Illustration by Jacob Dwyer

What do Dinosaurs and Good Healthcare Design Have in Common?

From Endangered Species to Extinction

Doctor as Designer


There’s a lot of bad design in healthcare, particularly within the pharmaceutical domain. I have previously blogged about these design fails, which include the dismal labeling of over the counter medications, the confusing product design of oral vaccines, and the counterintuitive delivery mechanism of the EpiPen.

Here is another example of bad design: the pill bottle.

You may ask, what is the ideal design for pill bottles?

According to the U.S. Pharmacopeia, which sets voluntary standards for prescription medication, and the Institute for Safe Medicine Practices, there are some guidelines to follow:

Words typed in easy-to-read 12-point type, with the patient’s name, drug name, and drug instructions in the largest letters. Warnings typed directly onto patient labels in a large typeface.

The generic and brand name of a drug.

Images or physical descriptions of the pills in the container.

No extra zeroes (like 5.0 mg)

The pharmacy’s information — name, address, and phone number — at the bottom of the label

Here are some clear violations of these design principles:

Pharmacy names that are much bigger than the names and instructions of the medication.

Dosage instructions are in very small 8 point font

There are missing warning labels or warning labels that are vertical rather than horizontal.

The generic and brand names are not both listed.

There are strange abbreviations of medication names that don’t make sense to the user (for example, “warfarin sod” instead of “warfarin sodium”)

There are even labels that provide totally unnecessary information, like the pharmacy lunch hour “closed from 1:30 to 2 pm for lunch” or text that says “please call 48 hours in advance for a refill”. (Why take up valuable real estate on the label to provide unnecessary information?)

Read this Consumer Reports article to learn more about the poor design.

Now meet the ClearRx pill bottle.

This pill bottle was designed by Deborah Adler while an MFA student at the School of Visual Arts. At the time, her grandmother had inadvertently ingested her grandfathers’s prescription pills, bringing to her attention the dangerous design of the regular pill bottle. She therefore decided to tackle a redesign of the pill bottle for her thesis project. Her design caught the attention of a Target creative director, and led to the creation of the Target ClearRX line of pill bottles.

It mostly adhered to the recommended guidelines, but went even further to improve the design of the bottle:

The name of the drug is on the top of the bottle so that it can be seen from above.

There is a hierarchy of information that has the most important information prominent and on top (drug name, dose, and instructions) with less important data (quantity, expiration date, doctor’s name) below.

Drug warnings are much larger and easier to read because of the triangular shape of the bottle.

Colored rubber rings attach to the neck of the bottle, with a different color for each family member, and the upside down design with the cap on the bottom reduces the amount of paper needed for the bottle label.

In fact, the design of the ClearRx bottle was so good that it was featured in the Museum of Modern Art, and the Industrial Design Society of America awarded ClearRX with its “Design of the Decade” award in 2010 !

Good design in healthcare is so rare that when it happens, it wins design awards!

The pill bottles had been used across all Target pharmacies, and a number of individuals reported deliberately switching their prescriptions to Target because of the design. However, in 2015 Target sold its 1672 pharmacies to CVS, including the intellectual property for the ClearRx bottle design.

CVS had the opportunity to scale the good design to all of their pharmacies, but unfortunately, this is what they did instead:

A CVS spokesperson told the AP that the company stopped using Target’s (TGT, +0.11%) pill bottles because it’s both easier and more cost-efficient to use the same bottles at all of its 9,600 locations across the U.S -Fortune)

Users are so upset by CVS’s move to kill the good design that they created a hashtag #redbottlesrock

Someone even created a petition created to try and bring back the ClearRX bottle.

Believe it or not, people are now digging through their trash to retrieve their old Target pill bottles to reuse them because they loved them so much!

This is a classic example of design for the healthcare enterprise rather than design for the patient. ClearRx, one of the few endangered examples of good design that existed in healthcare is now extinct just like the dinosaurs!

Just another example of the #sadstateofhealthcaredesign.

I tweet and blog about design, healthcare, and innovation as “Doctor as Designer”. Follow me on Twitter and sign up for my newsletter.



Doctor as Designer

Joyce Lee, MD, MPH, Physician, Designer, ACMIO, #EHR, #learninghealthsystems, #design, #makehealth