Bret S. Stetka, MD


May 09, 2016

A Deeper Look at Pill Psychology

Medscape: What previous data existed in pill color psychology and preferences?

Dr Ting: The association of pill color with medicinal effect has been reported in the literature, mostly in scattered cross-sectional description studies outside of the United States. In general, cooler colors have been associated with relaxing or depressive effects, while hotter colors like red may have more stimulant effect. Some of the reported pill color associations have been mixed when comparing studies involving different ethnic populations (eg, Malaysia versus Baghdad) and regarding different types of drugs. It has been shown that changing pill appearance, including color, with subsequent generic formulation refills of seizure medication contributes to poor patient adherence. But relatively little has been reported on pill color preference in US patients, particularly in the context of clinical trial design.

Medscape: To your knowledge, how aware are drug manufacturers of the influence of pill color on patient satisfaction (or dissatisfaction)?

Dr Ting: It is my understanding that significant market research goes into pill color selection by drug manufacturers. The pharmaceutical industry has paid increasing attention to pill color in developing brand identity—not only to set a drug apart from its competition and potentially from generic formulations, but also to convey therapeutic value to consumers. But there appears to be less attention paid to color selection in the context of clinical trial design, where patient perception of the study drug could affect the measured therapeutic and adverse effects. One could argue that a poor choice of pill color might doom a promising drug in development to fail clinical testing based on its appearance alone.

Medscape: Finally, what are the clinical implications of your findings in terms of both patient care and trial design?

Dr Ting: We were surprised to find in our patients with epilepsy a clear color preference among choices of standard over-encapsulation shells, with some colors even considered "unacceptable." Given such strong color preference observed in our study, it is likely that pill color has the potential to affect patient adherence to taking medications at home, as well as subject adherence in clinical trials, and deserves further attention and study—especially for preferences specific to special patient populations.

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