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.

CHC regulation: News from EFSA and FDA

The European Food Safety Authority has stated that its scientists “cannot currently establish the safety of cannabidiol as a novel food owing to data gaps and uncertainties about potential hazards related to CBD intake”. Following the submission of numerous applications under novel food regulations, the European Commission asked ESFA to give its opinion on whether CBD consumption was safe for humans. EFSA’s expert Panel on Nutrition, Novel Foods & Food Allergens (NDA) believes there is insufficient data on the effect of CBD on the liver, GI tract, endocrine and nervous systems and psychological wellbeing. While studies in animals show significant adverse effects especially in relation to reproduction, it is important to determine if these effects are also seen in humans.

In other notable CHC regulatory news, the FDA has placed Sanofi’s Actual Use Trial to support the Rx-to-OTC switch of ED treatment Cialis (tadalafil) on hold, owing to concerns about the protocol design. Cialis is the only PDE-5 inhibitor that offers men a choice when it comes to treatment for ED – for use as needed and for once daily use. The AUT has not yet recruited any patients, but Sanofi noted that it “continues to work with the FDA to move the programme forward and will engage the agency in upcoming meetings as it determines the next steps”.

Source: EFSA

Nicholas Hall’s Touchpoints: Why am I not surprised at the latest EFSA ruling on CBD? Even though the Chair of the NDA Panel, Professor Dominique Turck, has let a crumb of comfort drop from his high table when he said, “It is important to stress at this point that we have not concluded that CBD is unsafe as food”, the announcement will have disappointed an industry and the many manufacturers who have sunk millions into proving the unique benefits of this new class of consumer healthcare products. This is, after all, the organisation that won’t allow probiotics to be named as probiotics on packaging, although it seems to me highly significant that the authorities in Spain and Netherlands are leading the way to override this ridiculous ruling by the Dr.No’s at EFSA. 

In much the same way, California is pioneering the move for hemp-derived CBD to be treated as supplements and eventually brought under the DSHEA umbrella. This is another crumb of much-needed comfort at a time when the FDA seems in a state of paralysis regarding the regulation of medicinal cannabis. And I’m extremely concerned with the recent news that the FDA has stopped Sanofi’s Actual Use Trial for the switch of Cialis, which my good friend Mary Alice Lawless believes could be a threat to the whole switch process in USA.

Explore the best CBD and lifestyle launches from 2021 in the Innovation Showcase featured in our recent Innovation in CHC report. Drawn from CHC New Products Tracker, you can also explore innovation by marketer, region and country. To order your copy, or for further information, please contact melissa.lee@NicholasHall.com.

Nicholas Hall’s 32nd European Conference Review

CHC Insight Europe Deputy Editor Nathalie Corbett has filed the following report of the highlights of Nicholas Hall’s 32nd European CHC Conference & CHC Training Academy Workshop, which took place from 4th to 6th May in Athens:

  • Although innovation is key to driving growth, there is too little of it; we have seen few large switches globally and it is difficult to be a switch pioneer.
  • We must aim to bring value to consumers and only innovate where we meet their needs. Success of the past is not a guarantee of success in the future.
  • Being a launch machine is not necessarily the way to grow and new launches do not always equal success; it is just as important to manage the assets we already have for long-term brand sustainability and growth.
  • Self-care can help alleviate the growing strain on healthcare services, but we must work hard to gain the trust of HCPs and convince them of the important role of preventive wellness solutions.
  • We need to move towards sustainable and robust healthcare systems, working collaboratively to enhance their resilience.
  • We live in a time of rapid change, with many forces disrupting the health & wellness landscape and shaping consumer demand; one of the key challenges in today’s industry is adapting to this new reality, which is crucial to keep pace, remain relevant and enable innovation.
  • Health is not a one-size-fits-all concept and it is important to know and understand the varied landscape and identify the ever-changing motivations & drivers of individual groups in order to meet their needs.
  • We need to address consumer health & wellness needs more holistically; personalisation remains a global megatrend and one that will continue to evolve. We are seeing a shift to more personalised and proactive care that empowers consumers to identify their needs, make informed choices and adopt healthier lifestyles.
  • Protection has moved to the fore of consumer consciousness amid the Covid-19 pandemic, with today’s consumer health-oriented, informed, connected, empowered and proactively searching for better health & wellness outcomes.
  • The pandemic has seen an explosion in e-Commerce and accelerated demand for DtC purchases, providing huge opportunities, but bringing with it responsibilities and risks.
  • Systems need to be in place to anticipate these risks, coupled with processes to mitigate them; safeguards, best practices and governance are key. Be mindful of your obligations before charging ahead with innovation.
  • Technology can help us gather and sort a large amount of disparate data, granting us insights to better understand consumer needs, predict consumer choices and enable innovation.
  • It is important to constantly review and respond to data as it changes fast: Gather, Learn and Act.
  • AI is forecast to be the most disruptive technology over the next 50 years, unlocking value of more than US$13tn across all industries. However, while AI can support the work of people, it cannot substitute it, so it is essential to integrate both into business models. Technology should aid innovation but not be the end goal, and consumers must always sit at the centre of strategy. 

Nicholas Hall’s Touchpoints: My colleague Nathalie has written an excellent summary of the Athens meeting, with particular emphasis on the key word in the conference title, “Innovation”. And I wrote last week of the sense of joy among delegates, speakers and staff at being abroad – or just out of the office or home office – in the wide-wide world. I hope that this sentiment will be in evidence at next year’s meeting, which will take place in one of our favourite cities, London.

If you missed the chance to attend our 32nd European CHC Conference & CHC Training Academy Workshop in Athens last week, you can still purchase a recording of the event! View presentations from Nicholas and experts from companies including GSK, Menarini and Teva, who explore what is next for the CHC market landscape across the region. Please contact elizabeth.bernos@NicholasHall.com to purchase your copy.

Retail CHC growth accelerates to 4.8% in 2021

Below we look at the regional trends from the just published DB6 data on the performance of the global CHC market in 2021, showing how an upturn in Asia-Pacific helped global growth accelerate to 4.8% in the full-year period.

Europe (+3.3%) was the slowest growing region globally, although this does reflect an upturn vs 2020, thanks to robust growth in gastrointestinals (+6.1%) and a return to growth for cough, cold & allergy (+2.4%). Largest market Germany (-0.6%) saw its decline soften, while other Big 5 Western European markets rebounded to growth. Notably, Russia has fallen down the rankings from No.2 to No.4 in Europe, largely driven by devaluation of the Rouble, coupled with a flat year-end result (+1.8%)

Asia-Pacific (+5.6%) had a buoyant performance vs 2020, attributed to advances in largest market China (+6.9%) and a softening decline for No.2 ranked Japan (-1.2%), these markets have a combined share of almost 70% of total regional sales. Sales in China have rebounded somewhat, as harsh Covid restrictions generated a relatively weak 2020 comparator. Despite intermittent restrictions continuing, a relatively free environment has boosted sales across most major categories as consumers seek to remedy all ailments.

Americas (+4.9%) saw a slowdown vs 2020; the US market (+3.9%) has gained momentum throughout the year – finishing well, albeit slower than 2020 – thanks to a robust cough cold & allergy uptick (+6.5%) and notable increases in Lifestyle CHC (+10.8%) and gastrointestinals (+8.9%), more than offsetting the slowdown in VMS and decline in dermatologicals.

In Latin America, leading market Brazil (+11.7%) advanced thanks to double-digit increases in VMS (+16.2%), cough, cold & allergy (+11.6%) and Lifestyle CHC (+11%).

Only one month to go until our 32nd European CHC Conference & CHC Training Academy Workshop! Taking place in Athens on 4-6 May 2022, industry experts from GSK, J&J, Menarini, NielsenIQ and more will explore how as an industry we can move forward with CHC Innovation! Please contact elizabeth.bernos@NicholasHall.com to reserve your place.

Poland approves world-first OTC switch of tadalafil

We continue with the theme of Rx-to-OTC switch this week with news from Poland, where the Office for Registration of Medicinal Products, Medical Devices & Biocidal Products (URPL) has approved Adamed’s Tadalafil MaxOn ED treatment (tadalafil 10mg; film-coated tablets; 2- and 4-count SKUs) as an OTC medicine, effective 1st February 2022. This will join Adamed’s sildenafil options MaxOn Active (25mg) and MaxOn Forte (50mg), which launched in May 2016 and April 2020, respectively. Tadalafil is claimed to get to work within 30 minutes for up to 36 hours, vs claims for sildenafil that it works within 30-60 minutes for up to five hours.

Poland was again one of the most active Rx-to-OTC switch markets in 2021, with only China ahead of it last year in terms of number of launched products reclassified from prescription to OTC status. Three of the six products launched post-switch in Poland in 2021 were erectile dysfunction treatments, including Hasco-Lek’s Mensil Max, Aflofarm’s Inventum Max and Polpharma’s Maxigra Max (all sildenafil 50mg). In addition, there were two digestive health switches – Teva’s antidiarrhoeal Gastrolit and Polpharma’s antacid Famotydyna Ranigast – and Polpharma’s cold sore treatment Heviran Comfort Max.

Source: Nicholas Hall’s CHC New Products Tracker

Nicholas Hall’s Touchpoints: Last week our lead story was the likely switch of HRT in the UK, which we singled out as a pioneer. The latest news this week is from Poland, another switch centre of excellence and where the ED treatment tadalafil will be available in a non-prescription version for the first time anywhere in the world. Tadalafil was launched as a prescription medicine under the trademark Cialis, and Sanofi later acquired the CHC rights from Lilly, but the switch application in the USA has been held up for many years by the FDA.

My colleague Maryna Marriott of the CHC Insight Europe team tells me: “Poland continues to lead the way in switch innovation. The tadalafil approval follows a number of sildenafil 25mg and 50mg switches, with the Polish ED category totalling US$27.7mn in MAT Q3 2021, according to DB6, an increase of 28.5% vs the year-ago period. Men’s health clearly remains high on the consumer health agenda, and it seems likely a number of other tadalafil switches will follow in Poland.”

Switch is an expensive process in the USA, which is why it is subdued there at present. On the other hand, there has been renewed switch activity in Europe and parts of Asia. The problem for the CHC industry has always been that the benefits given to US companies gaining switch status – the cost to the patient-as-consumer drops substantially and there is often three years marketing exclusivity, whereas the ingredient can no longer be prescribed for the same indication – are not available to marketers in the rest of the world. That leads to the curious situation of some switches being regulatory wins but commercial failures. Let’s hope that Adamed is blessed with decent sales for its latest innovation.

Find solutions for success in this competitive CHC landscape with Nicholas and the team in Athens on 4-6 May 2022 for our 32nd European CHC Conference & Action Workshop! Meet with peers and hear from industry experts, including sessions from Bayer, Teva, J&J and many others face-to-face! For more information, or to reserve your seat, please contact elizabeth.bernos@NicholasHall.com.

Macro Trends: Economic & Demographic Outlook

In this week’s blog, we look at two recent reports on macro trends that will have a future impact on the consumer healthcare market. The first looks at short-term economic trends and the second longer-term demographic trends.

Last week the International Monetary Fund has revised down its forecast for global economic growth in 2021 to slightly below its July 2021 forecast of 6%. At a virtual G20 event, IMF Managing Director Kristalina Georgieva said: “The most immediate obstacle is the ‘great vaccination divide’ – too many countries with too little access to vaccines, leaving too many people unprotected. At the same time, countries remain deeply divided in their ability to respond – in being able to support the recovery, and in their ability to invest for the future.”

“We face a global recovery that remains ‘hobbled’ by the pandemic and its impact. We are unable to walk forward properly — it is like walking with stones in our shoes.” Three of the most painful stones are divergence in economic growth, inflation and global public debt. As the chart below indicates, the sectors currently facing the largest inflationary pressures include transportation and food, whereas prices in the health sector remain stable.

As for demographic trends, according to a report in The Times newspaper last week there will be more Nigerians than Europeans in 60 years’ time. Some two-thirds of Africans are aged under-25 years (in Senegal the average age is 19 years) and many capitals and cities on the continent are unable to cope with this “youthquake”, with no time or money to build the basic infrastructure, often coupled with a high cost of living. While this youthful energy could be a good thing, the lack of opportunities – coupled with climate migration – is driving many of the younger generation to leave Africa, with Europe becoming a spill over zone.

Nicholas Hall Writes: “Many of these new consumers will rapidly become empowered, and although it is not a factor that will influence next year’s P&L, sensible companies will start to plan for much larger immigrant communities, which will have very determined views on the CHC products they buy (and anyone who doubts this has only to take a look at the very specialised products sold to the Hispanic community in North America by companies like Genomma). Indeed, some of these populations will be made up of ‘illegals’, who will not sign up to see community physicians and for whom CHC will be primary care and possibly much more. And for that, I fear, we are not at all prepared as countries or an industry.

You can save up to GB£2,500 when you pre-order our forthcoming Hot Topic report, Sexual Health & Fertility! This title will delve into key topics, such as home diagnostics, intimate care, ED and many others, as well as tracking NPD and Rx-to-OTC switch activity, plus much more. To pre-order your copy, or for further details, please contact melissa.lee@NicholasHall.com.

MAT Q2 2021: Global CHC Market Trends

The latest update from Nicholas Hall’s CHC database DB6 indicates that in MAT Q2 2021, the retail (bricks & mortar) CHC market returned to growth following a decline in the previous reporting period – the first seen since DB6 records began. Overall global CHC sales were up 1.7% to US$151bn.

In terms of performance by geography, the Americas returned to positive growth (+1.3%), with a flat performance in North America bolstered by LatAm markets, including double-digit growth in Brazil (+10.6%). USA remains the clear No.1 CHC market globally, and grew modestly (+0.2%).

Asia-Pacific was the best performing region (+4.8%); while it continues to be impacted by loss of revenue from overseas visitors in key markets Japan (-4.0%) and Australia (-5.5%), high single-digit increases in China and India helped to lift the topline.

Source: Nicholas Hall’s global CHC sales database DB6 (all values at MSP).

Europe continues to decline (-2.0%), still heavily impacted by retraction in CCA and analgesics in Western Europe in particular. Key markets Germany (-8.5%) and UK (-10.8%) fell significantly, although this was partly offset by a positive trend in C&E Europe (+3.6%), with Russia maintaining mid-single digit increase (+4.1%) and Poland returning to growth after a decline in the previous reporting period.

Nicholas Hall Writes: “In 2020 we saw the market grow across the board during the first half, ease back in the second half, perform very badly in Q1 this year and return to growth in Q2. Is this a trend? Is it as simple as drawing the line forward to the point where we regain the pre-pandemic 3.7% retail sector growth rate? We all have our own point of view, but it would be a brave soul prepared to make a firm prediction. So in the best tradition of being a thrusting brand manager, I’m going to hedge my bets until I see the Q3 figures from DB6.

We are pleased to announce that Nicholas Hall’s DB6 mid-year update for 2021 is now available! Subscribers can access over 150,000 pieces of data, with more than 30,000 records covering 13,000+ brands and 3,000 companies across 63 countries. To find out more or to set up a free demo, please contact kate.holdcroft@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.