Survey shows growing support for pharmacies in Europe

According to a YouGov survey, commissioned by Stada and focusing on four European countries (Germany, Italy, Spain and UK), hope and confidence in healthcare professionals has grown in the wake of the Covid-19 crisis, though the picture does vary from one country to the next. With measures to reduce coronavirus infection rates defining daily life, Spaniards show the greatest concern for their health (51%), while people in Germany, Italy and UK are less worried (36-39%).

Germans (18%) are least likely to believe their healthcare system has absolutely proven itself, while 47% of Spaniards gave their health system top marks, followed by the UK (35%) and Italy (29%). Spaniards (32%) and Italians (28%) are most likely to have avoided visiting pharmacies vs only 14% in Germany and 19% in UK. In total, one in five people have greater respect and more recognition of what pharmacies provide on a day-to-day basis.

The potentially good news for community pharmacies in Europe is that the coronavirus crisis does not appear to be leading to a large number of people ordering more medicines online. In fact, only 6% of those surveyed say they are taking this action. However, it will remain to be seen how consumer attitudes to internet & mail order purchasing of OTCs change in the coming years, especially in Europe. According to DB6 VP, Celine Waller, internet & mail order is expected to account for 19.2% of the total CHC market within the next decade, more than doubling its share from 9.4% currently. 

The survey also highlighted the likely impact of Covid-19 on the VMS market in Europe. UK consumers and Germans are generally not motivated to take more vitamins or similar products (<9%). In Italy and Spain, the readiness to do so is higher, particularly for vitamin C, D and multivitamins (13-15%). Paying greater attention to nutrition and taking more exercise hold greater attraction in the southern countries than in Germany and the UK, where people are more likely to say that the coronavirus situation has not changed their habits. 

Ensure that you have registered to join Nicholas online for a special webinar presentation with Q&A, which will take place next week! On 29 April at 10:00-11:30 UK time, Nicholas will review 2019 CHC market performance, explore the impact of Covid-19 and identify growth prospects for the future. For those unable to join, there will be the option to purchase a recording and submit up to 3 questions via email. To find out more or to register to join, please contact elizabeth.bernos@NicholasHall.com without hesitation!

e-Commerce Developing Fast in Southern Europe

As more and more countries go into lockdown to enforce social distancing, the way that consumers do their shopping is of course having to change dramatically. Some countries are better adapted to this change than others – according to a recent report in the Financial Times, southern European countries like Italy and Spain currently only have low e-Commerce penetration, with respective shares of 4% and 5% of total retail revenues (prior to the Covid-19 pandemic).

France (10%) has a higher share than the two countries at its southern border, but still lags behind other markets in Europe (20% in the UK) and globally (36% in China). However, this situation looks set to change fast, with Covid-19 leading to a revolution in e-Commerce sales of groceries in southern Europe – for example, according to the FT report, supermarket chain Carrefour stated that its online customer base in Italy has already doubled to 110,000. Is this a trend that will outlast the current crisis?

And what impact will Covid-19 have on online sales of consumer healthcare products? Our recently published Digital Marketing & e-Commerce Report outlined the Top 20 leading internal & mail order markets for CHC products, with China and the USA the clear leaders, followed by Japan, Germany and the UK. Inevitably, the projected growth rates for 2020 will have to be revised, especially given this fast-changing crisis could also lead to changes in regulations governing the online sale of OTC medicines.

For example, Europe’s largest e-Commerce pharmacy group, Zur Rose, today submitted a request to Switzerland’s Federal Office for Public Health calling for a temporary exception that would allow mail order sales of OTC cold & flu medicines (at present, all non-prescription medicines can only be sold by mail order if specifically approved by a doctor). As well as owning Germany’s best-known pharmacy brand, DocMorris, Zur Rose is also active in France and Spain, and could be at the forefront of overcoming strict regulations governing the sale of OTC-registered medicines in those markets too.

For an in-depth look at the rising power of e-Commerce in the CHC market, order a copy of Digital Marketing & e-Commerce: Tapping the Potential of Online Sales and Digital Promotion in Consumer Healthcare! This report also explores social media, which CHC brands are employing effective digital marketing strategies, and the opportunities and challenges e-Pharma faces. For further details, please contact melissa.lee@NicholasHall.com.

Combination OTC painkillers gaining ground

Following the approved switch of Voltaren Arthritis Pain by the FDA in mid-February, there was more positive news for GSK’s US analgesics portfolio over the weekend with the FDA approval of Advil Dual Action. This is the first FDA-approved OTC combination of ibuprofen and paracetamol (acetaminophen) in the USA, and GSK is expected to launch the product later this year.

Franck Riot, Head of R&D at GSK Consumer Healthcare, said: “For decades, many consumers have been using ibuprofen and acetaminophen (paracetamol) to get the benefits of both active ingredients when safely treating their headaches, muscle aches, backaches, arthritis and other joint pain. Now Advil, the No. 1 selling OTC pain reliever, will offer US consumers the first-ever alternative option – a single, fixed-dose combination pain reliever.” According to the reported clinical research, this fixed-dose combination achieves superior efficacy compared to the individual monocomponents of ibuprofen (250mg) and acetaminophen (500mg) alone.

Dolostop Plus, another recent combination launch

Another combination OTC painkiller we tracked recently, formulated with both ibuprofen and paracetamol, is Kern’s September 2019 launch of Dolostop Plus in Spain. Indicated to provide symptomatic relief from mild to moderate pain in adults, these film-coated tablets are formulated with paracetamol 500mg and ibuprofen 150mg, with a stated dose of 1-2 tablets every 6 hours, and claimed to be the first and only OTC paracetamol and ibuprofen combination available in Spain.

In several markets around the world, such as the UK, Russia, Japan and Indonesia, combination paracetamol + ibuprofen OTC remedies are already well-established, but these recent developments in the USA and Spain point to growing acceptance among global regulators about the safety of fixed-dose OTC analgesic combinations.

Where will NPD take the CHC market in the future? Find out in our upcoming report, Innovation in CHC: NPD & Innovation in CHC under the Spotlight! This report, drawing on Nicholas Hall’s CHC New Products Tracker, assesses the global picture of CHC innovation in 2019, featuring ingredient trends, delivery format trends, analysing innovation trends by region and by marketer, plus much more! To pre-order your copy and save with the pre-publication discount, or for more information, please contact melissa.lee@NicholasHall.com.

Homeopathy under increasing scrutiny

France is the latest country in recent years to call into question the role and efficacy of homeopathy, as governments look for savings in the healthcare budget. Last week’s announcement by France’s Minister for Solidarity & Health Agnes Buzyn that homeopathic medicines will be dereimbursed in France from 1st January 2021 is another blow to this consumer healthcare niche. In 2017, NHS England recommended that doctors no longer prescribe “ineffective, over-priced and low value treatments”, including homeopathy, which is said to have no clear or robust evidence to support use.

The French decision was based on a final recommendation by the Haute Autorité de Santé (HAS) stating that homeopathics have little proven efficacy and should not be covered by health insurance. In its assessment, which spanned 9 months, HAS evaluated close to 1,200 homeopathic products, many of which are currently reimbursed up to 30% when prescribed. In the interim, the level of reimbursement available for certain homeopathics will be cut from 30% to 15% on 1st January 2020, allowing consumers, manufacturers and prescribers time to prepare for eventual dereimbursement.

Voicing its shock at the decision, key homeopathic player Boiron – which markets various leading OTCs in France, such as teething product Camilia – stated that around 1,000 jobs would be directly affected by the dereimbursement, given that 60% of the company’s business is in France and almost 70% of that is linked to reimbursed medicines. A November 2018 survey by Ipsos revealed that 77% of French people have used homeopathics.

In other countries, such as Spain and the USA, there has been a clampdown on homeopathic health claims. In November 2018, as part of a new marketing authorisation process for homeopathy, the AEMPS (Spanish Agency of Medicines & Medical Devices) indicated that homeopathics with no permitted therapeutic indication must state, “Sin indicaciones terapeuticas” (Without therapeutic indication) on packaging. Likewise, in May 2018, the American Association of Homeopathic Pharmacists announced that all homeopathic manufacturers will be encouraged to use the new disclaimer: “Claims based on traditional homeopathic practice, not accepted medical evidence. Not FDA evaluated.”

Keep up to date with the latest in-depth reporting on homeopathy by subscribing to OTC INSIGHT! We have 4 title covering the latest developments in Europe, Asia-Pacific, Latin America and North America. Click here to find out what key features OTC INSIGHT includes. To receive a sample issue or for details of subscription rates, please contact melissa.lee@NicholasHall.com.

Tracker hits 20,000 innovations

Our sister product OTC New Products Tracker has hit a significant milestone – 20,000 innovations added to a database that tracks consumer healthcare launch activity all the way back to the start of 2013, across 20 key markets. In this week’s blog, we look back at some of the highest-ranked innovations added to the archive over the past year.

A recent 4-star innovation is medical device Flow from Flow Neuroscience, a first of its kind home treatment on the European market. Positioned as a non-medicated alternative treatment for depression, the medical device comprises a brain stimulation headset and a therapy app. While stimulation is in use, the app acts as a virtual therapist that the user can interact with. Available in the UK since summer 2019, Flow retails for £399.

Adjacent OTC categories have been fuelling the fire of consumer healthcare innovation in recent years, with medical cannabis / CBD and probiotics two of the most active categories in terms of launch activity. US marketer CBDfx is arguably the most pioneering innovator among the new wave of medical cannabis companies, launching several new delivery formats over the past two years, including vaping pens (January 2018), “chill shot” drinks for anxiety (March 2019), sublingual hemp strips (April 2019) and acne face masks (June 2019).

Like CBD, probiotics have also enjoyed high levels of innovation in terms of delivery formats and positioning. Two examples of probiotics targeting a new consumer healthcare niche include Elebiotic, a recent Recordati launch in Spain positioned to manage recurrent acute otitis media in infants, and Khan’s Morning, a probiotic launched in South Korea in early 2019 that is claimed to help break down the alcohol and acetaldehyde that causes hangovers.

Review 20,000+ launches and innovations with OTC New Products Tracker, the ultimate competitive intelligence tool! Products are graded with a star rating, from 1* (essentially “me too” and generics) up to 4* (1st Rx-to-OTC switches in a category, creation of a new OTC class or other major leaps in innovation). With a recently-released major update including eye-catching new graphics and powerful search filters that help you visualise and explore the vast archive according to your exact specifications, now is the perfect time to set up your free trial. For a demo or more information, please contact waisan.lee-gabell@NicholasHall.com.

Sleep disorders on the rise globally

According to a new in-depth analysis of the global sleep aids market by Nicholas Hall’s Reports, sleeplessness and sleep disorders are on the rise, with approximately one third of the world’s population affected. Many consumers are happy to self-medicate, increasingly opting for a variety of herbal & natural, homeopathic and medical device brands, driving OTC growth in key markets like Brazil and Spain (see sample pages).

In terms of sales, sleep aids & sedatives generate an OTC total of over US$2.3bn globally, but have been characterised by low growth in recent years, and are in need of rejuvenation via new product development, adjacencies or connected health solutions. The self-medication sleep aids market (registered OTCs and a variety of supplements) also suffers from regulatory diversity across markets for common sleep aid ingredients.

Genuine innovation is thin on the ground, but generics and “me-toos” launch frequently. Adjacencies focused on sleep offer alternatives, with other categories also entering the fray including nighttime analgesics, cough & cold remedies, menopause and other supplements. Connected Health is a key area of expansion. Sleep aid brands partnered with technology – passive (e.g. analysing sleep patterns / providing feedback) or active (improving sleep) – may break the low-growth cycle.

Comment from Ian Crook, Managing Editor, Nicholas Hall’s Reports: Sleep is a health area that lends itself easily to self-medication via sedating antihistamines and herbal & natural ingredients such as melatonin and valerian, while medical devices and digital health focused on sleep are seeing increased investment. With widespread concern over the “sleep loss epidemic” and significant implications for overall health from lack of sleep, it is imperative that consumers have access to tools to help them sleep. Raised levels of stress, anxiety and smartphone / tablet use ensure rising demand that can be tapped into by the right self-care solutions.

The full report, Sleep: Exploring Opportunities for Growth in Sleep Aids & Sedatives, is available now and more details can be found here. To order your copy, please contact melissa.lee@NicholasHall.com

Key Trends around Gastrointestinals from OTC INSIGHT Europe

The latest issue of OTC INSIGHT Europe includes a round-up of the key trends & developments affecting the gastrointestinals category in France, Italy, Spain and the UK. It was a disappointing picture overall, with a significant decline in revenue for semi-ethicals in France dragging down the topline.