Oral Thin Films vs. Tablets: Which Is Better for Medication Adherence?

poshatwarritesh May 15, 2025 No Comments

When comparing oral thin films (OTFs) and tablets , medication adherence is a critical factor that influences treatment outcomes, especially for patients with chronic conditions such as hypertension, diabetes, schizophrenia, or Parkinson’s disease. Below is a detailed comparison of these two dosage forms in terms of ease of use, patient preferences, clinical evidence, and impact on adherence , based on current research and market trends.

🔍 1. Ease of Use and Administration

Feature	Oral Thin Films (OTFs)	Tablets
Swallowing Difficulty	✅ No water required; dissolves rapidly on the tongue	❌ May cause choking or discomfort, especially in elderly or dysphagic patients
Portability & Discretion	✅ Lightweight, discreet, easy to carry	❌ Requires water; less discreet
Dosing Accuracy	✅ Pre-measured doses	⚠️ Risk of splitting or crushing, which can alter dose
Administration Speed	✅ Dissolves within seconds	❌ Takes longer to take; requires water

Insight: OTFs eliminate the need for water and are ideal for patients with dysphagia or those who find swallowing pills difficult, such as children, the elderly, or psychiatric patients.

oRAL FILMS OR TABLETS

📊 2. Patient Preferences and Satisfaction

Clinical studies show high patient satisfaction with OTFs , particularly among:
- Pediatric populations
- Geriatric patients
- Patients with neurological or psychiatric disorders
A 2021 study evaluating CUREfilm OTF showed:
- 90% of users rated the experience as “very pleasant” or neutral
- No reported pain, numbness, or irritation
In contrast, up to 50% of patients with chronic diseases report difficulty adhering to tablet-based regimens due to swallowing issues or complex dosing schedules .

Insight: Patient-reported outcomes consistently favor OTFs for comfort, convenience, and ease of use , directly contributing to better adherence.

🧪 3. Therapeutic Efficacy and Bioavailability

Feature	Oral Thin Films (OTFs)	Tablets
Bioavailability	✅ Higher – bypasses first-pass metabolism	⚠️ Lower – subject to digestive degradation
Onset of Action	✅ Faster – sublingual/buccal absorption	❌ Slower – requires digestion and absorption
Drug Stability	⚠️ Sensitive to moisture; requires special packaging	✅ More stable under standard storage conditions

Example: KYNMOBI® (apomorphine HCl), a sublingual film for Parkinson’s OFF episodes , delivers rapid symptom relief by entering systemic circulation directly via the oral mucosa.

Insight: OTFs offer faster onset of action and improved bioavailability , making them suitable for acute or breakthrough symptoms where timing is critical.

📈 4. Adherence Rates in Clinical Practice

Non-adherence to medication affects ~50% of patients with chronic illnesses , leading to poor outcomes and increased healthcare costs.
Studies suggest that switching from tablets to OTFs improves adherence rates by up to 20–30% , especially in:
- Psychiatry (e.g., schizophrenia, bipolar disorder)
- Neurology (e.g., Parkinson’s disease)
- Pain management
For example, IGALMI , a sublingual film approved in 2022 for acute agitation in schizophrenia , has shown improved compliance due to its non-invasive administration and rapid effect .

Insight: OTFs reduce barriers like fear of swallowing, dosing complexity, and stigma, thereby enhancing real-world medication adherence .

🏛️ 5. Regulatory and Market Trends

Factor	Oral Thin Films (OTFs)	Tablets
FDA Approvals	Increasing approvals under 505(b)(2) pathway	Well-established regulatory pathways
Market Growth (2024)	Estimated at $3.1–$4.3 billion globally	Mature market with slower growth
Projected CAGR (2024–2034)	8–12% globally	<5%
Key Players	Aquestive Therapeutics, IntelGenx, LTS Lohmann	Pfizer, Merck, Novartis, etc.

Trend Insight: The global OTF market is expected to grow at a CAGR of 8–12% , driven by demand for patient-centric formulations and advanced delivery systems .

🧩 6. Limitations and Considerations

Limitation	Oral Thin Films (OTFs)	Tablets
Cost of Production	Higher due to specialized manufacturing	Lower cost at scale
Dose Capacity	Limited to low-dose APIs	Can accommodate higher doses
Stability	Sensitive to humidity and temperature	More stable
Storage Requirements	Often require blister packs or desiccants	Standard pill bottles suffice

Conclusion: While OTFs offer significant advantages in adherence and patient experience , they may not be suitable for high-dose drugs or resource-limited settings due to cost and stability concerns .

✅ Final Verdict: Which Is Better for Medication Adherence?

Criteria	Winner	Reason
Ease of Use	🥇 Oral Thin Films	No water needed; rapid dissolution; no choking risk
Patient Preference	🥇 Oral Thin Films	High satisfaction scores across age groups and therapeutic areas
Adherence Improvement	🥇 Oral Thin Films	Demonstrated improvement in real-world compliance for chronic diseases
Bioavailability/Onset	🥇 Oral Thin Films	Bypasses first-pass metabolism; faster therapeutic effect
Cost and Scalability	🥇 Tablets	Cheaper to produce and distribute at scale
High-Dose Applications	🥇 Tablets	Not feasible for most OTFs

Bottom Line:
For most patients , especially those with difficulty swallowing, mental health conditions, or requiring rapid drug onset , oral thin films outperform tablets in improving medication adherence.
However, tablets remain the preferred option for high-dose medications, cost-sensitive environments, and long-term chronic therapies where adherence challenges are less pronounced.

📌 Recommendations for Healthcare Providers

Prescribe OTFs for:
- Patients with dysphagia
- Pediatric or geriatric populations
- Psychiatric or neurologic patients
- Acute symptom management (e.g., breakthrough pain, agitation)
Use tablets when:
- Dosing requirements exceed OTF capacity
- Cost is a major concern
- Long-term therapy with proven adherence exists