups.
Please see graphs below:
1–2 for results from the US,
and 3–4 for Germany
Older people tended to highlight those factors associated with tablet size as being the most important cause of swallowing difficulties, whereas younger people also cited disliking the taste and odor of tablets/capsules.
Please see graphs below:
1–2 for results from the US,
and 3–4 for Germany
QUESTION
Do you have or have you had problems or discomfort prior to or while swallowing tablets/capsules? If so, how do/did they occur?
(Multiple responses were possible.) US results, part 1
CLICK AND HOVER
FOR MORE DETAILS
*Significant group difference, p<5% | N=1002
QUESTION
Do you have or have you had problems or discomfort prior to or while swallowing tablets/capsules? If so, how do/did they occur?
(Multiple responses were possible.) US results, part 2
*Significant group difference, p<5% | N=1002
QUESTION
Do you have or have you had problems or discomfort prior to or while swallowing tablets/capsules? If so, how do/did they occur?
(Multiple responses were possible.) German results, part 1
*Significant group difference, p<5% | N=1012
QUESTION
Do you have or have you had problems or discomfort prior to or while swallowing tablets/capsules? If so, how do/did they occur?
(Multiple responses were possible.) German results, part 2
*Significant group difference, p<5% | N=1012
MARKET OPPORTUNITY
Both, young and old people experienced difficulties swallowing tablets/capsules, but for different primary reasons. By addressing these difficulties through dosage forms that do not have to be swallowed whole or are both pleasant tasting and smelling for example, companies could meet the needs of multiple market segments.
Swallowing is not the only problem with tablets/capsules
  • THE ‘EASE OF INTEGRATION
    INTO EVERYDAY ROUTINES’
    WAS CITED BY
  • 0%
  • 0%
    OF PEOPLE APPRECIATE A PLEASANT FLAVOR/ODOR
  • 0%
    OF THE PARTICIPANTS MENTIONED THAT THE PACKAGING SHOULD BE EASY TO OPEN<
Nearly half of the participants also encountered other problems when taking tablets/capsules, with some factors varying depending on the age group. Older people for example, tended to have difficulties pressing tablets/capsules out of the blister, whereas younger people highlighted the inconvenience of taking them ‘on the go’.
Please see graphs below:
1 for results from the US,
and 2 for Germany
The survey also looked in more detail at the most important product characteristics: 64% of the participants reported that pharmaceuticals should be easy and comfortable to swallow. A pleasant flavor/odor and ‘ease of integration into everyday routines’ were important to 38% of the participants. A third mentioned that the packaging should be easy to open.
Please see graph 3 below
QUESTION
And besides potential problems with swallowing tablets capsules: Do you have or have you had any other difficulty in
connection with taking tablets/capsules? If so, in what form do/did these difficulties occur? (Multiple responses were possible.)
CLICK AND HOVER
FOR MORE DETAILS
*Significant group difference, p<5% | N=1002
QUESTION
And besides potential problems with swallowing tablets capsules: Do you have or have you had any other difficulty in
connection with taking tablets/capsules? If so, in what form do/did these difficulties occur? (Multiple responses were possible.)
*Significant group difference, p<5% | N=1012
QUESTION
If you had to take a medication or a food/dietary supplement short-term/long-term: What characteristics would then be particularly important to you? (at least one but not more than four characteristics)
USA N=1002, Germany N=1012
MARKET OPPORTUNITY
Besides making products easy to swallow, companies could increase customer loyalty and successfully differentiate their brand(s) by providing choice through a range of flavors and designing packaging that is easy-to-open and to carry around.
Alternative, user-friendly dosage forms are well-known by most people
In the US, most people were already aware of user-friendly dosage forms such as chewable tablets, lozenges and effervescent tablets, yet fewer had tried them in comparison to people in Germany. ODGs were the least well-known user-friendly dosage form: less than half of the US participants knew of them and only 16% reported having already used them.
Please see graph 1 below
Over 90% of people in Germany were aware of most user-friendly dosage forms such as effervescent and chewable tablets, lozenges and instant drinks. Almost all had already tried them, particularly effervescent tablets and lozenges. However, a smaller proportion had tried instant drinks (65%), chewable tablets (50%) and ODGs (39%).

Please see graph 2 below
QUESTION
Are you familiar with chewable tablets | effervescent tablets | instant drinks | lozenges | orally disintegrating granules | tablets/
capsules as a dosage form?
CLICK AND HOVER
FOR MORE DETAILS
N=1002
QUESTION
Are you familiar with chewable tablets | effervescent tablets | instant drinks | lozenges | orally disintegrating granules | tablets/
capsules as a dosage form?
N=1012
MARKET OPPORTUNITY
For companies looking to differentiate their offering, user-friendly dosage forms could be a fertile opportunity. Many people have heard of alternatives and a number have tried them already. For particular dosage forms, such as ODGs where awareness is lower, innovative companies could take market share by creating products that are viewed as new and exciting to the market.
User-friendly dosage forms outstrip tablets/capsules when it comes to user experience
TABLETS/CAPSULES SCORED LOWER FOR CHARACTERISTICS
SUCH AS EASE-OF-SWALLOWING, SENSATION IN THE MOUTH
AND PACKAGE-OPENING
Instant drinks scored highly across most criteria in the US as people thought they were quick and easy to ingest while being easy to swallow. ODGs came second, scoring highly for ‘opening the packaging’ and ‘integration into everyday routine.’

Please see graph 1 below
In Germany, lozenges received the best evaluation: participants found them to be easy to ingest and integrate into their busy lives. ODGs came second, scoring highly when it came to integration into daily routines. Effervescent tablets and instant drinks followed them closely and received mainly positive scores.
Please see graph 2 below
QUESTION
You indicated that you have taken chewable tablets | effervescent tablets | instant drinks | lozenges | orally disintegrating
granules | tablets/capsules yourself. How do you rate these in light of the following characteristics?
CLICK AND HOVER
FOR MORE DETAILS
*Significant group difference, p<5% | N=159-920
QUESTION
You indicated that you have taken chewable tablets | effervescent tablets | instant drinks | lozenges | orally disintegrating
granules | tablets/capsules yourself. How do you rate these in light of the following characteristics?
*Significant group difference, p<5% | N=388-935
MARKET OPPORTUNITY
People who had experience with user-friendly dosage forms scored them more favorably than conventional tablets/capsules across all criteria. This clearly indicates that they better meet consumer needs, making them likely to be more successful in the market than traditional solid forms.
Parents prefer alternative, user-friendly dosage forms for their children rather than tablets/capsules
Parents in the US preferred chewable tablets and instant drinks for their children, especially for those between one and three years. For older children, they tended to select chewable tablets as the favored option.
Please see graph 1 below
Most German parents preferred dissolvable products such as effervescent tablets and instant drinks for their children. The trend moves towards more solid forms such as lozenges and chewable tablets as children get older.
Please see graph 2 below
Having a pleasant flavor was the most important characteristic according to all parents, followed by ease of swallowing and pleasant sensation in the mouth.
Please see graph 3 below
QUESTION
Imagine that your child/one of your children had to take a medication or a food/dietary supplement. Based on your experience
as a parent, which dosage form would you favor for your child? (Multiple responses were possible.)
CLICK AND HOVER
FOR MORE DETAILS
  • Chewable tablet
  • Effervescent tablet
  • Instant drink
  • Lozenge
  • Orally disintegrating granules
  • Tablet/capsule
  • All, more or less
  • Other
N=62
N=87
N=128
N=135
QUESTION
Imagine that your child/one of your children had to take a medication or a food/dietary supplement. Based on your experience
as a parent, which dosage form would you favor for your child? (Multiple responses were possible.)
  • Chewable tablet
  • Effervescent tablet
  • Instant drink
  • Lozenge
  • Orally disintegrating granules
  • Tablet/capsule
  • All, more or less
  • Other
N=52
N=36
N=73
N=99
QUESTION
And, regardless of the age of your child/children, which of the following product characteristics are important to you
when you have to give your child/ children a medication or a food/dietary supplement?
USA N=294, Germany N=218
MARKET OPPORTUNITY
Parents felt that solid tablets and capsules are a poor option for their children – especially when they are younger than 12 years old. Companies targeting pediatric markets should consider developing user-friendly dosage forms that have a more pleasant taste and are easier to swallow.

5 GOOD REASONS TO MAKE MEDICINES MORE USER-FRIENDLY

1
The more than 50% of people having difficulties swallowing tablets/capsules represent a significant and yet nearly untapped market opportunity for Pharma.
2
Developing specific dosage forms for different cultures, ages and preferences will allow Pharma to better meet the needs of certain market subsets and foster customer loyalty.
3
By introducing dosage forms that are truly user-friendly, companies can increase revenue, prolong product lifecycles and differentiate themselves from competition.
4
Improving patient experience via enhanced convenience and greater ease-of-swallowing should increase compliance and boost the effectiveness of treatment.
5
User-friendly dosage forms often allow greater amounts and different combinations of active ingredients to be delivered in a single dose, helping to simplify treatment regimens.
CONTACT US
HERMES PHARMA GmbH
Georg-Kalb-Straße 5
82049 Pullach
Germany

Phone +49 89 79102 261
www.hermes-pharma.com

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