Healthcare Labeling

By Lisa Nieves Mateo | July 11, 2005

With constant healthcare reform and government pressure to lower the price of pharmaceutical products, cost has become a major issue in this growing market.

The healthcare labeling market is experiencing an era of change. A rise in managed care pricing pressures and government strain on pharmaceutical companies to lower the prices they charge consumers have altered the demands of the end user. Cost has become a major issues among suppliers, as pharmaceutical companies look for less expensive materials and more cost effective ways of packaging their product. These severe cost containment issues have also influenced a shift to automatic data collection, creating new opportunities for bar code labels and variable information technology.

Another strain on the industry affecting cost is the decreasing number of patients remaining in hospitalized care. "With changes in healthcare and managed care programs, and the rise of specialty centers devoted to specific ailments, patients are beginning to stay fewer days in the hospital," says Jerry Nerad, president of TimeMed Labeling Systems, Burr Ridge, Ill. "Many hospitals are underutilized, averaging at about 65 percent capacity. There are more surplus beds than ever before. With the number of rehabilitation centers and day surgery centers, people are opting to receive needed procedures on an in-and-out basis."

The label difference
Unlike labels in other markets where color appearance is extremely important, converters involved in the healthcare industry have to be concerned with a host of processing problems, including ink toxicity and functional requirements of the ink and the material. "Our customers not only take a printed sample of the label; they request a liquid sample of the ink to complete different lab tests," says Tim Stasak, process engineer for Tolas Healthcare Packaging, Feasterville, Pa. "They check for functional requirements like adhesion, light and heat resistance, and whether there is light penetration and moisture vapor transition strengths.

Stasak says heat resistance is especially important for labels that have to withstand intense conditions, such as a sterilization process. "If an ink does not have these properties, it will bleed off the label and may cause harm to the product," he says. "Printing in this market is a whole different world."

Daryl Madeira, pharmaceutical market manager of Avery Dennison, Fasson Roll North America, Painesville, Ohio, provides his observations. "On the ethical side, testing for label performance is conducted for heat pasteurization, mandrel testing to determine 'flag-off' for certain applications such as narrow web diameter syringes, and stability to make sure nothing migrates from the label through the walls of the container."

Before taking the plunge into this demanding market, converters must consider a few important factors. "First and foremost is product reliability. In this market there is a tremendous liability if the label doesn't take to printing well. The consumer's health depends on accurate and legible print," says Madeira. The same applies to adhesive technology. "You want to make sure the label stays with the product. This helps in counterfeiting, lost sales, and most importantly, health risks.

"Next is a strict attention to quality conformance. For converting and packaging in this market, auditing of facilities occurs on a regular basis," says Madeira. "Then there is product breadth. In the ethical market there are some products that have direct contact with the consumer. They rely on products that they can count on. However, in the over the counter market, shelf appeal has become more and more important," he adds.

Application opportunities
The healthcare market encompasses a variety of products, from those located in a hospital to those located in your local pharmacy behind or over the counter. Within the hospital segment, labels are found in every department.

"Label usage in hospitals conveys instruction, provides patient information, and helps reconcile patient charge items," says Nerad of TimeMed Labeling Systems. "Labels are in the laboratory, pharmacy, nursing department, central supply, medical imaging and material managing departments � I can go on and on. The possibilities are endless."

Opportunities also exist for labels used for tracking information in the healthcare market. "On the provider side these types of products can be used for wrist bands, radiology, asset management, and for central supply as equipment is moved from one room to another," says Faye O'Briskie, market development leader of the electronics printing business team at FLEXcon, Spencer, Mass.
Emerging trends in healthcare

Cost-effective packaging is always a topic of discussion in the healthcare field. One way end users have combated this stress is through the use of extended content labeling, which has taken away the need for packaging in some applications. This innovative form of labeling not only provides a more cost-effective alternative, but also allows for more information to be included on the product itself. "Consumers are much more savvy than before," says Madeira. "They expect more information on the label, particularly in over the counter applications when they are buying a product without the help of a doctor's prescription," he adds. In addition to expanded content labeling, the transition in packaging from glass to plastic containers is another trend from an economic standpoint, says Madeira.

Globalization is also on the horizon. "Companies operate on a global basis. How soon will it be before they want one package distributed all over the world? End users may decide that it will be more effective for them to standardize on one converter," says Dennis O'Toole, director marketing for the pharmaceutical packaging products division of Avery Dennison. "As a result, some discretion may be taken away from the converter. The end user may begin to specify what types of materials have to be used on a global basis. It's definitely something for converters to consider."

Taking another course is the emphasized focus on label suppliers for technical guidance. "There has been more of an emphasis toward label suppliers being more of a labeling expert due to downsizing, consolidation and the narrowing of their (the end user) vendor base. From my observations, vendors who can conduct more types of printing and provide their customers with a broader perspective of services will benefit," says Jeff Robinson, market development leader of the packaging business team for FLEXcon. "Inserts, expanded content labeling, printed cartons and the ability to convert a wide variety of materials are just a few examples. Security will also become more of an issue in this market, especially with the growth in RFID technology."

Bar codes and variable information
Bar codes and variable information is beginning to play a more prevalent role in healthcare, as many hospitals switch to automatic data collection systems.

"Bar code technology has been around for a long time. They have helped to eliminate errors and are creating more efficiency," says Nerad of TimeMed Labeling Systems. TimeMed has been a supplier of hospital labeling systems since 1955. One of TimeMed's major application segments in the healthcare market is the production of thermal labels for hospitals across the country. Hospitals then take these diecut labels and use them to print variable information via direct thermal/thermal applications. "Variable information printing is a growing part of the healthcare labeling market," says Nerad.

But this growth was not always as prosperous as the amount experienced today. "Due to a rise in managed care pricing pressures in the healthcare industry, hospitals have been slow in the past to respond to the advantages of auto ID information," says O'Briskie. Many healthcare professionals say the investment in the necessary equipment will not be justified even over time, while others remain reluctant to learn how to operate the equipment, she adds. "But with the development of a universal product number system, hospitals are beginning to reconsider this technology," says O'Briskie. "The introduction of improved integrative software systems, as well as portable, low cost data collection systems is also prompting this area to evolve."

Similar to other segments of the healthcare market, labels and the adhesive used in this tracking realm must also withstand certain performance requirements. According to O'Briskie, some examples include tamper evidence, temperature resistance, and excellent adhesion properties to ensure the label does not peel off from the product or ooze out from the side of the label. Some of the products offered from FLEXcon to meet these needs include THERMLfilm, THERMLfilm Select, LAZRfilm, COMPUcal Excel, Poly-2000, and alphaMAX films.

Demanding substrates
On the substrate end, price is becoming a much stronger factor. "There is a growing need to lower the cost of substrates with all of the health care reform and the government pushing pharmaceutical companies to lower the price they charge the consumer," says Robinson of FLEXcon.

One example in the ethical market is the progressive shift from polyester facestock to polypropylene. "Customers want the best quality possible. For vial and ampule labels, the ultra-clarity characteristics of a polyester facestock has been a popular choice. But now, a lot of customers are moving away from PET to a polypropylene facestock, which is a less expensive alternative," says Robinson.
This shift often carries a high investment price to pharma
ceutical companies. "For a pharmaceutical company to switch products, it can cost them thousands of dollars in clinical testing," says Robinson. But if the proposed product outweighs the initial investment in the long run, it may prove a worthwhile decision.

In yet another area is a move from paper to Tyvek. "Tyvek has replaced paper in many areas, even though it is more expensive. There are no fiber issues with Tyvek and it peels cleanly as opposed to paper," says Stasak.

On the release liner front, polyester seems to be taking control. "The costs are coming down for film liners. Additionally, during the dispensing process there are less web breaks and an increase in speed," says Robinson.

Adhesive technology is key. "You have to have good adhesive technology to satisfy the substrates it is applied to," says Nerad. "Labels in this market are being applied to different types of containers from glassware to plastics. They have to be durable and maintain certain characteristics, such as water resistance and various temperature ranges." One example Nerad uses is blood bank labels, which have to withstand refrigeration.

Precise printing
For a market where accuracy can mean the difference between life and death, label quality is key. "There is a tremendous focus on quality in the healthcare market. At times, only printing that has 100 percent inspection is acceptable. I've even seen some converters that perform 200 percent inspection," says O'Toole of Avery Dennison. "ISO certification, or other regiments and structured protocols centered around quality is a plus," he adds.

"ISO certification is important, especially if you do business over in Europe. It gives customers a sense of security because they know you are handling their product with extreme care and attention to detail," says Stasak.

On the printing side, flexo, gravure, offset, litho and letterpress are commonly used. "UV flexo is a popular printing alternative because of its durability, opacity and ability to produce fine print. Letterpress used to dominate the market, but UV flexo has made some great strides," says Robinson.

"In the pharmaceutical market, letterpress printing is widely used, however, UV flexo is coming on strong. As it approaches letterpress in quality, its advantages are becoming more well known," says Madeira. With the use of variable information printing, such as date stamping, digital may also see some opportunities in this market, he adds.