Dr. Elke Sternberger-Rützel


creative head and maker of XStraw

Dr. Sternberger-Rützel – You are pharmacist and therefore speak the language of the customer. What is so fascinating about the XStraw from your point of view?

That is clearly the customer benefit. The XStraw ideally reflects the patient’s wish to take medication more easily. In particular, we are talking here about children, seniors and geriatric patients. But also, for all the others XStraw is a huge relief.

How did you come up with the idea of developing the XStraw?

The basic idea of the XStraw was developed in the USA. The key question was: how can we ensure that children apply medication? When the product was licensed, a German pharmaceutical company licensed the patent and assigned various tasks in the market launch to me. Our first priority was the interests of the customers:It should easily work for children (and of course for everyone else). The dosage must be accurate. It should also be suitable for the intake of antibiotics and shall neutralize the unpleasant taste and smell of the drug product.And last but not least: an excellent quality had to be assured.

For which active pharmaceutical ingredients and indications do you see a particular benefit by using the XStraw?

We are currently seeing a great interest in drugs which have been developed for chronic diseases. This for example applies to diseases such as high blood pressure, high cholesterol, diabetes, arthritis, genetic defects or even ADHD. This is partly due to the associated long-term intake for the chronic diseases and, of course, the free choice of taste (by the intake possibility with an individually chosen beverage).Also, many cancer patients complain about difficulties swallowing due to discomfort and nausea - here too, the use of XStraw could be a huge relief. Regarding the APIs, of course, those which are already available as multiparticulates such as pellets or granules are excellent, as the projects can usually be realized very quickly with the XStraw.The XStraw also offers a great opportunity with combination therapies in which several APIs are contained in a large tablet, which makes it difficult for many people to swallow. These drug combinations for example are used for HIV patients.

Do you see any other possible fields of applications for the XStraw?

Currently we are developing small compact filling devices for the XStraw, which will make it possible to be used in connection with personalized medicine. The target groups for this are primarily pharmacies and hospitals, which can/could produce individual medications in very small batches.

Are there limits for the use of the XStraw or can it be used for all active substances?

This is primarily a question of cost-effectiveness - in fact, it can only be answered regarding to the specific idea or the specific API. Technically there are basically hardly any limits for the XStraw, if the corresponding API can be formulated as multiparticulates or is even approved as a pellet. So it must be economical for the manufacturer or provide other benefits such as patient compliance.

Topics such as the life cycle management of an API or the chance of market exclusivity in the context of a pediatric dosage form could be drivers here. Or the idea of to market a “Generic plus”.

Are there alternative products and medication options which work similarly?

In summary, my answer is no, I am not aware of any comparable solutions. I know a manufacturer who is on the market with an idea to use a drinking straw for application of medication. But with a significant difference: granules and liquid mix and the granules dissolve in the drinking straw. In comparison, the filter of the XStraw moves upwards, the pellets are dispersed and dissolves in the GUT. This is important for taste masking and for controlling the release of the API.Other key benefits of the XStraw are: The integrated controller ensures that the complete drug has been taken and informs the caregivers. The patient has the freedom to choose the flavor of a drink individually (which increases compliance in chronic diseases) In the XStraw several active ingredients can be combined.

Which challenges do prospective customers have to overcome before they can use the XStraw?

Beyond the development of the API in multiparticulars, it is all about costs. More precisely, the reimbursement of any additional costs. This is hardly intended in our health system. An overall cost analysis would be helpful for such decisions, because then small additional costs would quickly lead to positive saving potentials.The reason is, that due to the intake relief that the XStraw offers patients, we assume that their adherenceto their medication regimen is much higher. As a result, losses in the effect of non-use or altered intake (e.g. smashing, dissolving of tablets) can be mainly excluded. The background is that medicines only work properly if they are taken properly. Especially with large tablets or capsules, this is always a barrier for many patients based on swallowing problems. It means that with assured intake of medication as a high adherence, you could deduct the costs of all medications which have not or only partly been taken and all costs for hospitalisation. Practically, it surely would be possible to compensate the additional expenses for producing the XStraw via co-payments or the application of the overall cost analysis. It is also interesting in this context that the WHO recently asked the pharmaceutical companies not only to focus their innovative strength on the active pharmaceutical ingredients, but also to develop new therapy concepts, presentations and forms of application.