Medication adherence has a prominent role in the current national conversation about healthcare. In this interview FLAVORx CEO Stu Amos talks with ComputerTalk senior editor Will Lockwood about the role flavoring liquid medications can play in promoting adherence, and some of the challenges to making this process more efficient in order to increase its availability.

CT: Stu, give us some background on FLAVORx.

Amos: The company has been in existence for over 15 years. It was founded by a pharmacist family in Washington D.C. They started blending flavors into liquid medications to help children be compliant with their prescriptions. Today we supply close to 40,000 pharmacies, both independents and chains, with compliance products. We offer both liquid flavoring and solid capsules that are designed to help people with dysphagia or other conditions that make swallowing difficult. We also have a veterinary program to flavor medications, primarily for dogs and cats.

CT: Tell us more about how you approach medication flavoring.

Amos: The liquid flavoring product line is our primary focus. Today we offer from eight to 20 flavors and 10 or 12 of those are the most popular. We flavor everything from amoxicillin to some of the really tough tasting medicines used for some very serious conditions.  We've evolved over the years to where we have a formulary to match the flavoring to what is most palatable for children. We are obviously anxious that we not make the product too sweet or too much like candy. That is not what we are about. We are all about making medicine palatable. That is our key driver

CT: What types of pharmacies are typically offering flavored liquid medications as a service?

Amos: Right now, I'd say it is primarily multiple location pharmacies.

CT: Why is this?

Amos: That's an interesting question.  Perhaps there is a more equal balance of clinical service and commercial concern in these pharmacies.  More generally, I think, we find interest among pharmacies concerned with increasing revenue and margin and looking for opportunities to generate additional sales that can come along with attracting new customers with a service. Many pharmacies see flavoring and giving a child a choice of how they want their medicine to taste as a differentiator. We believe that this is the case, when you promote and market flavoring appropriately.  Pediatricians can alert parents that it is possible to make a medicine more palatable for the child and refer them to pharmacies that offer this service with the goal of improving clinical outcomes.

CT: What challenges in the reconstitution and flavoring process has FLAVORx been working to overcome?

Amos: We've really focused on taking time out of the process by automating. We've reduced the overall time to reconstitute and flavor a medication from three and half minutes or longer to 45 to 60 seconds by using equipment that combines reconstitution and flavoring. This is an area in which we've been successful in bringing greater efficiency to the pharmacies flavoring liquids. Where the challenge is right now, and this is an area where we are looking to form partnerships, is how do we make it easier for the pharmacy to identify appropriate medications and initiate the conversation about flavoring? One way to do this would be to use software flags, for example, so the pharmacy system can alert the pharmacist that this is a flavorable medication, and even indicate which flavors best suit the medicine based on a formulary that we've developed. This formulary can also, in some cases, indicate the flavors that don't work well. We designed it to guide people with the full recognition that when you add a taste to a drug, it's really important to get it right. So a flag could help prompt the pharmacist to offer flavoring and and then our formulary could help the parent and child choose the best option. Establishing this kind of system-based trigger and integrating our formulary should work to make offering medication flavoring quicker and easier.

The "Wheel of Yuck!" on FLAVORx's website offers the opportunity to see the company's formulary in action.

CT: Fundamentally this is an adherence tool, right? Considering the importance attached to adherence, that ought to make it very interesting to pharmacists looking for new tools to integrate with their other technology.

Amos: Adherence is a very interesting topic and has huge implications when it comes to clinical efficacy and the cost of care. I believe we are in this area, that it is one that resonates with people, and offers one answer to the question of how to drive cost out of healthcare. At FLAVORx, I certainly believe we are at a turning point, where we could see our products helping to make advances in adherence. To improve adherence, children need to want to take the medicine. One way to increase their enthusiasm is to make the medication taste better, of course, but the we also believe that children will be more adherent when they have been able to choose the flavoring, guided by the enormous amount of data about what works and what doesn't that we've collected from the 45 to 50 million prescriptions we've flavored to date. In the past we focused on making poor tasting medicine taste better and now we are focused on taste choice. This allows the child take ownership of his or her medicine.