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Pharmaceutical development is increasingly moving beyond the traditional emphasis on drug substance performance to include the full experience of medicine use. This shift reflects the recognition that therapeutic value is shaped not only by pharmacology, but also by whether patients can understand, accept, handle, administer, and continue using a product in everyday life. Despite major advances in dosage form engineering, digital health tools, adherence monitoring, and personalised pharmaceutical manufacturing, many innovations remain disconnected from the practical contexts in which medicines are used. A dosage form may be technically sophisticated but still fail if it is difficult to swallow, unattractive to children, burdensome for older adults, incompatible with daily routines, or unsupported by feedback systems that encourage continued use. This narrative review integrates three domains that are often discussed separately: dosage design, adherence logic, and real-world use systems. It argues that patient-centric pharmaceutical technologies should be understood as integrated use systems rather than isolated product features. The central question is how pharmaceutical technologies can be designed to support not only drug delivery, but also patient acceptance, behavioural continuity, and implementation in real healthcare settings. The review concludes that patient-centricity should be treated as a foundational development logic rather than a late-stage product attribute. Future pharmaceutical technologies will require early patient involvement, scalable manufacturing pathways, human factors validation, digital support systems, and regulatory strategies that define success according to real-world usability and patient-defined outcomes.

Drug–device combination products occupy a technically demanding position between pharmaceutical formulation, engineered device performance, and real-world user interaction. Their development requires the simultaneous control of drug product quality, delivery-system reliability, and safe administration by intended users. Yet these domains are still frequently treated as separable workstreams rather than as mutually shaping elements of one system. This conceptual framework article addresses the limitations of sequential development models in which formulation is stabilised first, device selection follows, and user validation is deferred until late-stage development. Such sequencing may appear efficient during early development, but it can conceal incompatibilities that only emerge during device verification, usability testing, clinical bridging, or regulatory review. The result is often redesign, delayed translation, or unresolved uncertainty about whether the final product can perform reliably under intended conditions of use. The objective of this article is to propose and defend the Formulation–Device–User Triangle as a unified design logic for drug–device combination products. The triangle positions formulation, device, and user as co-equal vertices that continuously constrain and enable one another. It is intended not as a replacement for existing quality, design-control, or human-factors processes, but as an integrating framework that makes their interdependence explicit. The proposed triangle reframes combination product design as a system-level co-development problem. It argues that a product is not ready for translation simply because its formulation is stable, its device is functional, or its users can pass a summative test. Readiness depends on whether the formulation tolerates device action, the device accommodates formulation variability, and the user interface supports reliable administration across real-world conditions.