Joshua Murdock, PharmD, BCBBS | Director of Market Intelligence, RXinsider

Adherence packaging has long been evaluated as an equipment purchase. Pharmacies compared packagers on speed, canister capacity, pouch or blister format, and footprint, and then fit the machine into their existing workflow.

That approach worked when packaging volume was modest and a single device served a single location. It does not hold up as well now. Many pharmacies operate multiple packagers, serve retail and long-term care (LTC) patients from the same site, and refill packs for patients whose regimens change mid-cycle.

As volume grows, so does the work surrounding each pack. Staff need to know which orders are ready, which patients have had a change in therapy, which devices need attention, and who is cleared for verification. 

That management layer runs on software, and it is becoming a central factor in how pharmacies evaluate adherence packaging.

Disconnected systems create operational complexity

Many adherence packaging operations grow one purchase at a time. A pharmacy might add a pouch packager, then a second model with its own software, then an inspection system, then a scheduling spreadsheet to track cycle fill dates by facility.

Each of those tools can work well on its own. The trouble is that each one often keeps its own medication records, user accounts, and order statuses.

The gaps between systems are usually filled manually by people. Technicians export orders from the pharmacy management system (PMS), route batches to a specific device, and walk the floor to check which jobs are finished. Pharmacists manually confirm whether a mid-cycle dose change was communicated to the packager before the pack was sealed. Each handoff takes time, and each one is a chance for an order to be delayed, duplicated, or keyed incorrectly.

Visibility suffers as well. When order status is spread across separate screens, no one has a reliable picture of what is queued, in progress, waiting on verification, or ready for delivery.

These costs rarely appear on an invoice. They do show up in overall team performance, though. Staff hours spent coordinating systems are hours unavailable for production or patient care, and those hours are not easy to replace.

Unified software creates a more coordinated operation

Another approach is to run the entire packaging operation from a unified software platform. Orders, workflow steps, user roles, medication records, packagers, and reporting all sit in one place, rather than in a separate application for each device.

That shift changes where the work happens. For example: 

• A medication record is built and maintained once, then applied to every packager that uses it. 
• User permissions are set once, so a technician cleared to fill and a pharmacist cleared to verify have the same access regardless of which device or workstation they use.
• Incoming orders can be assigned to whichever packager has capacity, rather than to the one for which a particular file was built.

Centralized management does not remove the need for judgment. It reduces the number of places where information must be reconciled by hand, where much of the hidden effort in a growing operation tends to accumulate.

Visibility and workflow automation keep production moving

Once packaging activity runs through a single system, it can be seen in one place. Supervisors get a current picture of the operation, with less need to walk the floor or call between stations.

Workflow automation builds on that foundation. Dynamic queues reorder work as conditions change, and rules-based workflows let a pharmacy define how that ordering happens. For example, a rule might move new admissions and discharge orders ahead of routine cycle fills or group facility-level orders to match delivery routes.

Automatic prioritization matters most near deadlines. LTC cycle fills, for example, are typically tied to set delivery windows, and a late batch can affect an entire facility rather than a single patient. When the queue reflects those deadlines on its own, staff spend less time deciding what to run next and more time running it.

Standardization supports growth

Growth tends to expose inconsistency. This is true in most industries. A process that works because two experienced technicians know its quirks can break down when volume doubles, a new packager arrives, or a second site opens.

Shared software gives a pharmacy a way to define its workflow once and apply it organization-wide. The same steps, checks, and approval rules can govern every user, every device, and every location. A batch filled at one site follows the same path as one filled at another, making quality reviews and audits easier to compare.

Standardization also shortens onboarding. A new hire learns one interface and one set of procedures instead of a different application for each machine. Staff can move between devices or sites without retraining, which gives managers more flexibility to cover absences and peak periods. Given the current demand for technicians, a shorter path to productivity carries real operational value.

The larger benefit is that growth stops adding complexity at the same rate it adds volume. When workflows are consistent, adding a packager or bringing a new facility online becomes largely a matter of configuration.

Connected operations extend beyond the packager

The next step is linking packaging to the systems around it. Packaging, inventory, reporting, and analytics each hold information that the others can use. The less of that information staff have to move by hand, the more useful it becomes.

Reporting is one example. A connected operation can track throughput, verification time, rework, and on-time delivery without anyone having to pull numbers from multiple systems. 

Each connection also removes a manual step, such as a re-keyed order, an exported file, or a status call between departments. Fewer manual steps mean fewer delays and fewer chances for error. They also keep a patient’s medication information consistent from order entry to delivery, which supports the adherence goals the packaging is there to serve.

The bottom line

Hardware is essential to adherence packaging. A packager’s speed, accuracy, and package format determine how much a pharmacy can produce in a day. What has changed is everything around the machine. Pharmacies now run more devices across more sites, mix retail and LTC volume, and handle frequent therapy changes. Packaging has become as much about coordinating work as dispensing medications, and that coordination happens in software.

Operations that grow without strain usually have a few things in common. Their workflows run through one system, staff can see the status of work as it happens, and rules handle much of the prioritization. Processes stay consistent across sites, and packaging data flows into reporting without manual steps. For pharmacies evaluating adherence packaging, the software that will run the operation deserves the same scrutiny as the packager on the floor.

References

BD Parata. (n.d.). Medication adherence packaging: Impact health outcomes — for your patients and your business.

Conn, V. S., et al. (2015). Packaging interventions to increase medication adherence: Systematic review and meta-analysis. Current Medical Research and Opinion.

National Community Pharmacists Association. (2026). NCPA releases 2026 Digest report [press release]. Pharmacy Times.

Pharmacy Workforce Center. (2026). Pharmacy demand report: Fourth quarter 2025 executive summary.