Recent controversies regarding spiking prescription costs have brought increased attention to pharmaceutical companies’ profit-making activities. 
These problems aren’t going away.
Health care costs are expected to continue rising at an average rate of 5.3%.  Greater emphasis is being placed on improved outcomes which is largely impacted by preventative medication and adherence, care is becoming increasingly more personalized, and payers are becoming increasingly willing to pay for better outcomes, which combined encourages companies to increase prices. [3, 4, 5]
Some disruptors have recognized the opportunity to deliver improved outcomes at reduced costs with 3D printing. Take Apreica Pharmaecuticals and their new epilepsy medication Spritam. Epilepsy is a notoriously difficult condition for providers to treat effectively.  The wide range of severities and ages treated necessitates personalized dosages, but only a limited range of doses are available.  The high doses of active ingredients conflict with patients’ needs for swallowable and easily digestible pills, which discourage adherence. 
With 3D printing, the pill is built layer-by-layer allowing for more porous and potent pills over the more conventional methods using compression, punches, and dies.  Built in this way, the medication becomes more effective and patient-friendly by drastically improving the time to disintegrate.  The benefits of becoming more patient-friendly can not be overstated as it is critical to improving adherence of preventative medications which improves outcomes and decreases overall health care spend. 
3D printing doesn’t only benefit the patient. Current production assemblies require extensive and expensive machinery which could be replaced by 3D printers at a much lower price.  Incorporating this technology also reduces the reliance on specialized labor and costly procedures to prevent contamination that hurt profitability.  Further, it makes just-in-time development feasible. Companies have previously batch produced a small set of dosages of the medication, but mass production is not conducive to the specialized and precise need for this medication. By consolidating production in a programmable printer, a more precise dose of active ingredients can be inserted into the capsule on a patient by patient basis.
But reducing the need for large time and capital investments reduces the barrier to entry, which improves competition and ultimately pricing. How are the pharma powerhouses coping with the threat of disruptors like Aprecia?
GSK is the only well-established pharmaceutical company to demonstrate an interest in exploring 3D printing technologies for its supply chain. GSK has started by launched a series of competitions for employees to incorporate innovative ideas in its operations. One such competition focused on garnering 3D printing ideas from its customer-facing employees. [9, 10]
Recognizing that the benefits and risks associated with this technology are still largely unknown or not fully quantifiable, GSK is focused more on assessing which drugs are most ripe for 3D printing technology. Skeptics claim that mass production of some medications will likely still be economical, think ibuprofen, and GSK is focused more on determining what qualities make a successful 3D printing candidate and what materials and systems they need in place to ramp up. 
Preparing for years to come, GSK has initiated partnerships with researchers, including faculty at the University of Nottingham, to begin studying the technology itself and novel methods to produce drugs. One publication has been produced to date, detailing their success in developing a UV inkjet 3D printed tablet, with the expectation that the partnership will continue over the next several years. 
GSK should be commended for being the only pharmaceutical behemoth to actively investigate 3D printing as a manufacturing tool. However, if they want to remain competitive, they will have to expedite their learning process and more rapidly engage in developing 3D printing techniques. Aprecia holds more than 50 patents for its technique and pharmaceuticals, which it claims will provide a competitive advantage to 2033.  Aprecia has hit the ground running, gathering patents and FDA approval. Unless GSK steps up their partnerships and research to begin patenting their own techniques, when disruptors step into their core competency drugs, they won’t have the time, resources, or legal backing to regain their market share.
Disruptors aside, GSK is overlooking a critical opportunity to reach untapped markets. Drugs are frequently are abandoned in the R&D process because the target market is too small to make production profitable for the company.  Often these patients are some of the most complex and in greatest need of effective treatments. GSK and others should be reviewing these discarded drugs to determine if they have profitability potential with 3D printing. This could be a great social responsibility initiative and first step to improving the currently negative public opinion of the industry. Will companies use 3D printing technology as an opportunity to drive ethical pricing and social responsibility, or will it just be another the newest way to boost margins?
- Daniel Kozarich, “Mylan’s EpiPen Pricing Crossed Ethical Boundaries,” Fortune, September 27, 2016, http://fortune.com/2016/09/27/mylan-epipen-heather-bresch/, accessed November 2017.
- CMS, “NHE Fact Sheet”, https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html, accessed November 2017.
- Sun Le, et al. “Validating the Modified Drug Adherence Work-Up (M-DRAW) Tool to Identify and Address Barriers to Medication Adherence.” Pharmacy: Journal of Pharmacy Education and Practice3 (2017): 52. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622364/
- Osayi E. Akinbosoye, et al. “Improving Medication Adherence and Health Care Outcomes in a Commercial Population through a Community Pharmacy.” Population Health Management6 (2016): 454–461. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296931/
- Aurel O, Iuga and Maura J McGuire. “Adherence and Health Care Costs.” Risk Management and Healthcare Policy7 (2014): 35–44. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934668/
- Abdul Wahab. “Difficulties in Treatment and Management of Epilepsy and Challenges in New Drug Development.” Pharmaceuticals7 (2010): 2090–2110. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036655/
- Aprecia Technologies, “3D Printing,” https://www.aprecia.com/zipdose-platform/3d-printing.php, accessed November 2017.
- Marcus Ehrhardt, “Is pharma ready for the future?,” Strategy + Business, November 30, 2015, https://www.strategy-business.com/article/00363?gko=746a4, accessed November 2017.
- Michael Petch, “Just say whoa. GlaxoSmithKline and the future of 3D-Printed pharmaceuticals,” September 13, 2016, https://www.autodesk.com/redshift/3d-printed-pharmaceuticals/, accessed November 2017.
- GSK, “Current needs for innovative solutions & new product development“, https://innovation.gsk.com/new-product-ideas/needs, accessed November 2017.
- Elizabeth A. Clarke, et al. “3D printing of tablets using inkjet with UV photoinitiation.” International Journal of Pharmaceutics1 (2017): 523-530. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pubmed/28673860
- Aprecia Technologies, “ZipDose Formulations,” https://www.aprecia.com/zipdose-platform/zipdose-technology.php, accessed November 2017.
- Wendy Lipworth and Ian Kerridge. “Why Drug Shortages Are an Ethical Issue.” The Australasian Medical Journal11 (2013): 556–559. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858608/