A Perfect Plethora of Pill Packaging

For some time I've taken an acid reducer (proton pump inhibitor), first as a prescription and later (when my prescription plan decided to put the generic version in their highest-priced tier), in the OTC form.

Now, you may think that OTC stands for Over The Counter. But after careful study, I have concluded that it's really a secret code for Overpackaged Tablet Compartmentalization. Observe:

The most economical package, for someone like me who takes it as a "maintenance" medication, is the 42-tablet package (six-week supply). This is a cardboard box (Figure 1) that could hold two or three 90-day bottles of the prescription capsules I used to get via my mail-order plan. So right off the bat you can tell there has to be a lot of dead space in that box.

Figure 1

We open it and find... three more boxes! Yep, the six weeks worth of pills is broken into three two-week courses, each with its own superfluous box (Figure 2).

Figure 2

These boxes are so flat you have to wonder how the pills are contained inside them. So let's open one. Now we have yet another subdivision -- this time into two separate week supplies, each consisting of one of those damn foil, paper, and plastic blister packs with separate compartments for each individual tablet (Figure 3). The card is perforated so that (in theory, though the perforations are erratic in quality) you can separate off one single pill, still nestled in its hermetically sealed cocoon, for your daily dose.

Figure 3

Now, if you can manage to separate the layers of the aptly-named blister pack at one corner -- and that's a big if -- you can peel the paper backing away to expose the foil, through which you push the tablet from the other side (Figure 4).

Figure 4

And I'm supposed to do this at 6 AM when I'm still 90% asleep? Yeah, right.

(L-R) Opening instructions, OTC tablet, prescription capsules (not same scale)

Now here's the really odd part. These overprotected pills are tablets. Not the arguably more fragile capsules, which the mail-order pharmacy dropped into the US mail with nary a gram of cushioning, just 90 capsules in a hard plastic bottle, inside an unpadded envelope. No, these are hard-surfaced tablets, which hardly seem to require the overblown packaging provided. Evidently the manufacturer must be convinced that, if they don't parcel out the pills clearly delineated by the week -- nay, by the day -- someone's going to OD on proton pump inhibitors and sue them.

This might make sense if your customer base consists only of people who are going to take it for a couple of weeks until their heartburn subsides. But given the widespread prescribing of PPIs for gastric reflux disease, coupled with insurance companies' reluctance to pay for a prescription when can by the OTC version at any drugstore, it seems inevitable that a large contingent of customers are going to be those who are using it as a long-term replacement for the maintenance prescription they can no longer get. You ought to be able to buy it by the bottle, at least 100-120 tablets, same as aspirin and ibuprofen.

Lord knows it would cut down on the crap going to the landfills.