Global CHC Market Movers, MAT Q1 2021

We have now published our latest Market Movers update on the CHC Dashboard website, highlighting 6 brands that have been driving growth in the global CHC market in the MAT Q1 2021 period, as well as 6 brands in fast decline, and below we look at the trends behind these exceptional brand performances.

Given that antiseptics & disinfectants were by far the biggest growth driver in the global CHC market in MAT Q1 2021, it’s no surprise that two of the six fastest-growing brands were hand sanitisers, Unilever’s Suave and ArtNaturals (ArtNaturals). Both were standout performers in the US market among a raft of new entries in the vibrant subcategory.

Rx-to-OTC switch has also been an important growth driver, with GSK’s May 2020 launch of topical analgesic Voltaren Arthritis Pain the notable development, generating sales in excess of US$100mn in under a year on the market. Former switch brand Plan B One-Step also performed exceptionally well in MAT Q1 2021, owing to limited access to prescribed contraception and family planning clinics during the pandemic. Foundation Consumer Healthcare also backed the brand with TV ads explaining it does not affect future fertility.

In China, the two fastest-growing CHC brands were Mayinglong Musk, a haemorrhoid preparation extended into new subcategories thanks to product innovation, and Fu Fang E Jiao Jiang, which marketer Dong-e E-jiao Group revived by returning to a policy of targeting general (not just high-end) consumers, helping ensure a return to growth overall for tonics & cure alls in China.

As for products that suffered falling sales in MAT Q1 2021, the clear majority (4 out of 6) were CCA brands, given the historically weak cough & cold season experienced by the industry in the first quarter of this year. Global No.1 brand Vicks posted further heavy decline in Q1, with MAT Q1 2021 sales falling by 24.5%; combo packs of Vicks NyQuil / DayQuil packs fell particularly hard (-54%).

Reckitt’s systemic cold & flu treatment Mucinex Fast-Max and cough remedy Delsym also suffered heavy decline in MAT Q1 2021, as did Taisho’s cold remedy Pabron in Japan, which was hit by the downturn for domestic and inbound channels attributable to Covid-related issues.

We are pleased to announce that Nicholas Hall’s North American e-Conference 2021 will take place on 21 September! Sponsored by Catalent, Nicholas will be joined by industry experts to explore Challenger Brands & Key Pillars to the New / Modern Marketing World. To register, or to find out more, please contact elizabeth.bernos@NicholasHall.com.

OTC Switch Update: China and Austria news

Significant Rx-to-OTC switch developments have recently been announced in the Chinese and Austrian markets. In China, the NMPA medical agency has approved the following switches from Rx to OTC (Class A, pharmacy-only):
 
• Slow-release ambroxol hydrochloride tablets 75mg (dual status cough remedy)
• Lactulose oral solution 67g per 100ml in 100ml or 200ml bottles (dual status laxative)
• Saccharomyces boulardii sachets 0.25g per bag (antidiarrhoeal)
• Glucosamine sulphate potassium capsules 0.25g (joint health)
• TCM systemic cold & flu remedies: Shufeng Jiedu Capsules (0.52g per capsule) and Qingkailing Effervescent Tablets (1g per tablet, dual status)
• TCM sore throat remedies: Huangshi Xiangsheng Tea 0.8g per sachet and Huangshi Xiangsheng Lozenge 0.6g per tablet (both dual status)
Source: Nicholas Hall’s Rx-to-OTC Switch Hot Topic Report

In Austria, Stada has launched Aurasin Akut (zolmitriptan 2.5mg tablets; 2-count SKU; suitable for consumers aged 18-65 years), which is indicated for the acute treatment of the headache phase of migraine attacks, with or without aura. Said to be a “game changer” by the marketer, this is the first non-prescription triptan in Austria after Stada received OTC authorisation for Zolmitriptan Stada 2.5mg in April 2021, while other zolmitriptan-based products remain Rx. A+P support will include radio, print and online activity from August 2021. This development brings Austria in line with the rest of DACH subregion: in Germany sumatriptan was switched from Rx-to-OTC status, and age restrictions (18-65 years) for almotriptan and naratriptan were removed, effective November 2020; while in Switzerland, as of July 2021, multiple triptans can be dispensed without a prescription following face-to-face consultation with the pharmacist.

Comment from Head of Consumer Healthcare at Stada Austria, Ulrich Grottenthaler: With the introduction of Aurasin Akut, a targeted, OTC, well-tolerated treatment for acute migraine attacks is made possible for the first time. The active ingredient zolmitriptan is already well established and also acts where the migraine pain originates. This sets us apart from other non-Rx painkillers. With Aurasin Akut, we enable patients who have once been diagnosed with migraine to get the best therapy for acute migraine attacks in an uncomplicated way and without a prescription in Austrian pharmacies — simply and quickly!

Now is your last chance to join this week’s hot topic webinar focusing on Immunity & Other Drivers of Consumer Healthcare for Europe. Taking place Wednesday 21 July, topics on the agenda will include WOW! brands, e-Commerce and disinfection, plus much more. To register, or to find out more, please contact elizabeth.bernos@NicholasHall.com.

CVS Study: Consumers taking better control of health

CVS Health’s just-published 2021 Health Care Insights Study, which asked 1,000 consumers and 400 providers for their thoughts on the state of healthcare and how they are navigating this evolving landscape, reveals preferences for a more personalised, customisable and accessible experience.

Even as access to health insurance coverage (55%) and location of care (43%) remain among the top factors that influence consumer healthcare decisions, more people are exploring different avenues of care, with a slight movement away from primary care providers (PCPs) to other healthcare resources. Routine care from PCPs has dropped since last year (56% vs 62%), while the use of online resources (19% vs 12%), community health centres (19% vs 15%) and local pharmacies (17% vs 11%) have grown in preference.

Other findings include:

  • 77% said the pandemic has led them to pay more attention to their health in general, while 50% indicated previous stay-at-home orders helped them achieve their health goals
  • In addition to increased substance use, feelings of stress have been pervasive, especially for men, who reported slightly higher levels of stress vs female respondents over the significant shifts that took place during quarantine
  • Young adults (18-34 years) were most impacted by the pandemic and the most likely age group to report depression (35%) and a higher rate of mental illness (28%) vs total respondents (23%)

Comment from CVS Health President & CEO, Karen Lynch: Over the past year-and-a-half, we have witnessed a dramatic shift in consumer healthcare preferences and needs. These shifts towards personalised care have the potential to impact our healthcare system well past the pandemic, with many people taking a more engaged approach to their own health. Going forward, we have an opportunity to take what we’ve learned and continue to foster an integrated health model that is centred around the needs of the individual.

Will consumer interest in boosting immunity outlast Covid? Is the shift to prevention products sustainable? These important questions will be explored in our forthcoming hot topic report focusing on Immunity. A number of categories including antivirals, immune supplements and vitamins C & D will be featured, alongside the latest launch activity and much more. To pre-order your copy and save with the pre-publication discount, or to find out more, please contact Melissa.Lee@NicholasHall.com.

MAT Q1 2021: Global CHC sales fall 0.6%

According to Nicholas Hall’s global sales database DB6, the retail (bricks & mortar) CHC market generated global sales of US$148bn, down by -0.6% versus a year ago. Further heavy decline for cough, cold & allergy (-14.5%), especially in North America and Western Europe, was largely responsible for the global fall in CHC sales. The Americas declined by -0.4%, driven by a -1.9% fall in North America, but slightly offset by a positive performance by LatAm markets (+8.5%), notably double-digit growth in Brazil (+10.6%).

Asia remained relatively weak (+2.6%); despite strong growth in China (+7.1%), the region continues to be impacted by loss of revenue from overseas visitors in key markets Japan (-9.1%) and Australia (-8.0%). Europe saw a significant downturn (-5.5%), heavily impacted by declines in CCA and analgesics in Western Europe. Key markets Germany (-13.3%) and UK (-13.9%) fell by double-digits during the MAT Q1 2021 period. In C&E Europe, meanwhile, Russia continued to post a positive performance (+4.1%), albeit at a slower rate than year-end.

As for global performance by major category, vitamins, minerals & supplements (+5.3%) remained the fastest-growing category – albeit at a slower rate than year-end 2020 – with immune-associated categories continuing to benefit from greater consumer focus on wellness maintenance and protection. Dermatologicals increased by +4.5%, its buoyancy largely attributed to the performance of antiseptics & disinfectants (+53.1%) during the pandemic. Lifestyle CHC grew by +2.4%, driven by double-digit increases in sedatives & sleep aids (+14.5%) as well as smaller categories such as obesity treatments, emergency hormonal contraception and erectile dysfunction.

Gastrointestinals returned a low level increase (+1.2%), while analgesics saw a decline of -1.8% globally, with systemics down -4.3%, largely owing to the effects of pantry loading at the start of the pandemic. Cough, cold & allergy saw the strongest decline, with sales falling by -14.5% in the 12 months to end March. Pantry loading, as well as the effects of lockdown restrictions, social distancing, mask wearing and hygiene measures resulted in significantly reduced incidence of respiratory pathologies.

At a time when consumers are highly aware of the importance of maintaining their immune system, we are pleased to announce that Immunity will be the focus of our next hot topic report! We will review a number of categories including antivirals, immune supplements and vitamins C & D and explore the latest launch activity, plus much more. To pre-order your copy and save with the pre-publication discount, or to find out more, please contact Melissa.Lee@NicholasHall.com.

Seasonal respiratory viruses re-emerge post-Covid

Recent reports from the UK and USA suggest a severe cold & flu season may be in store during winter 2021-22. With lockdown restrictions, increased hygiene measures and social distancing in force for over a year to reduce the risk of contracting Covid-19, the incidence of common respiratory viruses has been very low. However, with the lack of exposure to illnesses (especially among young children), many of us have not built up antibodies and as a result our immune systems may have been inadvertently weakened.

This has prompted warnings of a potential surge in influenza as measures are lifted; data released this week by the UK’s Office of National Statistics show that in the week ending 11th June, 84 death certificates issued in England & Wales mentioned Covid, while 1,163 deaths involving flu and pneumonia were registered. Additionally, a recent study by the Houston Methodist Research Institute shows the rapid re-emergence of seasonal respiratory viruses following the relaxing of Covid-19 restrictions in Texas in March 2021.

This trend was also reported in a recent article in STAT, in which Trevor Bedford, a computational biologist who monitors which viruses are circulating via the Nextstrain service, was quoted as saying: “Just in the last month [May 2021] or so we’ve started to pick up small amounts of seasonal coronavirus, RSV, metapneumovirus, etc. It’s the first time since April 2020 where we’re starting to see other things circulating.”

There is particular concern that by the time universities, colleges, schools and nurseries reopen this autumn across the northern hemisphere, there will be perfect conditions for high transmission of seasonal respiratory viruses, particularly RSV (respiratory syncytial virus). Andrew Pavia, Chief of the Division of Pediatric Infectious Diseases at the University of Utah, warned: “There will be two years’ worth of kids who are naïve to RSV, instead of one birth cohort. That could be fertile ground for a big RSV year.”

Epidemiologist Professor Neil Ferguson of Imperial College, a member of the UK Government’s Scientific Advisory Group for Emergencies, said in a BBC interview that we must be prepared for a potentially “quite significant” flu epidemic and increased hospitalisations this winter. To help save National Health Service resources, researchers are investigating whether seasonal flu jabs and a Covid vaccine can be administered at the same time.

We are pleased to announce that our Eye Health report is now published and available to order! You can review case studies of key brands, NPD activity and much more. Plus, ensure you have registered for the free webinar on 30 June here to discuss the topline findings. For more information, please contact melissa.lee@NicholasHall.com.

Stada Health Report 2021

According to the third Stada Health Report, a representative survey of 30,000 participants in 15 European countries, 29% have suffered from increased levels of anxiety during the pandemic, while 25% are troubled by stress and inner restlessness and 15% have reported sleep disturbances. Some 52% of respondents are more affected by the lack of personal contact with family & friends than fear of Covid infection (42%), while almost 1 in 3 worries about the financial and work-related repercussions.

However, 70% of Europeans have been willing to invest more in their own health. For 73%, their doctor is the first point of call for all health-related issues, with pharmacists and scientists also highly trusted (60% each). Despite a 14 percentage-point increase in people purchasing medication online, 43% stay loyal to community pharmacies, 13% of which specifically single out their local branch. Europeans care more about brand names and what is associated with them (38%) rather than sustainable & environmentally-friendly packaging (25%) or whether a product was made in Europe (20%).

In the report, Stada asks the question, “With an increased interest in and an aspiration to healthy living, how did people in Europe procure information on these topics? The short answer is: The internet. 54% of Europeans have increased their online searches for health-related information compared to previous years.” However, this spike in online health searches and literacy has not automatically translated into European consumers looking to bypass their pharmacist when acquiring medication, or information about it. According to Stada’s survey, only 14% of Europeans have ordered more OTC medicines via online pharmacies post-pandemic, and 43% flat out refuse to order them online at all. Despite the ever increasing number of e-Commerce platforms and other channels for obtaining medicines online, community pharmacies are still Europe’s first choice for OTCs.

Nicholas Hall’s Touchpoints: The Stada report quoted above is further evidence that increased levels of stress and anxiety, and disrupted sleep, are by-products of Covid. Insomnia was already considered a pandemic in the Western world by the World Health Organization; and sleep, stress and mood have joined immunity and disinfection as categories with rocketing sales in the past two years … The theme continues in the latest Gallup survey, which notes the high incidence of “worry, stress, anger and sadness among employees worldwide”. It seems that substantial numbers of office workers are refusing to go back to work in the traditional way and are insisting on continuing to work from home … This localisation of labour will almost certainly change our concept of shopping and could benefit independent neighbourhood pharmacies, giving a whole new meaning to the concept of Pharmacy Point-of-Care. It’s too soon to draw definite conclusions, but consumer healthcare companies would do well to re-examine their sales force objectives. One of the most successful modules of the CHC Training Academy is “Winning in Pharmacy”, and I can see this being even more popular as we come out of the Covid lockdown.

To find out more about Winning in Pharmacy, or the offerings from The CHC Training Academy, please contact maricar.montero@NicholasHall.com. The CHC Training Academy can also work with you to develop your own in-house customised training programmes according to your specific strategic needs.

AESGP 57th Annual Meeting Review

From CHC Insight Europe Editor, Sarah Carter, who reports that the AESGP sees a brilliant future for self-care, but that the industry must continue to adapt.

Focusing on self-care in times of the pandemic and beyond, the 57th AESGP Annual Meeting discussed opportunities, challenges and lessons learnt. While the pandemic has caused significant disruption and altered behaviours, priorities and shopping habits, it has driven a surge in interest in self-care, with consumers increasingly looking to stay well and prevent illness. Birgit Schuhbauer, who has just been re-elected as AESGP President for the next two years, stated that the CHC industry has a “brilliant future ahead of us”.

The CHC industry has had to adapt to this changing landscape, although a number of speakers stressed that it must do so at a quicker pace as technology and evolving consumer demands continue to disrupt the traditional self-care model. AESGP Director General Jurate Svarcaite concluded that there is no going back to the old model, stressing that the “new normal” requires collaboration and partnership.

Speakers also touched upon the infodemic and the increasing consumer appetite for instant information, which European Medicines Agency Executive Director Emer Cooke said was difficult to manage when you try to have a “sound scientific basis for what you communicate”. However, the worrying spread of misinformation and disinformation means that increased and better communication is vital.

The Annual Meeting coincided with the long-awaited implementation of the new EU Medical Device Regulation; participants shared their excitement and optimism at the development and celebrated how much work had been done, but were keen to stress there remains a way to go, particularly in terms of harmonisation across Europe and the capacity of notified bodies.

There is still time to register for our free webinar on 30 June discussing the topline conclusions from our upcoming report on Eye Health! With no purchase necessary, you can register directly for the webinar here. For more information, please contact melissa.lee@NicholasHall.com.

Rx-to-OTC switch drivers

Allergy and sexual health are two areas of the global CHC market that continue to expand in sales thanks to Rx to non-prescription switch activity in various markets. In Japan, the Ministry of Health, Labour & Welfare’s Evaluation (MHLW) Review Conference will discuss the potential Rx-to-OTC switch of emergency hormonal contraceptives at a meeting this week.

According to CHC Insight Asia-Pacific Senior Editor, Nicola Allan: “In June 2019, an MHLW steering committee permitted pharmacists to dispense EHCs during a face-to-face transaction after the consumer has had an online consultation with a doctor. Previously, the patient had to see a doctor face-to-face to obtain a prescription to give to the pharmacist. More than 9,000 pharmacists have undertaken training that allows them to participate in the new scheme, which has prompted the MHLW to consider further liberalisation of EHC sales.”

Meanwhile, in the UK, following an application from Sanofi, the Medicines & Healthcare products Regulatory Agency last week reclassified Nasacort Allergy Relief (triamcinolone acetonide 55mcg / dose) nasal spray from Pharmacy medicine to General Sales List. The suspension can be used for the relief of symptoms associated with seasonal allergic rhinitis, including sneezing, itchy and runny nose, itchy red or watery eyes, nasal congestion or sinus discomfort in adults aged 18+ years.

In terms of switch drivers, governments seeking to reduce healthcare costs remains a primary factor, but also important is the empowerment of consumers as they increasingly use digital solutions to improve and monitor their health, a trend that is being leveraged into test & treat models. Commenting on the just-published Rx-to-OTC Switch Hot Topic Report, CIMA Senior Market Analyst Victoria Blake said the report “considers the impact of Covid on struggling healthcare systems, and the increased burden on the undertreated population. While traditional mechanisms have proved too slow in recent years, the next generation of switches – such as statins, triptans, oral contraceptives and CBD – require new thinking and a different approach.”

According to Nicholas Hall, “we could be entering a Golden Age. Voltaren Arthritis Pain Relief Gel’s successful US launch; OTC approval for low-dose cannabis in Australia; the possibility of OTC oral contraceptives in a major Western market for the first time; plus recent statements by Sanofi on the likely switches of the antiviral Tamiflu and the erectile dysfunction treatment Cialis. These are just the tonic this industry needs as the recovery from Covid gets underway.”

Our hot topic report Rx-to-OTC Switch is now published! Written by Nicholas Hall’s CIMA team in association with switch expert Joe McGovern of Biograph Inc, you can access information on the historic and current switch environments in key global markets, including an overview of pipeline and strategic considerations. For more information, or to purchase your copy, please contact melissa.lee@NicholasHall.com

Google’s Derm Assist AI tool

Google is making a big move into healthcare with its announcement last week of a new AI skin care tool, Derm Assist, which is set to launch in Europe later this year. The new tool received a Class I medical device CE mark from European regulators, and is backed by landmark research that was published in Nature Medicine this time last year, showing how Google’s AI model was trained on more than 16,000 real-world dermatology cases and achieved accuracy on a par with US board-certified dermatologists. Another more recent study in JAMA Network indicated the AI tool also significantly improved diagnostic accuracy of non-derma specialists such as GPs.

In its blog announcement, Google said: “With our CE marked AI-powered dermatology assist tool, a web-based application that we aim to make available for early testing in the EU later this year, it’s easier to figure out what might be going on with your skin. Simply use your phone’s camera to take three images of the skin, hair or nail concern from different angles. You’ll then be asked questions about your skin type, how long you’ve had the issue and other symptoms that help the AI to narrow down the possibilities. The AI model analyses all of this information and draws from its knowledge of 288 conditions to give you a list of possible conditions that you can then research further. It’s not meant to be a replacement for diagnosis, but rather a good place to start.”

Google said that it sees billions of Google Searches every year related to skin, nail and hair issues, but that it remains difficult for people to describe what they see on their skin through words alone. According to the FT, Google cited studies showing that people only diagnose themselves correctly 13% of the time when it comes to skin conditions, presenting a huge opportunity for the Derm Assist tool. In the blog announcement, Google provided a visual walkthrough of how the tool will work on smartphones, starting with a prompt to submit a picture of your “skin concern” (examples include moles, birthmarks and rashes), with the visual information then analysed by the AI before being converted into a gallery of suggested conditions.

Google is keen to emphasis the inclusivity of its AI model, stating: “To make sure we’re building for everyone, our model accounts for factors like age, sex, race and skin types – from pale skin that does not tan to brown skin that rarely burns. We developed and fine-tuned our model with de-identified data encompassing around 65,000 images and case data of diagnosed skin conditions, millions of curated skin concern images and thousands of examples of healthy skin – all across different demographics.”

Review New Product Activity and the latest digital health developments across the industry with Innovation in CHC 2021, the latest report from CHC New Products Tracker. For more information, or to order your copy, please contact melissa.lee@NicholasHall.com

Vitamin D has a bright future

DSM’s Hologram Sciences has launched its first direct-to-consumer brand, d.velop, an immunity solution with an advanced vitamin D formula, diagnostic kit and digital support. Hologram says d.velop is made with an exclusive form of vitamin D (DSM’s ampli-D) that has been shown to help achieve optimal levels 3x faster and more effectively vs conventional vitamin D supplements. A three-month subscription (US$75 / 180 pills) comes with a free vitamin D test kit containing two tests to measure vitamin D levels before and after taking d.velop. An accompanying free app provides a holistic immunity score, helps consumers track their progress towards a healthier immune system and addresses other potential immunity factors, such as nutrition and sleep. D.velop is also available as a one-time purchase (US$25 / 60 pills) from the brand’s website.

Vitamin D supplements had their season in the sun in 2020, with global sales up 28% to just short of US$2bn, and new product development in the subcategory has reached an all-time high. New delivery formats have been the main source of vitamin D innovation in recent years, so it’s notable that DSM has unveiled a new patented form of the ingredient (ampli-D), marking a real leap forward for the subcategory. DSM has already launched ampli-D as Fortaro tablets in Australia in December 2020, positioned to support the health of bones, eyes, skin and the immune system, while US launch d.velop was awarded 3 stars by Nicholas Hall’s CHC New Products Tracker, not just for its novel formulation but also for the supporting diagnostic test kits and smartphone app.

In other vitamin D news, US VMS industry body CRN (Council for Responsible Nutrition) has launched “Vitamin D & Me!” (vitamindandme.org) – a consumer education initiative on vitamin D and Covid-19. It presents research, expert video interviews and news in a user-friendly format developed by Council for Responsible Nutrition member Nutrasource, focusing on consumers aged 55+ years; older adults are more prone to vitamin D deficiency and are at higher risk from worse outcomes from Covid and other respiratory infections. CRN Foundation President, Steve Mister, commented: “We have been fascinated … at the amount of research being conducted examining the potential relationship between vitamin D and Covid-19. [We are] delivering unbiased education on the latest science, which helps people make smarter decisions to maintain their health.”

Nicholas Hall Writes: “Vitamin D is essential to bone growth and other important bodily functions, and acts synergistically with calcium. The over-use of sunscreens had already given this subcategory stellar growth and Covid has added rocket fuel to what was the sixth fastest-growing subcategory in the global CHC market in 2020. Initiatives like DSM’s are highly appropriate and very welcome, especially as most top CHC players expect to buy-in important developments from technology providers. In the case of vitamin D and the D.velop brand in particular, the latest research from the CRN foundation underlines the significance of this particular innovation in an industry where 94% of all new products launched since 2013 have little or no point of difference.

Now is your final chance to register to join this week’s hot topic webinar focusing on Immunity & Other Drivers for Consumer Healthcare in Asia-Pacific! Join Nicholas to explore the non-existent cough & cold season, e-Commerce, where to find growth and innovation and much more. To register, please contact elizabeth.bernos@NicholasHall.com