Shionogi Healthcare has announced a groundbreaking improvement to the packaging of its pharmaceutical products. In order to facilitate greater ease-of-use for customers with visual impairments or who would otherwise be unable to read the instructions for use, Shionogi has added a new feature to its products that will allow users to receive the information on the package in multiple foreign languages and through text-to-speech. This feature, called Accessible Code, was developed through extensive testing to ensure that even a user who is fully blind can easily find and scan the QR code and receive the contained information. The text is also automatically displayed in the language of the user’s smartphone. The implementation of this feature, which will be added to the packaging of the New Sedes tablets and other over-the-counter (OTC) drugs, is a first for the industry and represents a significant milestone in the development of product information accessibility. For more information on the accessibility features that have been added to the packaging of Shionogi’s OTC drugs, click here (Japanese only).

According to a study conducted by the World Health Organization (WHO), people with visual disabilities make up approximately 4% of the global population. It was also found that within that 4%, about one in ten people with visual disabilities can read braille. However, the inclusion of braille text on project packaging would require a great deal of surface area and would significantly raise production costs. At the same time, it is important to ensure that people with impaired vision can still access the product information in order to use the drug safely and as intended.

Compared to the information that is available to people whose senses are unimpaired, the degree of information that is commonly accessible to people with visual impairments is very low.  This is particularly true in the case of printed materials, for which few good methods exist to make them accessible to everyone. In order to address this problem, Shionogi Healthcare worked to implement accessibility features that would not only make printed materials accessible to people with visual disabilities, but which could also be produced cheaply and easily.  The key to solving both of these problems was QR-code technology(1), which already sees use in a number of fields and settings around the world.

QR codes can be read using smartphones, which are today owned by 40% of the global population(2). Furthermore, the vast majority of smartphones manufactured today include a screen reader as part of their accessibility features. By leveraging the screen-reader function, printed materials can be made accessible by simply including their contents in a QR code, which users can then scan with their own smartphone. The screen-reader function available on the iPhone can be activated in the settings menu by following the steps shown below. Android devices have their own screen-reader software, which is called “Talkback.”

A survey of the use of Information & Communications Technology (ICT) devices(3) found that the number of smartphones used by people with visual disabilities has doubled between 2013 and 2017.

Additionally, a test conducted with the assistance of over 100 volunteers with visual impairments confirmed that QR codes included on printed materials could easily be read using a smartphone, provided the participants knew where the code was located.

Using the “QR Translator” system developed by PIJIN(4), the information on the materials could even be rendered into several different languages, further expanding the range of potential users. By including Accessible Code (QR code), which can be printed on a range as small as 16×16 mm, on the packaging of their products, Shionogi Healthcare has made the dosage and instructions for use available as audio and in a variety of languages for any user with a smartphone.

The specifications for Accessible Code (patent pending) that ensure it can be easily located and scanned by users with visual impairments are as follows:

  • The dimensions of the QR code must be at least 10 mm on each side, with a 3-millimeter margin on each side, for a total footprint of 16×16 mm (±1 mm).
  • A raised dot of 1 mm in diameter (identical in size to one JIS-standard braille dot) should be placed at each of the four corners of the margins. Alternatively, the outer perimeter of the margins can be debossed.
  • Each side of the QR code should contain no more than 29 cells (for a maximum size of 29 rows and 29 columns).
  • In order to avoid unintentional scanning, the product’s bar code should not be printed on the same side of the packaging as the Accessible Code.

Additionally, the code should be printed in black-and-white to make it easier to locate for those with failing eyesight or color blindness.

The Story of Accessible Code’s Development

In August of 2016, PIJIN was contacted by Kobe Lighthouse(5), a support and advocacy group for people with visual impairments, asking whether the QR Translator app couldn’t be adapted to include text-to-speech functionality.

PIJIN consulted extensively with Kobe Lighthouse in order to fully understand the specific problems that needed to be addressed, and it gradually became clear that a standardized QR codem, which could be printed on a variety of materials and products, would be the best solution for providing information in the form of audio.

Working from this understanding, PIJIN collaborated with several different organizations around the country to conduct widespread testing of the QR Code Reader app and also applied for participation in the Initiative to Develop Practically Applicable Welfare Equipment to Remedy Common Problems (課題解決型福祉用具実用化開発支援事業) being operated by the New Energy and Industrial Technology Development Organization (NEDO). Development of Accessible Code continued from May 2017 to March 2019. To see Nedo’s announcement about Accessible Code, click here (Japanese).

Through widespread testing involving more than 100 participants from around the country, PIJIN was able to collect extensive data on the specific factors and considerations affecting the code’s effectiveness (such as the ease with which it is located and scanned).

Product packaging featuring Accessible Code was first presented at the August 2018 Ideation Hackathon organized by web designer i-Collaboration Kobe(6), where it was seen by representatives from Shionogi, who later passed knowledge of the technology to Shionogi Healthcare, one of the group’s subsidiaries.

The Future of Accessible Code

Moving forward, PIJIN and Export Japan hope to continue to spread awareness of Accessible Code in order to make more and more printed media accessible to a wider variety of users. They foresee the code being used throughout the world to dissolve the barriers of language and ability that make information available to only certain groups of people.

In order to spread knowledge of Accessible Code on a wider scale, they have begun marketing it through Mirairo, one of the country’s largest contributors to the adoption of and development of Universal Design. With the help of Asahi Printing Co., Export Japan and PIJIN are also conducting an awareness campaign within the pharmaceutical industry to spread knowledge of the merits of Accessible Code.

About Shionogi Healthcare

In pursuit of their goal to “provide the highest-quality healthcare and promote healthy living for everyone,” Shionogi Healthcare cooperates with multiple partner companies and participates in a variety of projects and initiatives in order to offer the best in healthcare goods, services, and information, including over-the-counter (OTC) drugs such as Sedes, Cinal, and Pylon. The company currently plans to implement Accessible Code when redesigning the packaging for several of their products, including Sedes, Cinal, Pylon, and Berizym Granules.

About MIrairo Incorporated

Miraio’s mission is to “design a future which we can paint in our own colors, a future where we can walk our own path.” In addition to working to improve the employment climate for people with disabilities and promoting workplace diversity, Mirairo also created and administers a training course in “Universal Manners” through the Japan Univeral Manners Association. Both organizations were created by Toshiya Kakiuchi, who has received multiple awards for his work and also acts as an advisor to the planning committees for the Tokyo Olympic and Paralympic games.

About Asahi Printing Co. Ltd.

A veteran of the printing industry, Asahi was founded in Toyama Prefecture in 1872. Their company policing of “valuing the ‘heart of hospitality’ (tsutsumu kokoro)” is what drives them to continue to strive for new advancements in the field of packaging for healthy and beauty products. Asahi Printing is among the largest printing companies in the country, with over 20 different locations.


PIJIN are the developers of QR Translator, a service that is used around the world (in countries such as Amerika, China, Russia, and the in the EU) to easily create, manage, and edit QR codes that contain multilingual information. QR Translator codes can be found at Fushimi Waseda-taisha shrine and on the observation deck of the Tokyo Metropolitan Gov’t Building.

About Export Japan Inc

Founded in Osaka in April 2000, Export Japan is a web marketing firm that specializes in inbound tourism and multilingual content creation. Some of Export Japan’s more noteworthy clients include the Japan International Cooperation Agency (JICA) and, an English-language travel site that receives millions of visitors each month. Its diverse staff of a few dozen is made up of talented individuals from Japan, America, France, Poland China, Taiwan, Indonesia, Brazil, and Bangladesh, and the company’s goals are best described by its motto: “Contributing to intercultural relations through internet business.”

(1) QR (“quick response”) code is a high-capacity encoding system developed in 1994 by Denso Wave. It is open-source technology that has been implemented in a wide variety of different settings and industries.

(2) Global smartphone penetration rate by Statista

(3) Per a 2017 study conducted by Tetsuya Watanabe of Niigata University, “An analysis of differences among residences in the usage of communication support services and ICT devices by blind and visually impaired people” (Japanese).

(4) Developed by PIJIN, the QR Translator web service allows customers to generate QR Codes containing product information that is then automatically translated into several different foreign languages.  QR Translator is patented in Japan, America, China, Korea, and the EU.

(5) Founded in 2013, Kobe Lighthouse is a non-profit organization that provides support and advocacy for individuals who are blind or have other visual impairments.  The company’s chairman, Katsumi Ohta, was inspired to start the company when he lost his vision at the young age of 25 and realized that he wanted to support other people with disabilities both in their professional and personal lives.

(6) A non-profit organization based in Kobe, i-Collaboration holds seminars and workshops aimed toward developing technologies to support people with various disabilities.