Patent Publication Number: US-10327994-B2

Title: System and methods for customized medicine dosages in a capsule

Description:
FIELD OF THE INVENTION 
     The present invention relates to dispensing daily dosages of medications. More particularly, the present invention relates to the customization and modification of daily dosages of medication for administration to patients by reducing the number of pills and customizing the medications to be placed in a capsule. 
     DISCUSSION OF THE RELATED ART 
     Medication management systems play an integral part of long-term care facilities. For example, companies recognized the need for pharmacies to provide customers a secure, affordable and fully customized solution for medication management. Most patients rely upon the conventional process of a doctor and a pharmacist to make decisions about their dosing of medications. 
     Pills, tablets and the like (hereinafter tablet) come in many different colors, shapes, and sizes. Often, one tablet is used to provide one ingredient or medicine. Sometimes, a tablet may include two ingredients, such as a pain reliever and an allergy suppressant. Tablets, however, are filled with many inert ingredients, such as diluents and fillers, binders, disintegrants, lubricants, glidants, absorbants, flavorants and colorants. 
     As the population ages, many older citizens can take up to 20-30 pills per day for a multitude of chronic or acute diseases. Oral medicines are convenient and easy to administer, which explains their widespread popularity. Tablets remove the need to visit the doctor&#39;s office for a shot or dose. Pharmacies can track the doses of medicine and keep track of refills. Patients may travel with the tablets and taking them when needed is very convenient. 
     Such large number of tablets can be problematic. The different colors, shapes, and sizes may confuse patients, especially elderly or handicapped ones. A large number of doses can give rise to safety concerns due to medication adherance. Further, some medicines are taken on an empty stomach, after a meal, or with water. The costs to manufacture and package such large number of tablets are costly and passed on to the patient by health care costs and increased insurance premiums. The need to carry a large number of doses may be aggravating, especially if taking them to work or school. 
     The large number of medicines taken on a regular basis also is harder on robotics to dispense pills or tablets because of the different shapes and sizes for the same medicine by different manufacturers. A lot of time and expense is needed to accommodate the different sizes with a variety of packages. 
     As noted above, tablets and pills include up to 90% inert ingredients that do not provide active medicine to the patient. Further, some patients may only need ½, ⅓, or ¼ of a pill for a dose. This requirement makes the patient cut the pills into parts, sometimes not very exact. Many tablets cannot be cut, especially gel tabs. Drugs are sometimes metabolized at different rates in people of varying ethnic backgrounds, resulting in inconsistent and unpredictable therapeutic effects. It is tough to understand these differences when taking doses from different sources. 
     As noted above, the current state of technology with regards to manufacturing, dispensing, and consumption is overly complex and inefficient. This result is unfavorable to the patient. Current manufacturing involves many steps and a multitude of inactive ingredients. The inactive ingredients may be classified as diluents, binders, disintegrants, lubricants, glidants, adsorbents, flavorants, and colorants. These inactive and inert ingredients are utilized to improve palatability and appearance. Some of these ingredients have unique properties that can impact bioavailability and stability. The compounds typically do not have any bearing on the efficacy of the active drug compound found in the pills and tablets. 
     The manufacturing process of conventional pill doses produces formulations that are of a fixed strength without allowing customization based on specific patient need. Due to the complexity of the manufacturing process, and the supply chain dynamics of both active and inactive ingredients, medication recalls, backorders, and shortages have become common in today&#39;s market. These problems lead to astronomical drug pricing but, more importantly, those patients with a critical need of these medications may be forced to go without them for extended periods of time. This puts unnecessary strain on the health care industry by raising costs, addressing needs only when critical (i.e., no preventative care), and putting patients at risk to further injury or complications. 
     With regard to allergies, it is now established that many of these inactive ingredients induce allergic reactions. Some patients who are found to be allergic to the inert ingredients are often forced to try different medications that may not be as effective. Additionally, due to the complexity of the manufacturing process for pills and tablets, it may be impossible to pinpoint the exact cause of any complications related to new medications taken by a patient. 
     As noted above, the manufacturing and production processes are costly due to the different shapes and sizes of tablets and pills. Costs are needlessly high. With so many variables in the supply chain, prices may fluctuate daily, sometimes to prohibitively high levels. Witness recent skyrocketing increases in medicine costs by hedge fund investors with no regard to making medicine available to those that need it. Moreover, due to the nature of the present pharmacy services model, additional costs are tacked on by pharmacies to provide quality control prior to dispensing. These costs are even more pronounced when tablets are provided in multi-dose compliance packages that are typically used to improve compliance. Wasted time occurs, as well, to ensure that dispensing is accurate. The cost for all of this is passed onto the patient. 
     Conventional systems of drug manufacturing and dispensing also are extremely error prone. Errors that can occur include, for example, the wrong drug mixed in the wrong pill, the wrong additives mixed or missed (thereby reducing bioavailability), the wrong pill, the wrong drug, and the wrong strength. Errors are not limited to these examples. Every step of the process provides significant room for human or robotic/system error. 
     All of the above shortcomings ultimately lead to poor outcomes for patients. Improper dosages or errors result in patients going to the hospital or urgent care, thereby driving up health care costs. Sometimes, improper doses may lead to permanent health problems or even death. 
     SUMMARY OF THE INVENTION 
     To address these issues, the disclosed embodiments allow members of the health care industry, such as doctors, pharmacists, and other healthcare providers, to securely modify the dosage regimen relying on novel technology and automated systems that provide tracking, security, accountability and efficiency. There is a need for custom capsules where multiple patient medicines can be consolidated into a reduced number of capsules. Preferably, all the active ingredients for a variety of medicines are placed into one capsule. The capsule can be built for the patient with more exact or customized dosing than available through conventional processes. Further, less inert ingredients are introduced into the body. 
     According to some embodiments, a computer-implemented method for packaging medicine dosages for a prescription is disclosed. The method includes determining a plurality of dosages for the prescription. Each dosage corresponds to an active ingredient of a medicine. The method also includes arranging a plurality of canisters according to the plurality of dosages. Each canister includes a straw having the active ingredient for the respective dosage. The method also includes moving a plurality of open capsules to a first canister of the plurality of canisters. The method also includes cutting a first dosage for a first active ingredient of a medicine from the straw held by the first canister. The method also includes packing the first dosage into an open capsule of the plurality of open capsules. The method also includes repeating the cutting and packing steps for each open capsule of the plurality of open capsules. The method also includes moving the plurality of open capsules to a second canister of the plurality of canisters. The method also includes cutting a second dosage for a second active ingredient of a medicine from the straw held by the second canister. The method also includes packing the second dosage into the open capsule of the plurality of open capsules. The method also includes repeating the cutting and packing steps for each open capsule of the plurality of open capsules. The method also includes sealing the plurality of open capsules. 
     According to some embodiments, a computer-operated system for providing customized medicine in a capsule is disclosed. The system includes a first canister having a straw of a first active ingredient for a medicine. The system also includes a second canister having a straw of a second active ingredient of a medicine. The system also includes a packing assembly for each of the first canister and the second canister to cut the straw according to a specified dosage for each active ingredient and place the dosage into a capsule. The system also includes a computer configured to determine the amount for each specified dosage for a plurality of dosages of a prescription and to arrange the first canister and the second canister accordingly. The system also includes a conveyor belt to move the capsule to the canisters and packing assemblies. The system also includes a capsule tray fitting device to seal the capsule. 
     According to some embodiments, a system to place a plurality of dosages of different medicines into a plurality of capsules is disclosed. The system includes a computer to determine how much of each dosage of the plurality of dosages to place into the plurality of capsules. The system also includes a plurality of canisters arranged by the computer to dispense the plurality of dosages. Each canister corresponds to an active ingredient for each dosage within a straw held by the respective canister. The system also includes a rotor arranged at each of the plurality of canisters to cut the respective straw according to the corresponding dosage of the active ingredient as determined by the computer. The system also includes a plunging apparatus arranged at the each of the plurality of canisters to place the corresponding dosage into each capsule of the plurality of capsules and to place a separator on top of the dosage. The system also includes a capsule tray fitting device to seal the plurality of capsules having the plurality of dosages. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings are included to provide further understanding of the invention and constitute a part of the specification. The drawings listed below illustrate embodiments of the invention and, together with the description, serve to explain the principles of the invention, as disclosed by the claims and their equivalents. 
         FIG. 1  illustrates a system for providing for customized medicine dosing according to the disclosed embodiments. 
         FIG. 2  illustrates a system for packaging medications according to the disclosed embodiments. 
         FIG. 3  illustrates medicine being placed into a capsule according to the disclosed embodiments. 
         FIG. 4  illustrates an exploded view of a blade engaging a straw according to the disclosed embodiments. 
         FIG. 5  illustrates the medicine portion inside the capsule according to the disclosed embodiments. 
         FIG. 6  illustrates a plunging apparatus of a packing assembly receiving the medicine portion according to the disclosed embodiments. 
         FIG. 7  illustrates the plunging apparatus packing the medicine portion into the capsule according to the disclosed embodiments. 
         FIG. 8  illustrates the plunging apparatus and the packed capsule with the medicine portion according to the disclosed embodiments. 
         FIG. 9  illustrates the system moving the capsules to receive a second medicine portion using another canister according to the disclosed embodiments. 
         FIG. 10  illustrates a plunging apparatus for the next canister in the system according to the disclosed embodiments. 
         FIG. 11  depicts placement of the separator on the second medicine portion in the capsule according to the disclosed embodiments. 
         FIG. 12  illustrates the filled capsules within the system according to the disclosed embodiments. 
         FIG. 13  depicts the capsule tray fitting device of the system according to the disclosed embodiments. 
         FIG. 14  illustrates a fitted capsule according to the disclosed embodiments. 
         FIG. 15  illustrates a flow diagram for providing customized medicine dosages in a capsule according to the disclosed embodiments. 
         FIG. 16  illustrates another system for providing for customized medicine dosing according to the disclosed embodiments. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     Aspects of the invention are disclosed in the accompanying description. Alternate embodiments of the present invention and their equivalents are devised without parting from the spirit or scope of the present invention. It should be noted that like elements disclosed below are indicated by like reference numbers in the drawings. 
     The disclosed embodiments provide a customized multiple-medication capsule. A plurality of drugs or medicine may be included in one capsule, along with the ability to provide exact, non-fixed dosing with little to no inert ingredients. As noted above, most conventional oral drugs are compressed into tablets or capsule that include the active ingredient and a large proportion of inert ingredients that provide no medicinal benefit to the patient. 
     To reduce the amount of unneeded ingredients entering a patient&#39;s body and the number of pills required daily, the disclosed systems add all active ingredients, or pure drug compounds, to a thin membrane casing material that differs for different drugs. The thin membrane casing material may resemble a straw in that active ingredients are stored in the material. 
     The drugs are stored in individual casings as needed for each one. For example, some membrane casing may be more porous than other, some may be water soluble, some may be made of resins, some may expand, contract, or dissolve as the casing enters the stomach. In some embodiments, the membrane casing may be comprised of thin plastic. The membrane casings also may have different diameters and lengths. The composition and size of the membrane casings themselves are determined by the type of drug molecules in the active ingredient that are held inside, and to ensure sufficient stability. 
     The membrane casings may be filled in a mechanical vial/container. Canisters are arranged in a row or a machine. A blank capsule is fed into the machine. The machine rolls the capsule along a conveyor belt, for example, to align with the drug canister that includes active ingredients to go into the capsule. The canister dispenses the membrane casing the proper, or proscribed, length to ensure the correct dosage of the active ingredient for the patient. A blade may cut the appropriate length of the membrane casing. The cut portion is dropped into the capsule for the patient. This dosage, or length of cut, may be customized at any time for the patient by updating the control software used by the system. 
     The capsule moves further down the conveyance means to the canister of ingredient. This process continues until all drugs, or active ingredients, for the capsule based on patient need are inserted. When completed, the entire dose for a patient for a particular time of dosage according to the disclosed process may be fit into one or two capsules, as opposed to a large number of pills having inert and filler ingredients. 
     Some embodiments also include adding a small radio frequency identification (RFID) chip to the capsule. The RFID chip allows one to monitor the movement of the capsule as it traverses the body of the patient. The chip also may allow the location of the capsule through GPS or other geolocation system. A small medication transceiver may be worn on the stomach of the patient to determine if the capsule entered the patient&#39;s stomach. 
     Thus, the disclosed embodiments simplify the manufacturing process. Drug manufacturers only need to provide pure drug compounds of active ingredients to the pharmacies and other medical facilities that implement the disclosed system and process. The conventional inert and filler ingredients need not be provided or stored. The exclusion of the inert and filler ingredients also decreases the likelihood of allergic reactions due to these ingredients. 
     Further, by simplifying the manufacturing process, costs to pharmaceutical services and products to patients may be reduced. The cost to dispense also is reduced with the implementation of improved and automated pharmacy quality control processes, available using the disclosed system and processes. Improved quality control and the ability to customize dosages also reduce costs for providing the medicine to the patient. Errors also removed by reducing the number of steps in the capsule manufacturing process and automation. 
     Another advantage is the improved adherence and compliance by reducing the complexity of the daily medication dosage regimen for patients. This may be especially applicable for elderly or special needs patients. Adherence and compliance as a barrier of efficacy will be overcome. Because the medication is stored conveniently in a capsule form, the patient is able to travel easily without the need for pill boxes or multiple bottles of doses. 
     The solutions presented by the disclosed embodiments address many variables in the drug manufacturing and dispensing process. They do away with many of the current practices and provide pharmacies the ability to customize medication delivery for patients. The current state of technology does not empower a pharmacy to provide a customized regimen based on a patient&#39;s needs. Further, variability and the reduction of inert and filler ingredients is not possible or encouraged. 
     Competition is enhanced and lower costs for drug delivery may be realized as the active ingredients for the drugs may come from any manufacturer. Generic makers of active ingredients may provide the stock for the capsules and reduce costs. Further, pharmacies may no longer need a lot of shelf space for pills, tablets, and the like as the amount of filler and inert ingredients is reduced. Moreover, pharmacies do not need to keep different dosages of the same drug, thereby reducing redundant stock of the same medicines. 
       FIG. 1  depicts a system  100  for providing for customized medicine dosing according to the disclosed embodiments. System  100  may be located in a pharmacy or other medical services facility. System  100  dispenses capsules having a prescribed amount of medicine for one or more patients. System  100  includes a conveyor belt  104 , though other types of conveyance may be used. 
     System  100  also includes canisters  102 . Each canister delivers an active ingredient, or medicine, according to the dosage needed. Canisters  102  may be broken into canister  102   a , canister  102   b , canister  102   c , canister  102   d , and canister  102   e . These canisters hold different medicines for dispensing the prescription fulfillment process. Additional components are used in conjunction with the canisters to fill the capsules with medicine and disclosed in greater detail below. 
     Although  FIG. 1  shows five canisters, any number may be used within system  100 . For example, if the pharmacy routinely uses ten canisters to fill prescriptions, then system  100  includes ten canisters  102 . Moreover, canisters  102  may be switched out depending on the need for several orders of prescriptions. For example, if the drug ingredient used in canister  102   d  is not needed for several hours, then this canister may be switched out. 
     Capsule tray  105  moves along conveyor belt  104  to locations underneath canisters  102 . Capsule tray  105  initially holds empty capsules. An appropriate number of capsules may be held, such as 30 for a month&#39;s dosage. The tray may arrange the capsules in a row or series of rows. Capsule tray  105  may be comprised of plastic or metal. Attachment  107  attaches capsule tray  105  to conveyor belt  104 . Attachment  107  may be any means of attachment to the conveyor belt, such as VELCRO™, an indentation in the belt approximately the shape of capsule tray  105 , a plate, and the like. Attachment  107  moves capsule tray  105  along conveyor belt  104 . 
     Capsule top cap fitting device  106  is located at the “end” of conveyor belt  104  to place the top caps on the capsules after they are filled with the drug ingredients. Device  106  also may seal the capsules. 
     System  100  also includes computer architecture to input information for prescriptions as well as customization of the dosages. Computing device  120  may receive instructions or signals from computer  110  that is provided to canisters  102  on dosages and other parameters needed to fulfill the prescription. Computing device  120  includes a processor, memory and a bus to communicate information throughout the device. 
     Prescription  10  may be received in a pharmacy and inputted into computer  110  using input device  112 . Input device  112  may be a keyboard, display screen having a graphical user interface (GUI) and the like. Prescription  10  preferably has multiple medicines prescribed to the patient. The different medicines are entered into input device  112 . Computer  110  may execute algorithms and analysis to determine any possible interaction problems between the active ingredients or with the patient&#39;s own biological information. Computer  110  then may instruct computing device  120  to adjust dosages accordingly. 
     In some embodiments, computer  110  and computing device  120  may be one computer. These components are shown separately to highlight the different functions of each. Both systems may execute software instructions to provide the functionality disclosed below using a processor and a memory to store the software instructions, as well as computer architecture to facilitate transmitting and receiving signals and information to the other components within system  100 . 
       FIG. 2  depicts canister  102   a  and packing assembly  204  according to the disclosed embodiments. Capsules  202  are moved by conveyor belt  104  to be placed underneath canister  102   a . Canister  102   a  then places medicine  208  into each capsule  202  using packing assembly  204 . Packing assembly  204  includes several components that work together to place a specified amount of medicine  208  into the capsules. 
     As disclosed above, medicine  208  is the active ingredient for a prescription medicine. Preferably, medicine  208  does not include filler or inert ingredients. Packing assembly  204  places medicine  208  directly into each capsule  202 . As shown, capsule  202   a  is being filled by canister  102   a . Medicine  208  is held in drug filler straw  206 . Straw  206  includes a membrane  207  to hold medicine  208 , and to provide other features as disclosed below. Membrane  207  may extend out of straw  206  to deliver medicine  208 . 
     Packing assembly  204  includes rotor  210  and blade  212 . Rotor  210  moves blade  212  to cut portions of straw  206  having medicine  208  that is placed into capsule  202   a . Rotor  210  also supports arm  214 , which is connected to tube  216 . Tube  216  encloses packer  218 . Packing assembly  204  may receive instructions from computer  110  or computing device  120  to operate the various components in filling capsules  202 . 
     System  100  includes similar configurations for canisters  102   b - e . Capsules  202  move along conveyor belt  104  to receive different medicines  208 . 
       FIG. 3  depicts medicine  208  being placed into capsule  202   a  according to the disclosed embodiments. Canister  102   a  extends straw  206  having medicine  208  down towards capsule  202   a . Packing assembly  204  moves blade  212  using rotor  210  to engage straw  206 . A precise portion  302  of the active drug is detached from straw  206  to be placed into capsule  202   a.    
     Each capsule  202  within capsule tray  105  may be moved to receive a medicine portion  302 . The amount of medicine portion  302  to be cut by blade  212  is determined and corresponds to the amount of active ingredient prescribed in prescription  10 . As shown, blade  212  cuts through membrane  207 . 
       FIG. 4  depicts an exploded view of blade  212  engaging straw  206  according to the disclosed embodiments. As shown, packing assembly  204  may include four blades  212 , also known as blade cutters. The four blades may rotate using rotor  210  and as instructed by system  100 . A blade  212  cuts into membrane  207  extending from straw  206  to detach medicine portion  302  for placement into capsule  202   a.    
     Alternatively, packing assembly  204  may deploy two blades  212 . As noted, an amount of medicine  208  is extended out of straw  206 . One of blades  212  slices this amount held within membrane  207 . 
       FIG. 5  depicts the medicine portion inside capsule  202   a  according to the disclosed embodiments. Here, medicine portion  302  enclosed by membrane  207  has been cut by blade  212 . Rotor  210  keeps moving blade  212  past the point underneath straw  206  to position another arm of the blade for cutting. Membrane  207  extends from straw  206  to provide more medicine to remaining capsules  202 . 
     Medicine portion  302  within capsule  202   a  corresponds to the amount of active ingredient of the drug listed in prescription  10 . Packing assembly  204 , therefore, may cut a consistent amount of the medicine for each capsule. Straw  206  extends membrane  207  and medicine  208  to same amount each time. Further, as shown in capsule  202   a , medicine portion  302  is reduced in size from a whole capsule dedicated to delivering the active ingredient of the medicine. A conventional dosage using a capsule would include medicine portion  302  plus filler and inert ingredients. 
       FIG. 6  depicts plunging apparatus  600  of packing assembly  204  receiving the medicine portion according to the disclosed embodiments.  FIG. 7  depicts plunging apparatus  600  packing the medicine portion into the capsule according to the disclosed embodiments.  FIG. 8  depicts the plunging apparatus and the packed capsule with the medicine portion according to the disclosed embodiments. Because  FIGS. 6-8  are related, these figures are disclosed together. 
     Plunging apparatus  600  includes tube  216  and plunger  218  of packing assembly  204 . Plunger  218  moves downward as controlled by tube  216 . Initially, when capsule  202   a  is moved underneath tube  216 , plunger  218  is in an upward location, extending only slightly out from the bottom portion to the tube. A separator  602  is placed on the bottom end of plunger  218 . Separator  602  may be held by an adhesive portion  603 . 
     Plunging apparatus  600  extends separator  602  into capsule  202   a  to cover medicine portion  302 , thereby separating the active ingredients stored therein from other ingredients placed within capsule  202   a  by system  100 . Thus, the active ingredients in medicine portion  302  do not mix with other medicines or drugs. 
     After placement of separator  602 , plunger  218  moves upward back into tube  216 . Separator  602  is now part of medicine portion  302 . Capsule  202   a  is now finished with canister  102   a  and packing assembly  204 . Another capsule  202  may be moved underneath  216  to receive a separator. 
     Plunger  218  may be used to determine the volume of each drug deposited into a capsule when it is pushed down. As noted above, 30 mg of drug M may not have the same volume as 30 mg of drug N. Plunger  218  and plunging apparatus  600  receives instructions from system  100  on how far to place the dosage into the capsule based on the volume of the amount of drug prescribed. 
       FIG. 9  depicts system  100  moving the capsules to receive a second medicine portion using another canister  102   b  according to the disclosed embodiments. Capsules  202  have been filled with medicine  208  and are now ready to receive the second dosage of a different active ingredient according to prescription  10 . Conveyor belt  104  moves capsule tray  105  to canister  102   b.    
     Canister  102   b  delivers medicine  902  to capsules  202 . As shown, packing assembly  204  associated with canister  102   b  cuts a portion of membrane  207  extending from straw  206  out of the canister. This procedure executes as disclosed above with regards to canister  102   a . A prescribed amount of medicine  902  is measured out in membrane  207  and then detached by blade  212 . 
       FIG. 10  depicts plunging apparatus  600  for canister  102   b  according to the disclosed embodiments.  FIG. 11  depicts placement of the separator on the second medicine portion  902  in capsule  202   a  according to the disclosed embodiments. Capsule tray  105  is moved beneath plunging apparatus  600  that packs medicine  902  delivered by canister  102   b  into capsules  202 . As shown, plunger  218  holds a second separator to be placed in capsule  202   a . Tube  216  holds plunger  218 . 
     Medicine portion  1102  is the amount of medicine  902  cut from straw  206  of canister  102   b . Medicine portion  1102  is held by membrane  207  and relates the amount of active ingredient prescribed for the medicine by prescription  10 . Medicine portion  1102  is not the same active ingredient as within medicine portion  302 . Further, the medicine portions may not be the same amount, volume, weight and the like, though they could be the same. 
     As shown, medicine portion  1102  is placed on top of separator  602  for medicine portion  302 . Plunger  218  then places a second separator  602  on top of medicine portion  1102  to keep its active ingredients from mixing with other ingredients within capsule  202   a . Further, instead of requiring two capsules (or more) capsules to fulfill prescription  10 , the disclosed embodiments may use only one capsule  202 . Plunger  218  detaches second separator  602  and moves back upward to pack the next capsule in capsule tray  105 . 
     This process may be repeated at the other canisters  102   c ,  102   d , and  102   e  until capsules  202  are filled with medicine portions from each station.  FIG. 12  depicts the filled capsules within system  100  according to the disclosed embodiments. Conveyor belt  104  moves capsule tray  105  beneath each canister. The associated packing assemblies  204  places separators  602  on top of each individual medicine portions cut from straws  206 . 
     In some embodiments, a canister  102  and packing assembly  204  may place non-medicinal items into capsules  202 , such as a RFID tag for tracking capsules. Essentially, because of the reduced need for room in each capsule, the disclosed embodiments may place additional items that are not able to fit in conventional capsules. A separator may be used to keep the active ingredients of the medicine portions from interacting with the additional items. 
     Conveyor belt  104  moves capsule tray  105  towards capsule tray fitting device  106 .  FIG. 13  depicts the capsule tray fitting device of system  100  according to the disclosed embodiments. Fitting device  106  places top cap fittings  1302  onto capsules  202  to seal them for delivery in response to prescription  10 . Holder  1304  is moved into position above capsule tray  105  and pressed downward by bar  1306  to seal the capsules. Preferably, top cap fittings  1302  provide a snug seal so that heat or other means is not needed to properly keep ingredients from falling out the capsules. 
     At this stage, fitting device  106  also may perform other operations to identify and track capsules  202 . RFID tags or other components may be fitted into the capsules. A finished capsule  1402  may be shown in  FIG. 14 . Finished capsule, or dosage,  1402  includes capsule  202  and top cap fitting  1302 . It is sealed and may be taken by a patient as prescribed by prescription  10 . Finished capsule  1402  also may include information about the dosages on capsule  202 . Information may include text  1404  or other visual information that identifies some aspect of the medicines inside the capsule. Such information may include ingredients, patient name, and the like. The information also may include bar code marking  1406  for tracking and identifying the capsule. 
     Because each capsule is filled with ingredients that may differ between prescriptions, this information is important so that the proper dosage is provided to the right patient. Further, such information may be used for quality assurance measures. 
       FIG. 15  illustrates a flow diagram  1500  for providing customized medicine dosages in a capsule according to the disclosed embodiments. Flow diagram  1500  includes functions that are performed by, for example, system  100  disclosed above. Computer  110  or computing device  120  may execute instructions to perform these functions by sending instructions to the different components within system  100 . Where applicable, the disclosure of  FIG. 15  will refer to components of system  100  for illustrative purposes. 
     A patient may be diagnosed with a myocardial infarction, or heart attack. Part of the regimen for the patient includes the prescribing of five (5) medications: two anti-platelet drugs, one ARM, one statin, and one beta-blocker. Examples of these drugs may include aspirin at 81 milligrams (mg) and clopidogrel at 75 mg for the anti-platelets, losartan at 50 mg for the ARB, atorvastatin at 80 mg for the statin, and bisoprolol at 5 mg for the beta-blocker. 
     A doctor may prescribe these five medications. The patient will take the prescription to the pharmacy of choice and, in the traditional setting, be given five bottles of five different pills. The patient also will be instructed on how to take each set of pills. If the patient has a difficult time remembering to take the medication, then the patient may opt to go to a pharmacy that provides compliance packaging services. 
     According to the disclosed embodiments, the patient would bring the prescription to a pharmacy practicing the disclosed system and processes. Fulfillment of the prescription may occur as disclosed below. 
     Step  1502  executes by receiving prescription  10  at the pharmacy or medicine dispensing facility. The prescription may be for the active ingredients used in the example above. Step  1502  also executes by entering prescription  10  into system  100 . The information entered is the dosages and types of drugs, as given above. Step  1504  executes by designating the medicines, or active ingredients listed in prescription  10 , to a specific order. The medicines also may be designated to a specific capsule identification number, as shown in  FIG. 14 . 
     Step  1506  executes by loading the prescribed medicines into canisters  102 . An automated robot within system  100  may have the pure form of the active ingredients pre-loaded into the canisters. If not, then the robot will load straws  206  into canisters  102 . Straws  206  include medicines  208  related to the active ingredients of prescription  10 . 
     Step  1508  also may execute by arranging canisters  102  in a specified order to deliver the medicines. In other words, system  100  may determine that the different active ingredients should be packed in a specified order. The robot may move canisters  102  to be in this order. Moreover, some active ingredients may react harmfully when placed in the same capsule as another active ingredient. System  100  may analyze the different ingredients and check them against known medical information to determine a proper order for placing the medicine in capsules  202 , or remove the corresponding canister  102  from system  100 . 
     Step  1510  executes by loading empty capsules  202  into capsule tray  105 . For example, a month&#39;s supply, or  30  capsules, may be loaded. Capsules tray  105  is placed on conveyor belt  104  and moved along system  100 . 
     Step  1512  executes by determining the amount of medicine needed for each dosage, based on prescription  10 . System  100  receives the information, or determines it using computers  110  or  120 , for the correct amount of drug to dispense and sends these instructions to canisters  102 . Alternatively, other measures may be taken to determine how much medicine is placed into capsules  202 . One alternative is that the outer casing may be any sort of compatible material useable with most drug compounds. The outer casing may be changed depending on the various compounds to ensure stability. Thus, system  100  may instruct canisters  102  to change casings (such as membranes  207 ) along with dosage instructions. 
     Another alternative determination may be dividing the pure active ingredient into fixed doses instead of how much material to be cut or separate from straws  206 . Thus, packets of the active ingredients pre-measured may be loaded into canisters  102 . The packets may include membranes  207 . Another alternative is using capsules of different sizes depending on the overall regimen of medications. 
     Step  1514  executes by moving capsule tray  105  with the empty capsules to the first canister  102   a . Canister  102   a  may include a straw  206  with aspirin. Thus, aspirin is the first active ingredient to be placed into the capsules. Conveyor belt  104  could carry multiple capsules at one time so that they may be filled at the same time to ensure efficiency and timeliness. Alternatively, conveyor belt  105  refers to any device, such as rollers with stops, that moves capsule tray  105  and allows the filling of multiple capsules or formulations at one time. Capsules  202  themselves may have different shapes and sizes, colors, and the like. 
     Step  1516  executes by cutting or dispensing the specified amount of medicine as prescribed and dropped into the appropriate capsule. Alternatively, a pre-selected packet of a size may be placed into the capsule. The cutting process is disclosed above. Conveyor belt  104  may be fitted with different molds, such as attachments  107 , to hold capsule trays  105 . Capsule trays  105  hold multiple capsules in one section and may rotate when aligned with canister  102   a . System  100  efficiently cuts a plurality of doses of aspirin to drop into the capsules. 
     To ensure accuracy and safety, steps  1518  and  1520  may be executed. Step  1518  executes by weighing the amount cut or to be placed in the capsules. The length and weight of the medicine that is cut off is determined to ensure accuracy prior to placement in the capsule. Step  1520  executes by conducting a spectral analysis, such as spectrometry, to determine the composition of the medicine being cut or dispensed. The spectral analysis of the aspirin cut from straw  206  of canister  102   a  compares the received spectra to the known spectra for the medicine. 
     Step  1522  executes by placing a separator  602  into the capsule on top of the dosage of aspirin using plunging apparatus  600 . Step  1524  executes by repeating steps  1516  to  1522  for all the capsules in capsule tray  105 . As noted above, capsule tray  105  may be rotated by system  100  underneath canister  102   a . Alternatively, canister  102   a  may be moved to different locations of the capsules to dispense the medicine. 
     Step  1526  executes by moving capsule tray  105  to the remaining canisters. For example, canister  102   b  may dispense atorvastatin in doses of 80 mg. Steps  1514  to  1524  may be repeated for each dosage of medicine prescribed in prescription  10 . Step  1528  executes by inserting an RFID chip into each capsule, as disclosed above. Other nano devices may be placed into the capsules for compliance, safety, tracking, diagnosis, pharmacokinetics, and the like. 
     Step  1530  executes by moving capsule tray  105  to capsule tray fitting device  106  and fitting tops onto the capsules. Step  1532  executes by sealing the capsules shut with the different dosages of the active ingredients. The final capsule of the batch may be dispensed in a bottle or into compliance packaging for quality assurance of the batch. This capsule may be examined by a pharmacist or system  100  before the capsules of this batch are provided to the patient. 
       FIG. 16  illustrates another system  1600  for providing for customized medicine dosing according to the disclosed embodiments. System  1600  includes components and features disclosed in system  100  except with some differences, highlighted below. Conveyor belt  1650  moves the capsules beneath containers to receive specified dosages of various medicines as disclosed above. 
     System  1600 , however, includes canisters  1602   a ,  1602   b ,  1602   c , and  1602   d . These canisters include straws to dispense the various drugs into open capsule  1606 . Preferably, open capsule  1606  is located in a capsule tray, such as capsule tray  105 . Unlike system  100 , system  1600  places the RFID tags  1605  into open capsule  1606  prior to the dispensing of drugs. Thus, canister  1602   a  includes straws  1604  that hold RFID tags  1605 . Alternatively, canister  1602   a  may use tubes instead of straws as RFID tags  1605  are not cut according to a specified dosage. Further, canister  1602   a  may drop the tags into open capsule  1606  with the need of a packaging assembly. 
     Canister  1602   b  includes straws  1608  which hold drug, or medicine,  1612 . As shown, canister  1602   b  includes a plurality of straws  1608 . As straws are used, replacement ones may be moved to dispense additional dosages of drug  1612 . Rotor  1610  cuts the dosage from straw  1608  to place drug  1612  into open capsule  1606  along with RFID tag  1605 . Plunging apparatus  1630  then places separator  1617  on top of the dosage of drug  1612 . In this embodiment, plunging apparatus  1630  may be a distinct assembly from rotor  1610 . Both components, however, may receive instructions from computer  110  or computing device  120 . 
     Open capsule  1606  then moves underneath canister  1602   c  to receive a dosage of drug  1618 . Straws  1614  hold the active ingredients for drug  1618 . Like with canister  1602   b  and drug  1612 , the measured dosage is extended outside canister  1602   c  and cut by rotor  1610 . The dosage of drug  1618  is placed on top of separator  1617  placed prior to movement to canister  1602   c . The respective plunging apparatus  1630  for canister  1602   c  places another separator  1617  on top of the dosage of drug  1618 . 
     This process is repeated for canister  1602   d , straws  1620  and drug  1622 . Canister  1602   d , however, may only include about 3 straws  1620 . Perhaps drug  1622  is relatively expensive compared to other drugs and not administered frequently. It would not do the pharmacy much good to have large amounts of unused expensive drugs not being used. Alternatively, drug  1622  is quite common and just being used frequently in filling prescriptions. A sensor may be used in canister  1602   d  to alert personnel that it is down to 3 straws and may need to be refilled. Rotor  1610  cuts the specified dosage of drug  1622  from straw  1620  to be placed in open capsule  1606 . Plunging apparatus  1630  places separator  1617  on top of the dosage to cover it. 
     Filled capsule  1632  is now ready to be sealed. Filled capsule includes RFID tag  1605 , a dosage of drug  1612 , a separator  1617 , a dosage of drug  1618 , a separator  1617 , a dosage of drug  1622 , and a separator  1617 . Additional dosages of drugs may be placed into the capsule. As disclosed, filled capsule  1632  includes the active ingredients of the medicines prescribed and not fillers or inert ingredients just to occupy space in the capsule. 
     In other embodiments, an RFID tag is placed into each dosage. In other words, when an amount of drug is cut from the respective straw, an RFID tag is placed with the dosage along with the separator. In other embodiments, the RFID tag for each dosage may be placed into a separator, or each separator includes an RFID tag. The RFID tags may be used to determine compliance by ensuring the patient received the correct dosage of medicine in the capsules. In other words, a quick scan of the capsules before delivery to the patient checks to see if all prescribed drugs are included. Further, the RFID tags may be used to ensure the patient took the pills, which is beneficial feedback for healthcare providers as well as insurance companies. 
     The disclosed embodiments, using computer  110  or computing device  120 , may execute a mathematical analysis before filling prescription  10  to determine how many active ingredients will fit into a capsule. The analysis may be done according to dosage and the volume of each active ingredient, as well as the volume of the capsule. For example, the prescription may call for 30 mg of the active ingredient in drug  1612  and 30 mg of the active ingredient in drug  1618 . Even though the weight and the dosage are the same, the volume for each drug may be different. The disclosed embodiments may take this into account when doing its analysis of how to parse the ingredients for each capsule. 
     The disclosed embodiments, using system  100  or  1600 , may provide non-standard dosages of drugs. For example, the prescription may call for 117 mg of acetaminophen. This dosage is not possible off the shelf. To receive such a dosage, the patient would have to cut up a 250 mg dosage, which is not efficient or hard to do. System  100  or  1600  would be able to provide such a dosage along with the other active ingredients prescribed to the patient. 
     The following example may illustrate the disclosed embodiments. A prescription is received with the following instructions, with the term “dosage” indicating a different active ingredient or different dosage sizes of the same active ingredients: 
     
       
         
           
               
               
               
               
             
               
                   
                   
               
               
                   
                 Morning 
                 Afternoon 
                 Evening 
               
               
                   
                   
               
             
            
               
                   
                 Dosage A 
                 Dosage B 
                 Dosage A 
               
               
                   
                 Dosage C 
                 Dosage D 
                 Dosage D 
               
               
                   
                 Dosage F- before breakfast 
                 Dosage G 
                 Dosage E 
               
               
                   
                 Dosage G 
                   
                 Dosage G 
               
               
                   
                   
               
            
           
         
       
     
     The patient is instructed to take 11 dosages a day. This number of pills can be unwieldy and confusing. On a weekly trip, the patient would have to pack  77  doses of pills! Using the disclosed systems and processes, the number of capsules is reduced to 4 per day. One capsule includes dosages A, C, and G for the morning. A second capsule includes dosages B, D, and G for the afternoon. A third capsule includes dosages A, D, E, and G for the evening. The fourth capsule includes dosage F as it must be taken before breakfast on an empty stomach, while the first capsule is taken with breakfast. 
     In some embodiments, an analysis may be done to determine whether the active ingredients are compatible with each other. For example, prescription  10  includes medicine A that is taken with food and medicine B that is taken on an empty stomach. These medicines should not be placed into capsules with each other as they should not be taken at the same time. Thus, the canister with medicine B will be held out from the batch of capsules including doses of medicine A. Medicine B may be placed into another batch of capsules. 
     System  100 , therefore, may not include all doses in one batch, but analyzes prescription  10  to determine how many batches of capsules will be created. Other factors may be related to patient through medical conditions, doctor recommendations, known conflicts between medicines, DNA analysis, and the like. The active ingredients in the prescription may be run through a database of incompatible drugs. 
     Drug-drug interactions occur when a drug interacts, or interferes, with another drug. This can alter the way one or both of the drugs act in the body, or cause unexpected side effects. The drugs involved can be prescription medications, over-the-counter medicines and even vitamins and herbal products. The disclosed embodiments take this into account when determining which dosages to fill in which capsules. 
     For example, not all drug-drug interactions are equal. Sometimes when two drugs interact, the overall effect of one or both of the drugs may be greater than desired. For example, both aspirin and blood-thinners like warfarin and Coumadin, used to protect against heart attack, help to prevent blood clots from forming. Using these medications together, however, may cause excessive bleeding. Other times, the overall effect of one or both of the drugs may be less than desired. For example, certain antacids can prevent many medicines (such as antibiotics, blood-thinners and heart medications) from being absorbed into the blood stream. If this happens, the medicine may not work as well, or may not work at all. Thus, the disclosed embodiments must take into account such interactions when determining and specifying the dosages. Computer  110  may access a dynamic database that stores interaction information and does an analysis on a received prescription to determine the best way to fill the capsules. 
     Using another example, the active ingredient of digoxin and verapamil or amiodarone may cause a severe interaction which can raise or lower the digoxin levels, which is a very potent drug, by 60-75%. It may be hard to adjust the dose because current manufacturing methods create digoxin tablets that are extremely small. Thus, the disclosed embodiments would need to run the analysis through computer  110  against the database to ensure that these two drugs are not included in the same capsule. Amiodarone may decrease the clearance of digoxin, resulting in prolonged digoxin activity. There may also be an additive effect on the sinus node of the heart. The disclosed embodiments would identify this and flag this fact when determining how many capsules and what ingredients go into each. 
     The disclosed embodiments also may take into ethnicity and background, as different drugs impact people differently depending on the genetic makeup of the patient. The disclosed embodiments may have a patient fill out a questionnaire that includes pertinent questions involving the patient&#39;s background to add to the database. Once stored in the database, this information may be cross-referenced with well known medical databases to ensure harmful interactions are avoided in filling the capsules. 
     For example, the disclosed embodiments may perform a process that does computations based on drug to drug interactions. In the example, drugs A, B, and C are prescribed for the patient. Drugs A, B, and C are tested to determine efficacy of each drug on the other drugs that also are included in the capsule. Based on the computations and comparisons, the dosages for the drugs may be adjusted. Additional steps using the same tests are performed for ethnicity and other factors, including a DNA analysis. The disclosed process may act like a feedback loop that runs through the process again and again to get a final result for recommended dosages. 
     In another example, the patient is prescribed drug G for an illness. The patient profile (DNA, ethnicity, past history, allergies, and the like) suggests that this patient should take no more that 200 mg of element X per day. The disclosed embodiments analyzes and determines that drug G holds 125 mg of element X, which is perhaps not the main ingredient but included as part of the overall drug. The disclosed embodiments then perform an analysis on all prescribed drugs being taken by the patient. Drugs H, I, and J, for example, are the drugs prescribed in addition to drug G. The analysis determines that the aggregate total of element X would be 250 mg. Obviously, this amount violates the patient profile limitations. The disclosed embodiments may do an adjustment to minimize the levels of element X while still providing drugs G, H, I, and J. The amount of element X cut from the respective straw may be limited to 200 mg. 
     It will be apparent to those skilled in the art that various modifications and variations may be made in the disclosed embodiments of the disclosed methods and systems without departing from the spirit or scope of the invention. Thus, it is intended that the present invention covers the modifications and variations of the embodiments disclosed above provided that the modifications and variations come within the scope of any claims and their equivalents.