STATINS COULD BE A NEW OPTION FOR MILLIONS

ENGLAND: Draft updated guidance from NICE recommends that the risk threshold at which statins should be offered to prevent cardiovascular events can now also be considered for people at a lower threshold, meaning that around 15mn more individuals could be eligible. Until now, people with a >10% risk over 10 years of a cardiovascular event should be offered a statin. However, an independent committee considered new evidence on their side-effects and safety. 

While statins can cause muscle pains, the best evidence shows that most people do not experience this and many more will get muscle pains whether they take statins or not than have muscle pain caused by statins. While the draft guidance continues to recommend that risk factors which can be addressed should be managed, including stopping smoking, reducing alcohol consumption, taking exercise and eating a healthy diet, atorvastatin 20mg can now be considered as part of shared decision-making for people with a <10% risk over 10 years of a first heart attack or stroke.

^{For a short while (2004-2010), the world’s only OTC statin, Zocor Heart-Pro (J&J, UK)}

Nicholas Hall Writes: Last week I wrote about macro factors that might influence consumer health markets in the near future. Healthcare in general will experience both mega-threats and opportunities: a threat in the sense that inadequate provision of hospitals and general practitioners is likely to erode standards of public health, with serious political and economic consequences; but that in a more localised sense there is a huge opportunity for OTC players to promote the concept of self-care to a demographically-unbalanced population which increasingly will have to take better care of its own health.

Our lead story this week tracks the move towards even more statin prescriptions in the UK. Could this benefit CHC, bearing in mind that the low-dose statin Zocor Heart-Pro is a failed switch from the past? Yes, I believe there is room for optimism, not least because renewed consumer interest in cardiovascular health could drive demand for an OTC polypill containing a statin and other beneficial ingredients such as omega-3 and possibly low-dose aspirin. Regulators stamped down on earlier attempts to create a polypill, but a generation later – and with declining standards of public health – who can say for sure that a revived interest in this concept would necessarily fail?

Explore innovation by marketer, region and country in the 2023 edition of our Innovation in CHC report, coming soon! Drawn from CHC New Products Tracker, this report showcases 10 major ingredient trends, 5 delivery format trends and 100 key innovations from 2022. For more information, or to pre-order your copy with the pre-publication discount, please contact melissa.lee@NicholasHall.com.

Relaxation of China Covid rules shakes up CHC market

The news that China is to ease its strict Covid-19 controls has had reverberations across Asia’s CHC market. From now onwards, individuals who have the virus can isolate at home instead of in state facilities; people will be able to travel more freely; and national apps to track people’s movements will be deactivated. Immediate reactions include the following:

• JD Health has introduced an online Covid clinic offering 24/7 consultations for people with concerns about the virus; in the week following the easing of restrictions, the e-Commerce platform reported that sales of medicines for cold, fever and cough, as well as antibacterial and anti-inflammatory products, rose 18-fold vs the same period in October, and the transaction volume of antigen self-test kits increased by 344% week-on-week
• High demand for analgesics and cold remedies in China has caused concerns about supply issues in S Korea, which imports many of its raw materials from the country; S Korea’s MFDS has instructed local companies to increase production of paracetamol 650mg tablets until April 2023 to address the issue of shortages as domestic Covid-related demand has also been high
• Panic-buying of paracetamol-based products also ensued in Hong Kong; according to The Epoch Times, Lam Wai-man, Chairperson of the HK General Chamber of Pharmacy, said sales of Haleon’s Panadol had risen by 30-40% in a week and he believed that many of the products were being sent to Mainland China

^{Panadol is out of stock in many HK retail outlets. Source: The Epoch Times}

• The South China Morning Post reports that stocks of almost all TCM marketers rose (according to East Money) following the easing of restrictions, supported by the National Health Commission’s releasing a new list of 30+ TCMs recommended for treatment of mild Covid symptoms

Comment from CHC Insight Asia-Pacific Senior Editor, Nicola Allan: China has been pursuing a Zero Covid strategy for almost three years, which has adversely impacted the CHC market in Asia-Pacific in several ways. Systemic analgesics and cough & cold remedies in China have been affected by intermittent restrictions on their sale as the authorities sought to monitor people suffering from coronavirus symptoms such as cough and fever. In addition, China has historically outperformed the global CHC retail market, but in the 12 months to September 2022, growth of 3.6% was below the global average (+7%) as lockdowns pushed people to shop online. Meanwhile, countries such as Australia, Japan and HK have lost sales as a result of a lack of Chinese tourist shoppers. HK has been particularly hard hit, so the news that quarantine-free travel to / from the Mainland is set to resume as early as January 2023 will no doubt be welcome news to retailers around the border. There will likely be some bumps in the road regarding supply issues and the impact of Covid spreading through China, but hopefully the relaxed rules will have a positive effect on overall sales in the world’s No.2 CHC market.

We are pleased to announce that experts from J&J, Nielsen, McCann and other companies will join Nicholas on-stage at our 33rd European CHC Conference, taking place in London on 19-21 April 2023! See the latest agenda here. Stay tuned for further topics and speaker sessions to be announced! You can save with the early bird booking discount when you book your place. For more information, or for group booking discounts and sponsorship opportunities, please contact elizabeth.bernos@NicholasHall.com.

RETAIL CHC REMAINS BUOYANT IN MAT Q3 (+7.0%)

The MAT Q3 2022 update from DB6 shows the global retail market advanced by 7.0% in the 12 months to end-September 2022. Globally, this represents another strong single-digit result, albeit continuing to slow from record DB6 highs earlier in the year; with the exception of dermatologicals, all major categories observed a slowdown from MAT Q2 2022.

In terms of geographies, Europe (+10.7%) held its position as the fastest-growing region globally, with many key markets maintaining double-digit growth, driven by sustained significant increases in the cough, cold & allergy category (+28.9%), as well as continued robust growth in analgesics (+10.4%). Largest market Germany remained on a par with MAT Q2 2022 (+10.6%), with other Big 5 Western European markets similarly displaying solid advances, notably Spain (+15.1%). Poland was the strongest performing market (+17.9%), and for now, Russia’s growth remains healthy (+10.0%).

Americas (+7.5%) was the second-fastest growing region, although leading market USA saw its growth dip below the global average for the first time this year (+5.8%). Impressive MAT performances in cough, cold & allergy (+27.5%) offset more subdued returns in other segments, notably a flat VMS result and continued decline in dermatologicals (-3.0%). In Latin America, leading market Brazil improved over MAT Q2 2022 (+18.7%), with strong increases observed across most major categories: cough, cold & allergy (+55.1%), analgesics (+18.9%) and dermatologicals (+11.4%) were the most noteworthy.

Country	MAT Q3 2022 sales ($bn)	22/21%
USA	40.0	+5.8
China	32.0	+3.6
Japan	7.0	+1.7
Germany	5.5	+10.6
France	4.8	+9.9
Brazil	4.5	+18.7
Italy	4.5	+11.2
India	4.2	+7.3
Russia	4.1	+10.0
UK	3.2	+11.9
GLOBAL CHC	158.3	+7.0

Asia (+4.3%) held on to its comparatively muted growth. Largest market China (+3.6%) returned low single-digit growth in view of continuing lockdown restrictions, as well as pharmacy sales restrictions on particular products, primarily impacting cough & cold categories and systemic analgesics. A continued positive increase for No.2 ranked Japan (+1.7%), aided by a dynamic systemic analgesic performance (+11.6%), helped to offset the slight slowing in China; combined, these markets have a share of almost 70% of total regional sales.

Nicholas Hall Writes: With the all-important Q3 market figures announced above by my colleague, Kayleigh Griffin-Hooper and her team, showing that industry sales are holding up well, we expect this to be something of a record year. I’m very much looking forward to seeing the complete 2022 data set next March, when we will be able to review the continued growth of e-Commerce, and then we’ll know whether the industry has kept up with or even exceeded the 6.1-6.5% growth rate experienced during the pandemic.

We are pleased to announce a special end-of-year Reports sale, offering up to 50% across many of our titles until 31 December. To find out more about other year-end discounts across our services, or to create your custom discounted reports package, please contact melissa.lee@NicholasHall.com.

Focus on China: MNCs reveal CHC launch plans at CIIE

Leading global CHC marketers revealed their latest launch plans and deals at the 5th China International Import Expo (CIIE), held in Shanghai last week:

• Sanofi renewed its strategic co-operation agreement with China Resources Sanjiu, with whom it has worked since 2016, with a focus on the marketing of Essentiale. The parties will deepen co-operation and expand in the field of liver health, starting with the launch of Yi Shan Li, a sister product to Essentiale positioned to meet daily liver health needs. Sanofi also plans to launch Allegra allergy remedy in China and, via its Australian brand Ostelin, the company recently signed a strategic co-operation agreement with cross-border business solutions platform Huatang Dachang to bring better bone health options to Chinese consumers

• Bayer diversified vitamin C brand Redoxon with the launch of Calcium, Vitamin D & Vitamin C chewable tablets for adults and gummies for children to support bone health. These line extensions, which are a result of an existing strategic co-operation with Xianle Health (Sirio Pharma), are part of a strategy to build the brand into a comprehensive nutrition range (Redoxon probiotic powder was launched in China in 2021). As part of its co-operation with Jiangnan University, Bayer is developing a Scientific Innovation Laboratory of Probiotics, which will explore the benefits of probiotics beyond intestinal health to include categories such as allergy and immunity. The company also renewed its long-standing co-operation agreement with Shandong Xianhua Pharmaceutical to expand collaboration beyond nutritional categories to cover digestive tract health, pain and dry cough. Finally, Bayer, which markets ketoconazole-based scalp care brand Kang Wang, signed a co-operation agreement with Colori Cosmetics to jointly develop daily scalp care products

Source: SHINE

• Haleon marked its CIIE debut with the news that it will soon launch Voltaren patches (diclofenac sodium) in China, joining the established gel version. It also showcased recently-launched products including Centrum Multivitamin & Zinc Gummy and Caltrate Milk Minerals Gummy Strawberry Yoghurt flavour. In addition, the marketer highlighted digital self-assessment tools such as the Caltrate Magic Mirror Mobility test and Voltaren Smart Posture test

• J&J China Self-Care showcased products from around the world at the CIIE, such as children’s Tylenol and Benylin products, in line with China’s focus on children’s health and encouragement of personal health management. Recognising the need for improved understanding of self-care, J&J supported the China Health Promotion Foundation in launching a self-care promotion programme and has been working with academic associations and medical institutions to develop strategies to boost the concept of self-care in China

Nicholas Hall Writes: There is still a good appetite for investing in the Chinese CHC market by the leading players in our industry. Innovative new products continue to be launched there. Other emerging markets are interested in promoting trade. And, intriguingly, our most acquisitive player, Nestlé Health Science, wants to increase its China footprint – I’m sure that is one of the reasons why the company is looking at Blackmores, assuming that the rumours are true.

There’s still time to register for our upcoming Asia-Pacific e-Conference on 23 November! With presentations from Nicholas Hall and leading marketers, this online event also includes the presentation of our APAC Creative Marketing Awards. For more information, or to register without delay, please contact elizabeth.bernos@NicholasHall.com.

CRN Survey: Branded ingredients favoured by VMS consumers

The Council for Responsible Nutrition has revealed initial findings from its 2022 Consumer Survey on Dietary Supplements. The survey was conducted online in August 2022 among 3,133 US adults aged 18+ years, including 2,342 who report consuming dietary supplements seasonally, occasionally or regularly.

Liz Cummings, our Regional VP North America, reports from CRN’s Now New Next conference: 

US dietary supplement use has reverted to the pre-pandemic level of 75%, with multivitamins remaining the favourite among users. A wealth of regulation, science, economic and consumer insights was unveiled over the 3-day conference, which will be shared in future NHC publications. However, with CHC Newsflash highlighting the dynamic activity related to ingredients suppliers such as DSM, Kerry and ChromaDex, we thought it was timely to share the following results from the CRN survey: 

• 71% of supplement users agree that they “find more confidence using supplements made with branded ingredients”

• 62% perceived that supplements with branded ingredients cost more because they are more effective and better quality, and men were more likely to say that branded ingredients work better

• 61% are willing to pay higher prices for branded ingredients. Adults aged under 55 years are willing to pay more for branded ingredients

^{Source: CRN / Ipsos}

Nicholas Hall Writes: It seems we are awash with consumer research that confirms the importance of self-care, especially with regards to immunity, even though demand is returning to pre-pandemic levels. In many respects, consumers seem ahead of marketers (let alone regulators) in how they respond to the mega-trends of the day: the pandemics, economic pressures and the energy crisis.

As I wrote last week: “I see a paradox in matching this consumer U&A data with the relative failure of specific immunity products such as antiviral nasal sprays … So why is it that consumers who fear Covid-19, and who subscribe to the concept of immunity, are content to rely on, say, a multivitamin the category grew by 13.5% globally in Year 1 of the pandemic — and not divert to specialist products? I am still searching for an answer.” Another paradox is that, while the top CHC players are reporting excellent sales and the global sales data for the 12 months to June 2022 which we reported in late September is at a record high, retailers and e-Commerce platforms are reporting reduced traffic. And there are signs that many consumers are trading down to smaller packs or cheaper generics and private labels, which you would expect in a recession.

One of the joys of working in consumer health is its resilience. It truly is a “must have” category, but it is in the detail where we will make or lose our reputations. It seems that we must switch focus from macro-trends to the micro and to understand better what makes everything tick rather than the size of the clock. So, expect more springs, wheels and cogs to be presented in the autumn and winter months ahead.

Immune health is the focus of our recent Immunity hot topic report. With profiles of key brands across categories including antivirals, vitamins, foods & beverages and probiotics for immunity, our report explores the latest trends & developments, predicting likely future scenarios. To order your copy, or for further details, contact melissa.lee@NicholasHall.com.

Covid’s lasting impact on immune health perception

A report from Dutch-based health ingredients company Nutrileads highlights the fundamental change in consumer views on immune health in the wake of Covid-19. The report draws on data gathered by FMCG Gurus from surveys conducted with 45,000 consumers in 15 countries from 2019-22. Not only is immune health significantly more important to consumers, it is also perceived to have a far-reaching impact on long-term health and wellbeing.

For two-thirds of participants, immune health is their top health priority over the next 12 months – more than any other issue including digestive and heart health. In addition, 78% view poor immune health as being easily susceptible to long-term health problems, while 40% are taking a proactive approach to their immunity, even if they believe they are in good health. Consumers also expect more from immune health products; the top three claims they want to see on the product label are scientifically validated and clinically-proven (82%), multifunctional benefits (79%) and helps lead a healthy lifestyle (79%).

Comment from Nutrileads CEO, Joana Carneiro: This research shows us that the experience of living with the pandemic is likely to have a lasting effect. Consumers are more knowledgeable about immune health and place more importance on improving it on the longer term.

Nicholas Hall Writes: “The latest research gives us a better understanding of consumer perception of immunity after 2.5 years of Covid, and the sustained interest in using dietary supplements. But I still see a paradox in matching this consumer U&A data with the relative failure of specific immunity products such as antiviral nasal sprays … So why is it that consumers who fear Covid-19, and who subscribe to the concept of immunity, are content to rely on, say, a multivitamin – the category grew by 13.5% globally in Year 1 of the pandemic – and not divert to specialist products? I am still searching for an answer.”

In just over a month, you can log on to hear from Nicholas and industry experts during our Asia-Pacific e-Conference on 23 November! Topics on the agenda include the go-to-market model, self-care collaborations and sustainability through accessibility. For more information, or to register, please contact elizabeth.bernos@NicholasHall.com.

CHC GROWTH REMAINS STRONG, +8.2% IN MAT Q2 2022

The mid-year update from DB6 shows the global retail market advanced by 8.2% in the 12 months to end-June 2022. In terms of geographies, Europe (+11.6%) held its position as fastest-growing region globally with many key markets maintaining double-digit growth, driven by sustained significant increases in the cough, cold & allergy category (+32.6%), as well as a continued gains in analgesics (+11.1%). Largest market Germany improved moderately over MAT Q1 2022 (+10.8%), with remaining Big 5 Western European markets similarly displaying robust advances, notably Spain (+16.7%). Russia’s growth remains strong in this reporting period, driven by price rises — its conflict with Ukraine beginning formally at end-February 2022

Americas (+10.2%) was the second-fastest growing region globally; the US market slowed slightly from unprecedented MAT Q1 2022 growth to 9.2% — still growing well ahead of the global rate and advancing by over $3.3bn vs year-ago, driven by a 37%+ improvement in CCA, and notable growth in analgesics (+8.8%). In Latin America, leading market Brazil surged (+17.4%) with strong increases observed across most major categories; cough, cold & allergy (+49.9%) analgesics (+16.4%) and dermatologicals (+11.7%) being the most noteworthy.

Asia-Pacific (+4.3%) maintained its comparatively muted growth, with largest market China (+3.3%) slowing in view of continuing lockdown restrictions, as well as pharmacy sales restrictions on particular products, primarily impacting cough & cold categories and systemic analgesics. A continued positive increase for No.2 ranked Japan (+1.4%), aided by a dynamic systemic analgesic performance (+19.3%), has helped to offset the slight slowing in China; combined, these markets have a share of almost 70% of total regional sales.

Nicholas Hall Writes: As I hinted last week, MAT Q2 results for the global CHC industry went far beyond expectations. The industry held up well during the two years of the pandemic, with all-channel growth of 6.1% and 6.5% in 2020 and 2021. The assumption was that growth would start to slow and align more closely with the 5-year CAGR of 5.4%. But Q1 confounded that forecast and, looking just at the store retail sector, our combined efforts were rewarded with 9.0% growth at constant currencies. Surely that couldn’t last! Who says? As the latest results attest, growth is still buoyant at 8.2% and presumably will be a lot higher when e-Commerce is added. If only we had the data, but nobody does, although we are working very hard to bridge that gap!!

Another shock to the system is how well Europe performed, with the leading countries delivering double-digit growth, or very close to it in the case of France. Of course, it helps that cough, cold & allergy surged in the first half of 2022, but that alone does not explain the spectacular rate of growth overall, which has for example put Germany 0.6% ahead of where it was in 2019! 

Log on to hear from Nicholas and experts from Bayer, Havas Health and more at our Asia-Pacific e-Conference on 23 November! You can expect insights into sustainability, the Go-To-Market model and self-care collaborations. This online event will also include the presentation of our Regional CHC Creative Marketing Award. For more information, or to register, please contact elizabeth.bernos@NicholasHall.com.

Hologic Survey: Women’s Health Worsened in 2021

The 2021 Hologic Global Women’s Health Index, a survey of almost 127,000 women and men in 122 countries, shows that health situations for women did not improve in the second year of the pandemic and many worsened. Hologic launched the survey in 2020 in partnership with Gallup to assess how female health & wellbeing needs were being met.

Preventive care, which is still inaccessible to many women, remains the weakest of all health dimensions: some 60% of women in 2021 (equating to a population greater than 1.5bn) reported that they were not tested for four of the most frequent, fast-growing, and / or deadly conditions globally: just 12% of women were tested for any type of cancer, 34% for high blood pressure, 19% for diabetes and 11% for STDs / STIs. Emotional health is also a key dimension, with a growing body of evidence that it can affect cardiovascular health and other physical health risk factors.

^{Source: Hologic Global Women’s Health Index report}

Nicholas Hall Writes: It’s a sad fact that women were more stressed, worried, angry and sad in 2021 than at any other point in the past decade, according to this insightful survey, with 43% of the sample claiming to have experienced worry and 41% stress during much of the day before the survey was conducted.

The Hologic Chairman, Stephen MacMillan, commented: “No matter what pandemics, wars or other crises roil our societies, we must commit ourselves to improving the health of women, because they form the backbone of our families, communities and societies.” That is so true! Yet looking through the narrower lens of consumer health, we offer very few specialist products for women beyond feminine intimate health.

Log on to hear from Nicholas and experts from Bayer, Havas Health and more at our Asia-Pacific e-Conference on 23 November! You can expect insights into sustainability, the Go-To-Market model and self-care collaborations. This online event will also include the presentation of our Regional CHC Creative Marketing Award. For more information, or to register, please contact elizabeth.bernos@NicholasHall.com.

OTC hormone replacement therapy now available in UK

Following a landmark reclassification by the UK’s Medicines & Healthcare products Regulatory Agency in July 2022, postmenopausal women in the UK can for the first time access a low-dose, locally applied hormone replacement therapy without a prescription. Effective 8th September 2022, leading health & beauty retailer Boots (Walgreens Boots Alliance) is offering Gina vaginal tablets (Novo Nordisk, estradiol 10mcg) OTC to women aged 50+ years who have not had a period for at least one year.

The tablets, which cost £29.99 (US$34.60) for a pack of 24 plus applicators, treat vaginal atrophy, which is experienced by around half of postmenopausal women. Symptoms include dryness, soreness, itching, burning and uncomfortable intercourse caused by oestrogen deficiency. Boots Pharmacy Director Anne Higgins described the move as “another important milestone in women’s health”.

^{Novo Nordisk’s new OTC brand Gina}

Comment from Proprietary Association of Great Britain CEO, Michelle Riddalls: This is a huge step forward helping women to take control over their health by enabling and supporting self-care. The pandemic forced us all to rethink the way that healthcare is delivered and brought to light the central role that self-care can play in managing health issues. Our research has shown that this is what consumers want. It has also brought huge benefits to patients, healthcare providers and to taxpayers via more efficient and effective use of NHS resources.

Nicholas Hall Writes: This week I am writing very little as a mark of respect for our beloved Queen Elizabeth. I know – the show must go on! But what a show that was, running for 70 years through good times and bad, almost never putting a foot wrong despite a vastly changing world, not to mention wayward family members. I am spellbound by what the Queen stood for and achieved. But we will have dried our tears by this time next week, when it will be business as usual, even though the memories will never fade!

In just over a month’s time, you can sharpen your skills and increase your understanding of Self-Care at the CHC Training Academy workshop in Bucharest. Taking place on 26 October, the workshop will be followed by a free 1-day conference, hosted by RASCI, focusing on Health Literacy, opening with a keynote speech from Nicholas Hall. To register, or for more information on group booking rates, please contact elizabeth.bernos@NicholasHall.com without delay.

CDC Report Shows Further Falls In US Life Expectancy

Life expectancy in USA has fallen for the second consecutive year, according to provisional data published by the US Centers for Disease Control & Prevention. For 2021, US life expectancy at birth was 76.1 years, the lowest since 1996 and down from 77.0 years in 2020. Male (73.2 years) and female (79.1) life expectancy also declined to levels not seen since 1996.

The almost one-year decline between 2020-21 was primarily owing to increases in mortality because of Covid-19 (50% of the negative contribution), unintentional injuries, heart disease, chronic liver disease & cirrhosis and suicide. This would have been greater were it not for the offsetting effects of decreases in mortality owing to influenza & pneumonia, chronic lower respiratory diseases, Alzheimer’s & Parkinson’s disease and perinatal conditions.

Source: https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf

Nicholas Hall Writes: Does falling life expectancy matter? Yes, it matters a lot, to individuals and their friends and families; and to society, especially as some of the early deaths are among members of the economically-active population who financially support both the younger and older age groups. It also matters to our industry in that it continues to change the demographics, which may present new marketing opportunities.

As is his wont, tech billionaire Elon Musk has repeated his warning of a global underpopulation crisis, most recently tweeting that “population collapse due to low birth rates is a much bigger risk to civilisation than global warming”. Experts disagree. Demographer Joseph Chamie hit back: “He’s better off making cars … than at predicting the trajectory of the population. Yes, [in] some countries, their population is declining, but for the world, that’s just not the case.” This is backed by the UN’s World Population Prospects 2022 report, as we reported back when it was first published in July, which predicts that on 15th November 2022 the global population will reach 8bn and that it could grow to around 8.5bn in 2030 and 9.7bn in 2050, before peaking at around 10.4bn people during the 2080s.

Benchmark leading brands and track competitor activity across major and local players with CHC New Products Tracker. Featuring 36,000+ entries, this ultimate competitive intelligence tool allows you to create your own customised searches. Please contact david.redford@NicholasHall.com to set up a demo.