Question
Subject: Capsules vs Tablets
Category: Health > Alternative
Asked by: chubby711711-ga
List Price: $100.00
Posted: 24 Jun 2005 11:54 PDT
Expires: 24 Jul 2005 11:54 PDT
Question ID: 536724
Do consumers prefer taking capsules over tablets for herbal
supplements and vitamins & minerals? How much more is the consumer
willing to pay for a capsule dosage form compared to a tablet?
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Chubby711711-ga,
Thanks for your question. The issue of whether consumers prefer
tablets or capsules when taking any type of medication, including
herbals and supplements, has been studied on several fronts.
The Capsugel company has a useful page comparing information on
consumer preferences over the years. This company makes many types of
capsule products for use in drug manufacturing. Of course, a company
that sells capsules may be biased in their presentation of data, so I
have attempted to temper the information they provide with additional
references.
____________________________
Capsugel commissioned a study by the Burke Marketing Research
Institute to investigate patient preference regarding various pill
forms. Capsules were preferred over tablets - a trend that has been
increasing over the years since 1976 according to this study. The
results of this study can be found at this site:
http://www.capsugel.com/services/rx_dpstdy.php
____________________________
Another study mentioned by the Capsugel company is the PRAXIS Market
Research Group. This study found that thte gelatin capsule was
preferred for its perceived effectiveness, easiness to swallow, and,
to some degree, convenience.
____________________________
Another study, although dated at this point (1972), looked at pill
forms in psychiatric practice. Obviously a variable placebo effect
with different pill forms would influence the outcome of any
psychiatric study where the pill forms differed between two groups, so
this factor needed to be further teased out. Dr. Hussain's paper
found that patients in England taking capsule pill forms consumed the
pills more consistently, requested continuation of their medication
more regularly, and generally had a greater placebo effect (felt that
the capsule form of the same medication had a greater positive
effect). Today, most clinical trials of psychiatric medications
require that the medications be in capsule form.
Hussain MZ. Effect of shape of medication in treatment of anxiety
states. British Journal of Psychiatry. 120(558):507-9, 1972 May.
____________________________
A Japanese study in 1991 of 1000 patients found that easiness to
swallow was an important factor in choosing capsules over tablet pill
forms. Interestingly, this survey found that both tablets and
capsules were essentially equally acceptable dosage forms.
A complete reference for this study is not provided by the company, unfortunately.
____________________________
Capsugel also commissioned a study done by the Povlin research group
in 1997 to look at preferences among consumers for dosage forms of
herbals and vitamins.
"Povlin Study; United States; 700 consumers; 1997
CAPSUGEL commissioned Povlin Research to determine consumer preference
for solid oral dosage forms. 400 herbal users and 300 vitamin users
were interviewed.
* The majority of herbal users, 74%, expressed preference for two-piece capsules.
* Vitamin users preferred the two-piece capsule over a tablet by a 2-to-1 margin.
* Ease-of swallowing was the dominant reason (66%) for preferring
capsules over tablets.
* Women are the dominant decision-maker in households regarding
herbals and vitamins."
____________________________
Capsugel maintains a library of publications, which is accessible
after a short, free registration.
http://www.capsugel.com/services/library.php
Of interest, one abstract describes preference in the UK for herbal
products in the capsule form, again for their ease of swallowing.
This does not appear to be a peer-reviewed article, however.
"Dosage preference for herbal products in the UK: tablets versus
Two-Piece Capsules. A study conducted by Taylor Nelson, Sofres
Healthcare (BAS 198E - 4 pages)
This document reports a study performed by Taylor Nelson/Sofres
Healthcare about the dosage preference for herbal products in the UK.
The key objective of the survey was to identify whether consumers had
a preference for herbal remedies in a tablet or capsule form. In
summary, the survey demonstrates that there is a very big market in
the UK for herbal health supplements, with most consumers preferring
these herbal supplements in two-piece capsules for their ease of
swallowing. These results have all been tested at the 99% confidence
level and have all passed the test."
____________________________
You can contact Capsugel for information on these papers using the
link at the bottom of the publication list.
============================
To ensure that the above information is not unduly biased, I
investigated other sources of information. Medscape has published an
article online looking at this issue from a different perspective -
pill burden and medication compliance. The idea is that taking a
larger number of pills and/or pills in in a dosage form that they find
less preferable may lead to decreased medication compliance (not
taking the pills prescribed). This particular study looked at
compliance in dialysis patients with hyperphosphatemia, although the
results are likely to be applicable to a wider range of individuals
taking similar numbers of pills per day.
http://www.medscape.com/viewarticle/498979
The following excerpt addresses your question:
"The term 'pill burden' is generally considered a function of the
number of pills required for therapy. However, the burden on the
patient is also a function of the difficulty patients have with taking
the prescribed doses due to other factors, such as pill size, pill
form (capsule vs tablet), and method of ingestion (swallow vs chew),
of which are relevant. Calcium acetate as a gelatin capsule was
considered easier to swallow and generally preferred to the tablet
form in 90% of patients in a study of patient preferences in 20
dialysis patients.[3] Beyond this report, these considerations remain
largely unexplored in the literature. These additional pill-burden
mechanisms have taken on new currency with the availability of
lanthanum carbonate, a binder that is chewed rather than swallowed."
As in the studies and surveys cited above, the capsule form was again
preferred, here by 90% of participants.
============================
Although I assume that the primary target of your proposed product
will be adults, there is some information available on children's
preferences for various medication forms. The paper below looked at
medication compliance in general and contains a section on Page 5
discussing medication forms with respect to compliance. This section
also cites references at the end of the article that looked only at
preferences, without regard to compliance (references 47-49). The
full text of the article is available free online at the links below
(PDF and HTML formats).
Winnick S, Lucas DO, Hartman AL, Toll D. How do you improve
compliance? Pediatrics. 2005 Jun;115(6):e718-24.
http://pediatrics.aappublications.org/cgi/reprint/115/6/e718.pdf
http://pediatrics.aappublications.org/cgi/content/full/115/6/e718
============================
Natural Products Insider has a page discussing various dosage forms,
looking more at practical concerns (e.g. dose size vs. dosage form).
http://www.naturalproductsinsider.com/articles/221randdfoc1.html
Here is a relevant excerpt:
"Ultimately, the materials physical properties, chemical properties
and oral bioavailability determine whether the active ingredient is
appropriate for a tablet or capsule. If the total volume required is
high, beyond two grams, a sachet or bulk powder is the logical course
of delivery. It would be difficult to justify a tablet or capsule
formulation knowing it would require consuming a large number of pills
at any given time. Large dosing volumes or multiple dosing reduces
consumer compliance and limits the marketability of the end product.
Nutraceuticals and natural therapies that require reasonable amounts,
below 2 grams, should consider the tablet or capsule form."
============================
PharmQuality.com has an article discussing oral drug delivery systems.
"Taking Control" by Cindy H. Dubin
http://www.pharmaquality.com/Feature3.htm
Here is an excerpt:
"'Because softgels are patient preferred, an oral dosage form such as
this should help increase patient compliance,' says Roger Gordon, PhD,
president of Banner Pharmacaps in High Point, NC. 'Oral drug delivery
is not necessarily the least expensive delivery route, but it is one
of the most convenient.' 'Convenience is indeed a driving force in
oral drug development today and patients are willing to pay a premium
to take just one pill a day,' says Woody Bryan, PhD, vice president,
business development, Shire Laboratories Inc., Rockville, MD."
============================
Consumer preference for one dosage form over another raises an
immediate question that must be factored into a business model - If,
like the compliance studies above have shown, a person takes more of
some pill because it's, say, a capsule, then you can estimate how many
more pills that person will need to buy. In other words, they are
more willing to pay more for the capsules, and are more likely to take
them more frequently and for a longer period of time.
============================
Another useful article comes from Nutraceuticals World:
Nutraceuticals World, Jan 2004 v7 i1 p28(5), Tablet & capsule trends:
an overview of the latest developments. Rebecca Madley-Wright.
A major trend in dosage forms in herbals is to sub-specify the dosage
forms of already marketed pills. For example:
"Discussing this trend was Bill Chekan, global director of marketing,
Capsugel, Greenwood, SC. "In the battle for market share, particularly
when the product lines of many nutraceutical companies include the
same product (i.e., glucosamine, gink-go, MSM, etc.), there has been
heightened activity to show that the dosage form itself is a form of
differentiation," he said. "At a 'tactical' level, labels that used to
simply say '60 capsules' now say things such as '60 Easy-to-Swallow
Capsules,' '60 Enterically Coated Capsules,' or '60 Vegetarian
Liquid-Filled Capsules.'"
Further,
"At Arizona Nutritional Supplements (ANS), Chandler, AZ, Greg St.
Clair, president, said he has seen requests come in that run the
gamut. "ANS has seen an increase in requests for unique forms of
tablets and capsules," he said. "The developments in aqueous-based
coating systems have led to an increase in the amount of unique color
coatings requested. In addition, requests for vegetarian products have
increased leading to use of more vegetarian capsules and use of
excipients, which meet vegetarian standards. Lastly, there has been an
increase in the availability and requests for liquid capsules.""
The article goes on to summarize the various trends, and incorporates
some of the issues discussed above (e.g. "swallowability"):
"Discussing trends in all three segments--tablets, capsules and soft
gels--was John Altenberg, vice president--Marketing, Leiner Health
Products, Carson, CA. "Tablets are still the dosage form of choice for
supplements in general due to price and familiarity. If a company
brings forth a product in a tablet and then introduces it in a soft
gel, consumers may not want to pay the premium," he explained.
"However, for the fat-soluble ingredients such as CoQ10, fish oils and
vitamin E, soft gels are the preferred form of delivery and continue
to do well." He added, "Some people shy away from capsules because of
potential tampering issues. However, I know there is technology now
where the capsules can be heat sealed to minimize tampering. In
addition, I believe two-piece capsules are still the dosage form of
choice when it comes to herbals because they capture the value and
benefit of the whole herb."
Mr. Altenberg also discussed the issue of compliance, singling out
"swallowability" as a barrier for some dosage forms. "Swallowability
is still a big issue with larger tablets and soft gels," he said,
adding, "Also, consumers do not comply with directions that advise
them to take a certain amount of pills throughout a given day. Asking
consumers to take two to three pills a day of a particular product is
a very difficult proposition with respect to dietary supplements. Some
products lend themselves very well to once-a-day dosing but others are
more challenging.""
With regard to compliance, the article has the following to say:
"The issue of compliance was also highlighted in the 2003 Health &
Wellness Trends report published by the Natural Marketing Institute
(NMI), Harleysville, PA. According to the report, 17% of consumers are
dissatisfied with the quantity of pills they take, while 17% claim to
have difficulty swallowing pills/capsules. As a result, almost a
quarter (23%) prefer to get their supplements in other forms besides
pills or capsules. That said, tablets, capsules and soft gels still
lead the pack in the dietary supplement arena with a majority of
consumers still preferring to get their supplements in these
formats--tablets (66%), capsules (65%) and soft gels (60%)."
Clearly the issue of compliance is key:
"Mr. Altenberg feels the future for dietary supplements hinges on
improving compliance. "Glucosamine and chondroitin started out as six
pills a day and now it's down to two pills a day to get the same
amount of active ingredients," he said. "There is always going to be a
convenience factor that will be important to supplement manufacturers
and although the industry has made considerable progress, there is
still a long way to go. Clearly one pill a day dosing is the ultimate
goal.""
============================
After extensive searches of the Infotrac, Ovid Medline, Lexis-Nexis,
and other databases, it does not appear that a formal study of how
much more consumers are willing to pay for capsule vs. tablet form of
oral medications or supplements has been performed - or at least none
that is publicly available. Such data is likely highly variable
depending on the specific medication / supplement and the area of the
country or world in which it is being sold. Ideally, one would
introduce various oral dosage forms into a market and vary the prices
to collect the specific data. An alternative would be to conduct a
marketing survey to ask people in different areas what they would be
willing to pay for a specific product in different dosage forms.
Based on prices from other sources, such as Drugstore.com and CVS.com,
prices for tablet forms vs. capsules are very similar. For some
commonly available, well established oral medications, one can see
that prices are quite similar. The increased revenue apparently comes
from increased compliance (as discussed above). Here is an example
for Tylenol: 8.2 cents / 500mg geltab, 8.2 cents / 500mg tablet,
8.89 cents / 500mg caplet. For example, in a very cost-conscious
sector, consumers are more likely to say "Tylenol is Tylenol, why pay
extra for the caplet," but more affluent consumers may not care about
such small differences in price.
Obviously there are some limitations for many products, for example
Omega-3 oils that must be made in gel or capsule forms.
============================
I hope this information was useful. Feel free to request any clarification.
-welte-ga
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Some searches used on Google and the Infotrac databases:
"drug delivery" capsule tablet preference
capsule tablet preference
"drug delivery" capsule tablet pricing
capsule tablet prices "dosage form" |
