RETAIL CHC GROWTH HITS 7.2% IN 2022

The year-end 2022 update from DB6 shows the global retail market advanced by 7.2% in the 12 months to end-December 2022. Globally, this represents yet another strong single-digit result, slightly ahead of the MAT Q3 2022 results (+7.0%). In another somewhat turbulent year, impacted by a surging cough & cold market, post-Covid recovery, global economic crises and continuing conflict in Europe, we look below in more detail at how the market has performed.

• Cough, Cold & Allergy continues to be the key driver behind global growth; the second largest category returned sustained double-digit growth, advancing 18.2% in the current reporting period. Excluding allergy remedies, once again all subcategories observed double-digit increases, with standout performances in cough remedies (+26.3%) and systemic cold & flu and systemic decongestants, both growing at 21.6%.

• Analgesics (+7.6%) was the second-fastest growing major category to year-end 2022, driven by a double-digit increase in systemics (+10.3%), which continues to benefit not only from recommendations for OTC products to treat fever and pain following Covid vaccinations, but the uptick in cold & flu incidence. Topical formats continued on a slowing trajectory (+1.9%), with 4 out of 5 leading markets in decline.

• Gastrointestinals (+5.8%) was the third-fastest growing category, slowing marginally from MAT Q3 2022. Sustained robust performances from typically travel-associated subcategories including antinauseants (+13.4%) and antidiarrhoeals (+10.4%) spearhead the increase, while largest subcategories antacids and laxatives grew more modestly, progressing by 4.0% and 5.1% respectively.

• Lifestyle CHC slowed vs MAT Q3 2022 (+3.7%). The second-largest subcategory, sedatives & sleep aids (+3.1%), generated somewhat muted growth following significant gains throughout the pandemic, offset to some extent by steady growth in the largest subcategory, eye care (+6.5%), owing to growing awareness of device and screen-related dry eye, successful switches and NPD. Ear care was the fastest-growing subcategory and the only one to advance by double-digits (+11.8%), although its modest 2.1% share of the category means that this has minimal impact on the topline.

• Vitamins, Minerals & Supplements (+3.7%) continued to soften to end-2022, with several key subcategories slowing vs the previous reporting period. Immunity-related subcategories maintain positive growth but are abating: immune supplements (+6.3%) and vitamin C (+3.1%) are the best performing of these, while zinc flattens to 0.3%, albeit with a significantly higher value than pre-pandemic times. Elsewhere, ebbing growth in the largest subcategory, multivitamins (+2.5%), has muted overall category returns. Multi-functional ingredient magnesium was the strongest-performing subcategory to year-end 2022, advancing by 10.5%.

• Dermatologicals (+3.2%) remains the weakest major category globally but continued its path of improvement in 2022. Antiseptics & disinfectants remains negative in growth terms (-7.6%) but the decline is weakening as post-Covid correction continues and absolute sales are significantly higher than pre-pandemic levels. Excluding this subcategory, dermatologicals increased by 4.8%, with notable performances in lip care (+10.5%) and lice treatments (+10.2%), both recovering from negative Covid impact.

(Store Retail) Country	YEAR END 2022 sales (US$bn)	2022/21 (%)
USA	40.7	+4.9
China	30.2	+4.6
Japan	6.5	+5.0
Russia	6.1	+7.2
Germany	5.6	+11.7
France	4.7	+9.1
Brazil	4.6	+21.5
Italy	4.5	+10.8
India	4.2	+7.3
UK	2.9	+8.7
GLOBAL CHC	157.7	+7.2

^{Source: Nicholas Hall’s global CHC database DB6}

In terms of geographies:

• Europe (+9.5%) was the second-fastest growing major region globally (just behind Rest of World, which rose 9.8% driven by inflationary growth in Turkey), with several key markets maintaining double-digit growth, driven by sustained significant increases in the cough, cold & allergy category (+24.2%), as well as continued robust growth in analgesics (+9.6%). Second-largest market Germany accelerated by 11.7%, with other Big 5 Western European markets similarly displaying solid advances, notably Spain (+13.4%). Romania was the strongest-performing market (+18.0%) in the reporting period and now enters the Top 20 countries globally (18th) for the first time. Owing to exchange rate impact, Russia is now Europe’s largest market — in value terms, the market grew in line with the global rate (+7.2%), although declined by 5.4% in volume terms.

• Americas (+7.0%) saw growth in leading market USA remain below the global rate (+4.9%), but in sales terms the market has now crossed the $40bn mark, ending 2022 with an almost 26% share of global sales ($40.7bn). Sustained robust growth in cough, cold & allergy (+23.2%) helped to offset more subdued returns in other categories, notably a decline in vitamins, minerals & supplements (-1.1%). In Latin America, leading market Brazil continued to improve, ending 2022 with 21.5% growth and sustained increases observed across most major categories: cough, cold & allergy (+51.0%), dermatologicals (24.9%) and analgesics (+18.5%) being the most noteworthy.

• Asia (+5.2%) brightened to year-end 2022. Largest market China (+4.6%) improved over the previous reporting period aided by the relaxation of the country’s lockdown restrictions in early December, and No.2 ranked Japan surged — by its standards — to 5.0% growth, driven by a dynamic performance in cough, cold & allergy (+17.1%). Combined, these markets have a share of almost 70% of total regional sales.

The broader CHC market, encompassing all channels + CBD, grew by 8.2% globally, driven by the continued expansion of e-Commerce. The pandemic accelerated growth in this channel, and while the market is slowing from the 2020 peak, the internet & mail order channel advanced by healthy double-digits (+19.4%) in 2022. The channel now accounts for 16.9% of the broader CHC market (up from 15.3% in 2021).

Nicholas Hall Writes: Consumer health in the store retail sector grew by 7.2% in calendar year 2022, and by 8.2% in all channels. That is an amazing achievement during the third and hopefully final year of the pandemic. We’re still working on our short and long-term forecasts, but we expect that over the next five years CHC in all channels will grow by 6-7%. That is still ahead of the growth rate before the pandemic and a nifty achievement bearing in mind the mega-threats referred to in this column in previous weeks.

One of our internal debates is whether the revival in the consumer health care market was more than a rectification of the hit that Cough, Cold & Allergy took during the pandemic. I was always optimistic and didn’t believe that we were merely putting back lost sales as consumers changed their lifestyle and self-care habits. This is confirmed by the fact that the CCA category is now well above pre-pandemic levels at almost US$33bn vs US$27.9bn in 2019 (store retail only). That gives great confidence, although the question remains whether CCA sales growth is sustainable.

We are pleased to announce that the DB6 year-end 2022 update is now available! Nicholas Hall’s global database DB6 offers over 150,000 pieces of data, with more than 30,000 records covering 13,000+ brands and 3,000 companies across 63 countries. Available as a full subscription or for ad hoc purchases, to find out more, or set up a free demo, please contact kate.fielding-smith@NicholasHall.com.

UK TO FAST TRACK INNOVATIVE MEDICAL PRODUCTS

UK: The Government has awarded an extra £10mn (US$12mn) to the Medicines & Healthcare products Regulatory Agency to help bring innovative new medicines and medical technologies to patients quickly. In the Spring Budget 2023, Chancellor of the Exchequer Jeremy Hunt said: “From 2024 [the MHRA] will move to a different model, which will allow rapid, often near automatic sign-off for medicines and technologies already approved by trusted regulators in other parts of the world such as USA, Europe or Japan. From next year, a swift new approval process will be set up for the most cutting-edge medicines and devices to ensure the UK becomes a global centre for their development. And with an extra £10mn of funding over the next two years, [the MHRA] will put in place the quickest, simplest, regulatory approval in the world for companies seeking rapid market access. We are proud of our life sciences sector, which received more inward investment than any in Europe last year.”

Nicholas Hall Writes: The UK is without doubt the most liberal regulatory environment in the world – although sometimes it doesn’t feel like it on the ground. The UK is predominant in Rx-to-OTC switch: HRT and the daily oral contraceptive have been switched as global or regional firsts. Last week, we announced that Cialis had been approved in the UK as a global pioneer (although the ingredient tadalafil is already available OTC in Poland), and the UK is home to the topical ED treatment, MED3000, which has the potential to challenge sildenafil and tadalafil as it claims comparable efficacy without side-effects. There are blind spots, of course, including melatonin and CBD, but the good news continues to roll.

^{Futura Medical’s MED3000 (brand name Eroxon) will roll out across Europe in the coming months}

The switch of Gina, the first HRT treatment, is especially important, although Novo Nordisk seems an unlikely OTC pioneer. Perhaps that is why the company has run into difficulties in the weight loss sector. In recent editions of Newsflash, we’ve commented on the growing incidence of obesity and excess weight, now of almost stratospheric proportions; but new treatments have failed to take off. That is why the launch of Novo’s Wegovy is so important, and at some stage could be a switch candidate. Let’s hope that the suspension of Novo Nordisk by the Association of the British Pharmaceutical Industry is just a slap on the wrist and doesn’t dent the reputation of this interesting new product or lessen Novo Nordisk’s enthusiasm to invest in the UK.

And the latest news from the British government is that it is looking for an even faster route to market for innovative new products, piggybacking on approvals given by trusted regulatory authorities in other jurisdictions. This is a sure sign that the UK government continues to be amongst the most progressive in healthcare and has been since 1985.

ED treatments is one of the categories explored in our recent Sexual Health & Fertility report. Other categories reviewed include daily OCs, male & feminine intimate care and menstrual products. To order your copy, or for more information, contact melissa.lee@NicholasHall.com.

CIALIS TOGETHER GRANTED OTC REGISTRATION IN UK

According to the UK’s Medicines Health products Regulatory Agency’s latest list of authorisations, published at end-February 2023, Cialis Together (tadalafil 10mg, Opella Healthcare / Sanofi) has been granted P (Pharmacy medicine OTC) registration. This is the second such OTC approval globally, following the world first Rx-to-OTC switch of Adamed’s Tadalafil MaxOn ED treatment (tadalafil 10mg; film-coated tablets; 2- and 4-count SKUs) by Poland’s Office for Registration of Medicinal Products, Medical Devices & Biocidal Products (URPL) in February 2022; it is now available OTC (launched in October 2022) alongside a rival version from Polpharma’s Maxigra, which launched first in June 2022.

OTC activity in the erectile dysfunction category is intensifying globally. Futura Medical, which is aiming for its topical gel formulation MED3000 – branded as Eroxon – to become the first major ED treatment available OTC in USA, said in late 2022 that the FDA had confirmed the dossier was under formal review and “indicated that [it] had successfully passed the initial technical screening”. Granting of US marketing authorisation was said to be on track to be achieved by end-Q1 2023.

^{Polpharma’s Tadalafil Maxigra 36h is claimed to get to work in 16 minutes and last for 36 hours}

Nicholas Hall Writes: I’m interested in our lead story as we’re all keen to know what will happen when Viatris’ Viagra meets stiff competition in its UK lead switch market, where Viagra was first to launch and has attracted no branded competitors, so that it virtually dominates the market. Poland was a different matter as Viagra came relatively late into the marketplace, by which time there were a number of sildenafil brands, sold at lower prices with mass advertising, followed by the first switch anywhere in the world of tadalafil. Not surprisingly, Viagra has had only modest results in Poland.

Now we face the prospect of OTC Viagra meeting strong branded competition in its lead market, with a formulation that might not be as well known, but in medical terms is generally recognised as superior. Will Sanofi launch Cialis Together with saturation advertising, or with a more muted campaign that seeks a secondary position in the market? This is an interesting proposition in its own right, but especially as Viagra in Europe may well change ownership in the next year.

There is still time to save up to GB£1,350 when you pre-order the 2023 edition of our Innovation in CHC report, publishing soon! Drawn from CHC New Products Tracker, this report explores innovation by marketer, region and country. It 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, contact melissa.lee@NicholasHall.com.

Alli granted final marketing approval in Japan

Following the recommendation of orlistat for direct-to-OTC approval in Japan, anti-obesity drug Alli has been granted final marketing approval by the Ministry of Health, Labour & Welfare. Taisho, which gained the rights to develop and market orlistat in Japan from GSK in 2009, is yet to announce the product’s release date.

Victoria Blake, head of Competitive Intelligence & Market Analysis (CIMA), writes: The World Health Organisation reports that worldwide obesity has almost tripled since 1975 – in 2016, almost 2bn adults were overweight. However, a report in 2020 found that across 7 major markets (France, Germany, Italy, Spain, UK, Japan and USA), Japan had the lowest total prevalence of obesity at 4%. While orlistat is a welcome innovation to the self-care market as a scientifically-proven solution to weight loss, it is notable that the target audience appears to be significantly smaller than in some Western markets (prevalence was reported at 40% for the USA). Nevertheless, serious government concerns regarding the economic healthcare impact of obesity in Japan’s older population led to the Metabo Law in 2008, which attempts to address obesity concerns through regular monitoring of waist size in those aged 40-74 years. Alli was switched in the USA in 2007 and in the EU in 2009 (the first drug to go through the EU Centralised procedure). Lack of repeat purchases was a key factor behind limited growth for the brand, consumers prone to expecting “miracle cures” and rapid results when it comes to weight loss vs faith in longer-term, proven regimen. We watch with interest to see how Taisho’s strategy unfolds for orlistat in this new market.

Nicholas Hall Writes: I wanted to lead with this story this week, not because Alli is a wonder brand – sadly, it failed in the consumer market – but because of the huge unmet demand for effective weight loss products, which is rightly pointed out by my colleague Victoria Blake. In fact, there is no other sector in consumer health where demand is so high and delivery so poor. In all other sectors we have great products and the job is communicating their benefits to consumers. This is the exact reverse, where demand is almost unlimited among an increasingly overweight population, but where we just don’t have safe and effective products in consumer health or indeed in the prescription market. So no one who reads this column will be surprised that weight loss and obesity is to be a major topic covered in my signature report, New Paradigms 2023 – the Future Resumed. 

One of the problems that Alli faced was honesty. The brand was marketed in terms of delivering major benefits, but those benefits could only be achieved if consumers modified their lifestyle as well. This they were largely unwilling to do, and there is a great deal of anecdotal evidence that consumers taking a weight loss product feel empowered to consume more of their favourite foods and drinks, even though contrary to the necessary changes that enable it to be effective. And, of course, weight loss brands stress simplicity, not the complex set of lifestyle changes necessary to deliver benefits.

We are delighted to announce that Nicholas will explore “The Future Resumed” in the upcoming 2023 edition of his signature New Paradigms report! Offering insights into unmet consumer needs, demographic drivers, emerging markets and more, this report will provide an essential strategic review of key factors impacting the CHC industry. To pre-order your copy at a discounted rate, or for more information, please contact melissa.lee@NicholasHall.com.

Mental health drive needed in France

Consumer attitudes related to mental health and emotional wellbeing are expected to continue to drive the need for innovation to improve mood and reduce stress, according to ingredients and supplement manufacturer Nexira Health. An Innova Market Insights report cited by the company reveals that 53% of global consumers have taken action to improve their physical wellbeing, while 44% have acted to improve their mental and emotional wellbeing.

Nexira also noted that supplement launches over the past five years have increased by 26%; after immune health, the second most launched claim is brain-mood health (+25%). To emphasise wellbeing and mood health in 2023, Nexira is highlighting Serenzo, a supplement ingredient based on sweet orange essential oil formulated with acacia gum designed specifically for mental and emotional wellbeing. In a 12-week consumer study, Serenzo supplementation reduced subjective feelings of stress by 50%, significantly improved mental load and appeared to boost mood and emotional wellbeing. 

^{Nexira’s new targeted branding for its VMS range}

Nicholas Hall Writes: Isn’t it strange how the pandemic has changed public perception of consumer healthcare? Perhaps it was to be expected that consumers would move away from the previously unstoppable prevention trend and spend more of their disposable income on treatments with tangible benefits. But who could have predicted that in the search for immunity, consumers would be more attracted to general products like vitamin C and multivitamins than more specific brands. The relative failure of antiviral products like ColdZyme is a real mystery to me. If these brands cannot succeed during the worst pandemic the world has experienced in the hundred years since the Spanish flu, when can they? On the other hand, consumers have reached out directly to OTCs and supplements that improve the quality of sleep and reduce stress. This will put a massive premium on the price that potential acquirers will have to pay for mega-successful brands like Prevagen and Natrol.

With these growing lifestyle niches, the market seems even more wide open to new entrants. Nestlé Health Science and Unilever have made big inroads into the VMS sector, with particular success in e-Commerce, which accounts for 40-50% of their health & wellbeing businesses. It seems that Big Tobacco is also circling and may look to dig deeper in attractive adjacent categories such as CBD; and I am fascinated by the news story that the packaged fruits marketer, Dole, is keen to reposition itself after 170 years as primarily a purpose-led health & wellness company.

H&B REPORT: WOMEN’S HEALTH A TOP WELLNESS TREND IN 2023

According to Holland & Barrett’s (LetterOne) Wellness Trends Report 2023, areas of particular interest to consumers this year will include:

• Women’s wellness – a big business in 2022 – will ramp up even further, with personalised solutions and FemTech founders continuing to help lead the revolution on breaking down taboos around menopause, menstrual health, fertility and more

• Wellness tech gets personal. From patches tracking dietary biomarkers to carbon levels in the breath determining metabolic function, the future is all about using health data for optimum health. Health tech innovation is also becoming more focused on key target groups, such as those suffering from, or at risk of, chronic conditions

• Sleep As well as vitamin D and magnesium, newly-trending ingredients include glycine, spearmint and plant polyphenols, EGCG and l-theanine. Meanwhile, consumers are keeping orthosomnia — the worry about getting enough sleep — at bay with remedies containing lavender, chamomile and CBD. There will also be an increase in smart tech to synchronise circadian routines

• Ayurveda Ayurvedic remedies such as ashwagandha and curcumin, combined with scientific scrutiny, are experiencing a rise in popularity 

• Beauty from within Collagen’s status as a skin-smoothing beauty superhero is here to stay, but people are also starting to understand the broader benefits, and younger customers are using type 2 collagen supplements to keep their joints in optimal health

^{To read the full report, click here.} 

Nicholas Hall Writes: Last Wednesday we held the NHC Start of the Year Meeting at our Southend-on-Sea HQ. What a pleasure after three years to have 35 team members in the room and most of the rest of our global team dialing-in. One of our main objectives was to brainstorm a new Strategic Narrative for the CHC industry, which will drive our Global Trends roadshow after the new DB6 data is published in early April. And, of course, the Strategic Narrative will be at the heart of New Paradigms for CHC 2023, which we have just scoped and which will be published in July. As usual I will write almost every word of this completely revised 4th edition, supported by what I truly believe to be the biggest and best market analysis and creative solutions team in the CHC industry – 54 out of our total headcount of 65 plus numerous network partners, associates and freelancers.

And many of the overarching issues to be discussed in New Paradigms are illustrated in the latest edition of CHC.Newsflash: women’s health, MedTech and FemTech, lifestyle products, natural remedies, sustainability and China (reviewed at a time when Dr Nouriel Roubini warns us in his latest book, Megathreats, of the dangers of deglobalisation). And even before we publish the new report, I hope to meet as many of you as possible at our April conference in London, when we will give you a sneak peek of the new Strategic Narrative.

I will be joined on stage in London by speakers from PAGB, Haleon and Perrigo, plus other industry experts, for our 33rd European CHC Conference 19-21 April. Exploring The Future Resumed, you can review the full agenda or explore group booking options by contacting elizabeth.bernos@NicholasHall.com.

Stark 2023 growth warning from IMF head

The Managing Director of the International Monetary Fund has cautioned that 2023 is going to be a “tough year”, with one-third of the world economy expected to be in recession. The three big economies, USA, EU and China, are slowing simultaneously, translating to negative trends globally. Kristalina Georgieva added in an interview with the CBS News programme Face the Nation that, while USA is most resilient and may avoid recession, the strong labour market is a “mixed blessing” as interest rates could remain tight to lower inflation.

Meanwhile, half of the EU – severely hit by the war in Ukraine – will be in recession this year and China, which in 2022 slowed dramatically because of its zero Covid policy, will slow down further (+4.4% growth in 2023 projected) as the relaxation of restrictions leads to soaring coronavirus cases. Overall, IMF forecasts that Advanced Economies will grow by 1.1% in 2023, while Emerging Market and Developing Economies will rise by 3.7%, led by India (+6.1%) but dragged down by Russia (-2.3%).

When asked what leaves her hopeful, Georgieva said: “I know when we work together, we can overcome the most dramatic challenges. In 2020, the world came together in the face of tremendous threat and was able to overcome this threat. In 2023, we have to do the same.” 

Nicholas Hall Writes: For most of 2022 I wrote in CHC.Newsflash about a market performing surprisingly well, but there was an implicit warning that the party would come to an end one day. Kristalina Georgieva, head of the IMF, has issued a stark warning of tough times ahead economically, but that is light reading compared with Nouriel Roubini’s new book, “Megathreats”, which highlights the 10 trends that imperil our future. Known by some as Dr Doom, Roubini prefers to be known as Dr Realistic, but in my estimation he is Dr Right as he called out many past mistakes with great foresight, including the debt binge that has made the global economy today almost unmanageable.

So how will these megathreats affect Consumer Health? In one sense, we are privileged as healthcare is a must-have category, and self-care will fill part of the vacuum left by the inability of healthcare providers to meet the needs of a growing and demographically-unbalanced population, about which Dr Roubini also writes persuasively. But consumers can only spend the money in their pockets, regardless of whether it is earned or borrowed, which is why I am so concerned about the future of CHC brands and why generics and private labels are now seen as the new growth segment.

I’m also concerned about the viability of retailers and even e-Commerce platforms, as the economic crisis will lower customer footfall and push up costs including the cost of borrowing, forcing thousands of outlets to close. We are already seeing that as a sub-plot of today’s global medicine shortages. Partly this is a story of unpredictable demand caused by the afterwave of the Covid-19 pandemic, but it also seems to me that the supply chain has become very fragile as companies look for ways to cut costs by reducing inventory to breaking point. So our 2023 mission here at the Nicholas Hall Group is to reassess the Strategic Narrative for Consumer Health and offer advice to clients and the industry at large on how to survive mega- and microthreats.

We are pleased to announce that experts from Haleon, Perrigo and PAGB, plus our sponsors Pharmalinea will take the stage alongside Nicholas at our 33rd European CHC Conference! See the all-new agenda here. Taking place in London on 19-21 April 2023, save with the early bird booking discount when you book your place before 19 January! For more information, or for group booking discounts and sponsorship opportunities, 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.

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.

e-Commerce Update: Zur Rose, Amazon

Swiss-based Zur Rose, which posted a 0.4% rise in external revenues to CHF963.9mn (US$1bn) in local currency terms in H1 2022, declined to comment on reports that it was exploring strategic options, including a possible sale. According to Bloomberg, Europe’s leading online pharmacy is working with advisors to look at alternatives and has held talks with potential suitors including US-based private equity groups KKR and Hellman & Friedman. Zur Rose, which gets most of its revenue from Germany and Switzerland, was founded in 1993 by a group of doctors and went public in 2017. It runs online pharmacies, has a medical wholesale business in Switzerland and also operates a marketplace in southern Europe for consumer health and beauty products.

In other news, Amazon will reportedly cease offering its on-demand 24 / 7 healthcare service Amazon Care at end-2022. According to a memo sent to employees by Amazon Health Services Senior V-P Neil Lindsay, it was not the right “long-term solution” or a “complete enough offering for the large enterprise customers we have been targeting”.

Nicholas Hall Writes: e-Commerce has grown significantly in recent years, especially during the pandemic, but clearly it is not a licence to print money as many had thought. The fact that Europe’s No.1 e-pharmacy has consistently lost money is a sobering fact. Zur Rose, which owns DocMorris, could pursue other options to improve its balance sheet, and a deal isn’t expected in the near future given current valuation levels; but the company is unprofitable and the glory days of the pandemic, when its capitalisation soared, are behind us. Nevertheless, the company has more than 11mn active customers across its core European markets, and some analysts bet that Zur Rose will get a boost from the accelerated roll-out of electronic prescriptions in Germany. 

And when we look more broadly at the concept of digital health, even the behemoth Amazon doesn’t always get it right. Analysts are saying that the end of Amazon Care is just a stumble on the company’s path to taking a comprehensive position in the US$4tn US healthcare sector, and eventually the world market. But it looks as though the playbook will need to be rewritten if Amazon and its Chinese and European competitors are to meet their ambitious goals. Maybe one of these companies will buy Zur Rose!

Trevor Gore, Founder of Maestro Consulting, will discuss Opportunities with Collaboration in the Self-Care space during our Asia-Pacific e-Conference on 23 November. This will also include the presentation of our Regional CHC Creative Marketing Award. For more information, or to register, please contact elizabeth.bernos@NicholasHall.com.