Military Potential of Omega-3

A new study will determine if omega-3 supplementation can improve cognitive processes in high-performing soldiers.

Military interest in omega-3 is not new; a 2014 edition of Military Medicine focused on the fatty acids as “nutritional armour”. The interest surrounding military use of omega-3 is mainly related to its reported indication of mood improvement, and possibly reducing suicide rates among serving and ex-military personnel. It is also believed that a faster recovery from traumatic brain injury and the improved reaction times of fighter pilots could also be other benefits found from consistent omega-3 use.

Furthering ongoing studies, a new study is set to officially determine whether omega-3 supplementation can improve cognitive processes in high-performing soldiers. The Ranger Resilience and improved performance on Phospholipid bound Omega-3s (RRIPP-3) study will be conducted by the medical University of South Carolina (MUSC), and will include second lieutenants entering the Infantry Basic Officer Leaders Course (IBOLC) and subsequent Ranger Training at Fort Benning.

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The purpose of the study is to investigate whether supplementation with krill oil concentrate can improve specific cognitive processes that underpin key elements of soldier performance, which may have a measurable impact on performance and mental health under psychophysiological stress of military officer training.

This will be an extension of a study recently published in the Journal of Affective Disorders which outlined that omega-3 could potentially help sufferers of post-traumatic stress disorder (PTSD), which is known to produce psychophysiological symptoms such as a pounding heart.

The study will overall seek to answer three questions:

  • Will treatment with krill oil concentrate containing the omega-3 HUFAs improve cognitive and psychiatric functioning during US Army Infantry Basic Office Leadership Course?
  • Will treatment with krill oil concentrate containing the omega-3 HUFAs improve the performance of officers during portions of the U.S Army Infantry Basic Office Leadership Course and Ranger Training?
  • Do the effects of the supplements continue once a person stops taking them? Are there any group differences in functioning observed two months after treatment is discontinued (i.e. after Ranger Training?)

Kraków Conference Debrief

I hope you’ve now had a chance to explore our full-year 2015 OTC Market Stats update, which includes up-to-date OTC trends and sales data at global, regional and country level (with the addition of Algeria and Morocco this year). I’ll be covering the key results as usual in the next tutorial blog, but for now, here’s your exclusive round-up from Nicholas Hall & Company’s latest event – Regards, Owen Hartnett.

Another successful conference

Nicholas Hall’s OTC INSIGHT 27th European Conference & Action Workshop was held in the beautiful Polish city of Kraków. Representatives from some of the world’s leading companies detailed their strategies to build sustainable OTC brands while delivering real benefits to the consumer, with all in agreement that the consumer must be at the heart of the brand for it to succeed (this year’s theme was indeed “Building Blocks for a Successful OTC Brand”). It was a great pleasure to meet people so passionate about our industry during the Networking Hours and coffee breaks in which I was conducting live OTC DASHBOARD demo sessions.

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An OTC DASHBOARD segment will feature in the upcoming conference video

One standout topic for me was the need for the consumer healthcare industry to engage with digital by choice, not necessity. Nick Melnyk, Managing Director of Central & Eastern Europe at Sanofi, warned that we could end up working for tech giants in future if we aren’t better equipped and more willing to turn to a digital strategy, noting that it is not the most adaptable who survive, but those who disrupt. Our ever-growing OTC DASHBOARD client base suggests a lot of you are already utilising healthcare data in this way, but we are still a long way off in terms of digital, especially in comparison to industries such as media, telecom and FMCG.

Thursday evening saw the return of the prestigious OTC Marketing Awards Ceremony, sponsored by Medical Brands. With so many talented marketers in the room, picking a winner for each award was far from easy, but the recipients below are certainly worthy winners in their respective categories.

Flonase_asset2Most Innovative Global OTC Marketing Campaign 2016

GSK’s early-2015 launch of Flonase Allergy Relief (following Rx-to-OTC switch approval) has garnered over US$300mn in sales, while remembering to put the consumer at the very heart of its brand proposition. Nick Srikanth, Chief of Staff, Europe Americas Region, graciously collected the award.

Screen Shot 2016-04-29 at 11.13.44The 2016 Colin Borg Award for the Best European OTC Advertising

Focusing on the special connection between father and son, P&G’s #HugYourDad campaign for Wick VapoRub Germany is a great example of a brand connecting emotionally with its consumers. Anna Sacha, Global Head, Consumer & Market Insights, was on hand to claim the top prize.

Screen Shot 2016-04-29 at 11.35.40Most Innovative New Product of the Year 2016

RB’s Strepsils Flurbiprofen Spray (Dobendan / Benactivdol Gola in other markets) wins this year’s Most Innovative accolade as it is the first OTC flurbiprofen product of its kind in a convenient spray format. A delighted Akhil Chandra, Global Category Director Analgesics, received the award.

Nicholas Hall concluded that people must be at the heart of innovation (basis of the newly-launched OTC Training Academy) and closed the conference by revealing the destination for next year’s event: Munich, Germany. I very much look forward to seeing some of you then, or perhaps actually much sooner, as the next stop in the OTC DASHBOARD calendar is the 52nd AESGP Annual Meeting in Athens!

OTC DASHBOARD is a subscription-only web service powered by Nicholas Hall’s DB6 Global OTC Database. To find out how we can help you to save time, work smarter and keep connected, get in touch with us today at: otcdashboard@NicholasHall.com

OTCs in Action Episode 59: Erasing painful memories in Russia

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“Our life is full of events, sometimes unintended and unpleasant. None of us are immune from falling, getting cut, being in an accident or having surgery. Fortunately, the modern level of medicine is that most of these situations are repairable. But the memory of the incident is likely to scar. Unfortunately, the scar does not always work carefully and quietly. If this happens to you, know that you are not alone. Pathological scars – a common problem. About 15% of people who have had any surgery or injury have unsightly scars. This means that over a million people are in need of treatment. Imoferaza cream will help you to adjust the appearance of the scar and make it inconspicuous.” (translated from Russian)

This week OTCs are in Action in Russia, where NPO Petrovax Pharm has launched Imoferaza to treat scarring with hyaluronidase enzyme technology. The product acts on the connective tissue that forms the basis of a scar. Applications described on the brand’s website include skin injuries, burns, tattoo removals, piercings, acne (post-acne) and make the preventive claim of “reduces the likelihood of unsightly scar”. The active ingredient is delivered in a cream formulation that soothes and softens skin while helping it retain moisture.

Although the technology is surely a benefit for Russian consumers, what caught OTCs in Action’s eye is the brand’s website graphics, which emphasise the emotional pain that can linger from scars:

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For more information on Nicholas Hall’s OTC INSIGHT regional journals, click the link below:

http://www.insight.nicholashall.com

OTCs in Action Ep 55: Overdoses spur fast-track naloxone switch

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Peter McKnight, of the School of Criminology at Simon Fraser University, wrote about the rising rates of fentanyl overdoses in the 13 August 2015 Toronto Globe & Mail, and observed:

So, 45 years after US president Richard Nixon first declared what has become a worldwide war on drugs, opiates remain as easy as ever obtain.

But what if opiates aren’t your drug of choice? What if you’re looking instead for a drug that can reverse the deadly effects of opiates? Well – and here’s more irony – that drug is a lot harder to get. It’s called naloxone, a drug that blocks the effects of opioids in the brain, thereby reversing an overdose and preventing the loss of consciousness and cessation of breathing that often follow. A non-addictive, non-intoxicating, low-risk drug, naloxone has been used in Canadian emergency rooms for more than 40 years.

The trouble, of course, is that most people don’t shoot up in hospitals. People commonly use drugs – and overdose – at home, in a washroom or in an alleyway. And if we are to reduce the risk of death or brain damage, naloxone must be available wherever and whenever an overdose occurs.”

This week OTCs are in Action in Canada, where Health Canada announced its intention to make naloxone available for emergency use for opioid overdose without a prescription so that families can have emergency treatment kits at home and readily available, according to Nicholas Hall’s OTC.NewDirections. The agency is reviewing safety and efficacy data during a consultation period ending on 19th March, after which it intends to waive the usual six-month implementation period that follows such decisions so that the change in status can occur as quickly as possible.

To review a prior OTCs in Action on naloxone availability, click here:

nicholashallcompany.wordpress.com/2015/08/03/otcs-in-action-episode-36-naloxone-to-the-rescue/

To learn more about Nicholas Hall’s OTC.NewDirections, click here:

http://www.nicholashall.com/otc-newdirections

To read Mr. McKnight’s original editorial, click here:

http://www.theglobeandmail.com/opinion/why-is-an-opiate-antidoteharder-to-obtain-than-the-drug/article25959264/

Editor’s Introduction to Cough, Cold & Allergy

Sneak peek at some highlights from Global OTC Cough, Cold & Allergy

With so much going on in the US allergy remedies category ­– from Allegra’s swift dash up the rankings to the switch of intranasal corticosteroid Nasacort, from new A+P campaigns to allergy extensions of blockbuster cough & cold brands Mucinex and Vicks – it is small wonder that it was the source of double-digit growth (+11%) in 2014. Not to mention 2015 developments like the February debut of Flonase and the planned launch of Rhinocort. Yet this was just one of a handful of strong performances around the globe in the past year, with the global CCA market responding positively to a spike in flu infections across several regions, switch activity, format innovation and other new launches.

A handful of highlights from around the globe include:

  • In Brazil the move to Rx status of vasoconstrictor-based nasal decongestants led to a significant downturn, but innovative launches subsequently revived topical decongestants sales
  • China’s cough and sore throat remedies benefited from A+P targeting smokers, both for treatment of respiratory conditions caused by smoking and for freshening breath
  • In France dereimbursement is gradually transforming CCA into a pure OTC market, with increasing numbers of semi-ethicals losing reimbursement and becoming pure OTCs – and so able to be advertised
  • CCA is Russia’s largest OTC category by a considerable margin, with over $400mn separating it from VMS (second largest category); CCA options are prominent on a proposed mass market list
  • In Turkey marketers are increasingly launching products classified as food supplements (particularly throat lozenges) and medical devices (notably saline topical decongestants) as these are less tightly controlled than registered medicines

For a comprehensive view of the Global OTC Cough, Cold & Allergy market, including in-depth coverage of the 15 leading CCA markets, check out our just-published report. For more information, download the brochure or contact Nino Hunter.

OTCs In Action Episode 9: Traditional Medicine minister appointed as MNC manufacturing multiplies

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OTCs are in Action in India. Indian prime minister and enthusiastic yoga practitioner, Narendra Modi, has appointed Shripad Yesso Naik to be the first minister of the Yoga & Traditional Medicines division of the Health Ministry. According to the Wall Street Journal India, this department has been concentrating on herbal and traditional remedies for 25 years, and will be supported with a 2015 budget of $144mn. Traditional medicines are used by 70-80% of the Indian population, and the Government’s focus on improving quality standards and expanding manufacturing will impact not only the domestic market, but exports as well.

Nicholas Hall & Company’s DB6 global database forecasts that the market for OTC medicines in India will grow by about 158% over the next 10 years to US$5.7bn, with a 10% CAGR. Currently, the OTC market remains ill-defined, with OTC basically a default status for products not classified as Rx, complicated by widespread sales of Rx drugs under the counter without a prescription. This is likely to change over the coming years, as health professionals, most recently the Indian Medical Association, support the creation of an OTC list in line with global standards.

Not surprisingly, multinational companies are garnering for position in India. In the past year, Nicholas Hall & Company’s OTC.Newsflash has reported the following:

– This month, J&J completed the acquisition of fruit-based electrolyte drink ORS-L from Jagdale Industries for US$122mn. The company also recently announced it was building a new $66mn manufacturing facility for personal hygiene and skin products in Telangana

– In September, Abbott opened a new plant in Gujarat, which will manufacture nutritional products specifically for the local market. The US-based MNC invested US$73mn in the facility, its third in India

– Earlier this year, GSK increased its stake in its pharmaceuticals subsidiary in India from 50.7% to 75% in a $1bn deal, following a voluntary Open Offer

This week OTCs in Action thanks Nicola Jay, editor of Nicholas Hall & Company’s OTC INSIGHT Asia-Pacific, for her expertise on the OTC market in India.

OTCs in Action Episode 8: Procreate & Protect

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Did you hear the story of the Egyptian bus driver who tried to avoid a random drugs test by using his wife’s urine? According to the Al-Yawm al-Sabi website, after the driver confirmed that he had submitted his own urine, officials said: “Congratulations, you’re pregnant.”

While the bus driver likely greeted this news with mixed emotions, achieving a positive pregnancy test can be a frustrating and heartbreaking journey for many people. This week, OTCs in Action are the new home tests kits that can help prospective parents to conceive. Each year 11mn couples will try to have a baby and about 7mn of those couples will have fertility issues. Yet while male infertility accounts for half of all infertility problems, mainly owing to low sperm count, only 20% of men have their sperm levels tested. The new SpermCheck home test kits, currently rolling out in the UK and US, identify whether men have normal or low sperm counts. The problem can often be reversed with lifestyle changes such as eating a healthy diet and avoiding smoking and alcohol. The availability of a simple, convenient and cost-effective home test can allow a couple to easily identify, and possibly remedy, a possible roadblock to pregnancy at an early stage.

2014 has been a watershed year in the expansion of at-home testing. The French Parliament adopted a bill allowing the mass market sale of pregnancy and ovulation tests, ending the pharmacy monopoly on those products. In Japan, The Council for Regulatory Reform has proposed the Rx-to-OTC switch of 49 types of diagnostic tests, among them colorectal cancer screening kits, which can give consumers life-saving information. The Australian Government has also taken an important step in protecting public health this year by removing a restriction preventing the manufacture and sale of HIV home self-tests.

OTC.NewDirections keeps Nicholas Hall & Company clients up to date on scientific and regulatory news. Visit www.nicholashall.com/otc-newdirections to set up your free 30-day trial.

OTCs in Action Episode 7: Distribution, Classification Matters

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As a consumer of OTCs in the US, I can buy OTCs and dietary supplements in any store, and have the freedom to self-select – I simply lift the product off the shelf, put it in my basket and pay for it. This is not the case in many countries worldwide, where distribution of OTCs is limited to pharmacies, and often requires the medicines to be given to the consumers by a pharmacist or technician.

This week, OTCs are in Action in Latin America. Nicholas Hall & Company’s bi-monthly periodical, OTC INSIGHT Latin America, has reported on two very different events that are equally important in ensuring consumer access to OTC medicines.

In Argentina, the Buenos Aires Propuesta Republicana (PRO) party has made a proposal to allow the sale of OTCs through self-selection displays in pharmacies located in the autonomous state of Buenos Aires. According to PRO party member, Helio Rebot, “the idea is to facilitate access to those medicines most often required for everyday use.”

There has been much debate in recent years as to whether BA should adhere to the national law, which requires that OTCs be stored behind the pharmacy counter, thus curbing self-selection, or whether the state should be allowed to make its own rules on this issue. While the PRO initiative acknowledges the need for a pharmacist’s presence to “address consumer concerns”, the proposal also calls for “the option of home delivery of OTCs” via a telephone order system. Nicholas Hall & Company will be following this story closely.

Elsewhere in the region, Colombian President Juan Manuel Santos has halted an initiative by regulatory body INVIMA that would have limited access to many traditional and herbal remedies by converting them to Rx status. Regulatory Director Elvira Cajigas de Acosta subsequently indicated that there will be a case-by-case revision of about 60 natural ingredients, and maintained that the reverse-switch of “two or three” may be considered.

Traditional and herbal remedies are a mainstay of self-medication worldwide, but their OTC status is in jeopardy in many countries as governments try to classify proven, legitimate remedies appropriately, while using enforcement action to tackle adulterated and falsely advertised products.

To learn more about Insight OTC INSIGHT Latin America, visit www.nicholashall.com.

OTC in Action Episode 2: Seducing voters with OTC oral contraceptives?

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OTCs are in action for political gain, with US Republican Senate candidates in four states proposing the oral contraceptives should be switched from Rx-to-OTC to expand access for consumers, whilst diverting free Rx OCs for consumers from mandated health insurance coverage, according to a Wall Street Journal article published on the 10th of September.

Under the Democrat-supported Affordable Care Act, Rx oral contraceptives are a preventive health service and, as such, are covered with no out-of-pocket cost to women. Many opponents of the ACA, including Republicans and health insurers, oppose this benefit. Of course, this opposition does not play well with some voters, including women who are eligible for the OC benefits. By calling for OCs to be switched to OTC, candidates are hoping to appease voters with more convenient access, while gratifying insurance companies by taking the Rx OCs off their benefits list.

Not so fast, though, says the American Congress of Obstetricians & Gynecologists. The candidates’ use of the respected medical group’s past endorsement of OTC OCs to justify the switch may backfire. Dr John C Jennings, President of the ACOG, rebuked the candidates, commenting: “We feel strongly … that OTC access to contraceptives should be part of a broader dialogue about improving women’s healthcare, preventing unintended pregnancies and increasing use of contraception, including long-acting reversible contraception (LARC). Over-the-counter access should not be used as a political tool by candidates or by elected officials.”

Ultimately, it’s a risk-benefit decision to be made by the FDA based on scientific and consumer studies, and there appears to be no such application on the docket. However, we at Nicholas Hall & Company believe OCs will switch eventually. Last spring, OTC INSIGHT Asia Pacific reported that the progressive Medicines Classification Committee in New Zealand, which often serves as a bellwether for Rx-to-OTC switches, said the proposed switch of several OCs to pharmacy-only classification “could work” if the applicant, Green Cross Health, included more collaboration with GPs in its proposal.

Scottish Independence: The Healthcare Aspect

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This week the people of Scotland will decide whether to end the country’s 300-year+ political union with England and the rest of the UK. As a Scot without a vote – owing to my residence in England – I’ve been watching from the sidelines while the debate has swirled around fundamental issues such as currency, the economy, EU membership and defence.

Healthcare – in particular, the NHS – has also been a key issue. This is despite the fact that, in the short-term at least, day-to-day healthcare provision will be unaffected, as the NHS and wider healthcare policy are already fully devolved to the Scottish Parliament. In addition, the Scottish Government intends to continue using the MHRA as medicines regulator, which should hopefully prevent a divergence in medicines regulation and access (imagine the absurdity of a medicine being deemed safe for OTC distribution in England but not Scotland …).

One can only guess how independence could affect health provision in Scotland in the long-term. Scotland currently enjoys higher NHS spending per head of population than England, while the Scottish Government has introduced flagship policies such as “free” prescriptions and personal care for the elderly (there’s nothing free about it of course, as patients pay for it through taxation), which it claims will be maintained if Scotland goes it alone. Opponents have questioned the affordability of such policies, casting doubt on the pro-independence camp’s estimates regarding the income it will receive through oil revenue and job creation.

What is clear, no matter which way the vote goes, is that Scotland will continue to face some strong public health challenges, with life expectancy remaining below that of the UK average for both men and women. For example, a report earlier in 2014 stated that Glasgow – Scotland’s largest city – has lower life expectancy than most of the developed world, with 25% of boys born there expected to die before the age of 65, owing mainly to poor lifestyle. Perhaps we’ll never find out how an independent Scotland would tackle these problems, but ultimately all that matters is that they are tackled.