Pill Color May Effect Generic Adherence Rates

Posted by Pharmacist on January 28, 2013

More than 70 percent of prescriptions in the United States are for generic medications. Though the drugs are chemically the same as their name brand counterparts the shape, color and/or other aspects of their appearance may be different.

On December 31, 2012 a study from Brigham and Women’s Hospital (BWH) was published in the Archives of Internal Medicine. It finds patients who take generic prescription drugs that vary in color are 50 percent more likely to discontinue taking the medication.

Aaron S. Kesselheim MD, JD, MPH, was the principal investigator of the study and is currently an assistant professor of medicine in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH. “Pill appearance has long been suspected to be linked to medication adherence, yet this is the first empirical analysis that we know of that directly links pills’ physical characteristics to patients’ adherence behavior,” he said. “We found that changes in pill color significantly increase the odds that patients will stop taking their drugs as prescribed.”

The study was conducted comparing the odds of patients who were taking antiepileptic drugs receiving pills with different shapes or colors from their previous prescriptions. They found that users who received pills with different colors were the most likely to have interruptions in prescription filing. With antiepileptic drugs a few days can increase the patient’s risk of seizure and carry serious consequences.

Kesseheim says “Patients should be aware that their pills may change color and shape, but that even differently-appearing generic drugs are approved by the FDA as being bioequivalent to their brand-name counterparts and are safe to take. Physicians should be aware that changes in pill appearance might explain their patients’ non-adherence. Finally, pharmacists should make a point to tell patients about the change in color and shape when they change generic suppliers.”

It’s important to note that discussing these potential differences at the pharmacy level may be the last opportunity to help improve adherence rates and reduce risk for the patients.

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