Seasonal respiratory viruses re-emerge post-Covid

Recent reports from the UK and USA suggest a severe cold & flu season may be in store during winter 2021-22. With lockdown restrictions, increased hygiene measures and social distancing in force for over a year to reduce the risk of contracting Covid-19, the incidence of common respiratory viruses has been very low. However, with the lack of exposure to illnesses (especially among young children), many of us have not built up antibodies and as a result our immune systems may have been inadvertently weakened.

This has prompted warnings of a potential surge in influenza as measures are lifted; data released this week by the UK’s Office of National Statistics show that in the week ending 11th June, 84 death certificates issued in England & Wales mentioned Covid, while 1,163 deaths involving flu and pneumonia were registered. Additionally, a recent study by the Houston Methodist Research Institute shows the rapid re-emergence of seasonal respiratory viruses following the relaxing of Covid-19 restrictions in Texas in March 2021.

This trend was also reported in a recent article in STAT, in which Trevor Bedford, a computational biologist who monitors which viruses are circulating via the Nextstrain service, was quoted as saying: “Just in the last month [May 2021] or so we’ve started to pick up small amounts of seasonal coronavirus, RSV, metapneumovirus, etc. It’s the first time since April 2020 where we’re starting to see other things circulating.”

There is particular concern that by the time universities, colleges, schools and nurseries reopen this autumn across the northern hemisphere, there will be perfect conditions for high transmission of seasonal respiratory viruses, particularly RSV (respiratory syncytial virus). Andrew Pavia, Chief of the Division of Pediatric Infectious Diseases at the University of Utah, warned: “There will be two years’ worth of kids who are naïve to RSV, instead of one birth cohort. That could be fertile ground for a big RSV year.”

Epidemiologist Professor Neil Ferguson of Imperial College, a member of the UK Government’s Scientific Advisory Group for Emergencies, said in a BBC interview that we must be prepared for a potentially “quite significant” flu epidemic and increased hospitalisations this winter. To help save National Health Service resources, researchers are investigating whether seasonal flu jabs and a Covid vaccine can be administered at the same time.

We are pleased to announce that our Eye Health report is now published and available to order! You can review case studies of key brands, NPD activity and much more. Plus, ensure you have registered for the free webinar on 30 June here to discuss the topline findings. For more information, please contact melissa.lee@NicholasHall.com.

CBD industry revving up again in 2021

2020 was a tough year for the CBD industry, with Covid causing disruptions to supply chains as well as lower footfall in bricks & mortar retailers, and these setbacks were reflected in greater hesitancy from CBD marketers in terms of NPD activity – according to our CHC New Products Tracker service – with launch activity in 2020 much lower compared to 2019. However, recent regulatory developments in Australia and Mexico, and the uptick in M&A activity in the CBD industry over recent weeks, suggest 2021 will see a revival in NPD activity and sales.

For example, Curaleaf, a leading US provider of consumer cannabis products, last week signed a definitive agreement to acquire EMMAC, the largest vertically-integrated independent cannabis company in Europe, for around US$286mn. Curaleaf Executive Chairman, Boris Jordan, commented: “[This acquisition] provides an advanced base to reach scale within the nascent European cannabis market and transform Curaleaf into a truly international cannabis consumer packaged goods company. The consumer and political liberalisation trends around cannabis that are sweeping USA are also increasingly taking hold in Europe … The European cannabis market has the potential to exceed the US cannabis market over the long-term and will help fuel our growth for years to come.”

In addition, a wholly-owned subsidiary of British American Tobacco last week subscribed for around 58.3mn common shares – a 19.9% equity interest – of Organigram, a leading licensed cannabis producer, for C$221mn (US$176mn). The companies have also entered into a Product Development Collaboration Agreement, under which a Centre of Excellence will be established to focus on developing the next generation of cannabis products, with an initial focus on CBD. “The cannabis industry is still in the nascent stages of product development. We believe that product innovation backed by core fundamental R&D is necessary to establish a long-term competitive advantage in the cannabis industry,” said Organigram Chief Strategic Officer Paolo De Luca.

Another M&A CBD development from last week was MediPharm, a research-driven global leader in cannabis extraction, entering into a GMP white-label supply and contract manufacturing agreement with Cannim. The company has also commenced registrations for the launch of next-generation OTC products in Australia in 2021. Under the 3-year agreement, with options to extend, MediPharm will supply a full range of specially-formulated CBD and THC cannabis oil products, sold initially under Cannim’s Lumir brand. MediPharm will also provide Cannim with contract manufacturing options.

Finally, a bill that would legalise the recreational use of cannabis was approved in Mexico’s lower house of Congress last week and will move to the Senate for final approval. The legislation would enable users aged 18+ years with a permit to carry up to 28g of cannabis and grow up to eight plants at home for personal use. President Andres Manuel Lopez has argued that the bill could help to curb Mexico’s violent and powerful drug cartels. John Walsh, Director of Drug Policy for the Washington Office on Latin America, a US advocacy group, said: “Mexico, given its size and its worldwide reputation for being damaged by the drug war, to take this step is enormously significant. North America is heading towards legalisation.” Canada and Uruguay are the only countries in the world to have legalised cannabis for recreational use. With its liberal switch environment, Mexico could be an early adopter of OTC cannabis, possibly the second or third market after Australia.

Discover who the main CBD players are, and how big the market could get in our recent report, CBD 2020: The 20 Most Important Questions about CBD in the Future of CHC. To find out more, or to order your copy, please contact melissa.lee@NicholasHall.com.

NPD roundup: Women’s Health in 2020

To mark International Women’s Day, our blog this week rounds up some of the most notable women’s health NPD activity in the global CHC market in 2020, with examples from all four major regions (Europe, Asia-Pacific, North America and Latin America), as provided by our CHC New Products Tracker service.

Probiotics & prebiotics was a particularly lively source of women’s health innovation, including Farmoquimica’s late 2020 launch of Simbiofem in Brazil, positioned to balance female intestinal flora and claimed to be the first probiotic in the market for women’s health. In Spain, FertyPharma unveiled Fertybiotic Mujer Plus in early 2020, uniquely positioned to improve the fertility of women with PCOS (polycystic ovarian syndrome), while in South Korea Huons launched Elruby Menolacto Probiotics in Q4 2020, offering the benefit of an original formula to help support menopausal women. In the USA, a particularly innovative women’s health probiotic launch was HUM Private Party, with a unique formulation that combines a proprietary women’s probiotic blend with cranberry extract, which is positioned to support healthy vaginal and urinary tract health.

As for digital health solutions, which are profiled in one of the chapter’s of our upcoming Innovation in CHC report, a notable women’s health development in the UK was Velieve (Healthy.io), an at-home service for women to determine if they have a UTI (urinary tract infection). Velieve was test marketed in London first and is available as a kit (containing a urine collection cup, dipstick and colour board), which is delivered within 3 hours of ordering online, and the user is then required to download the Velieve app to guide them through the test, turning their smartphone into a medical device to read the dipstick.

Finally, looking at VMS, there were also several notable women’s health developments in China in 2020, including GSK’s extension of calcium supplement Caltrate with Caltrate Women, Unilever’s rollout of Olly The Perfect Women’s Multi and Eu Yan Sang’s launch of Gold Label Bak Foong Small Pills (a plant-based formula positioned as a treatment to alleviate menstrual pain).

Seize your last chance to save on our forthcoming report from Nicholas Hall’s CHC New Products Tracker, Innovation in CHC 2021. Putting innovation and NPD activity from 2020 under the microscope, click here to pre-order your copy without delay. For more information, or to place your order, please contact Melissa.Lee@NicholasHall.com

Sexual health OTC revolution

Building on the news covered in last week’s blog that Sanofi is planning to implement the US Rx-to-OTC switch of erectile dysfunction treatment Cialis by end-2024, this week we look at another major development in the OTC sexual health & fertility category – the announcement by the UK’s MHRA that it has launched a public consultation on the reclassification of two progestogen-only contraceptive pills containing desogestrel, marking the first time the agency has considered such a change.

MHRA is asking the public and stakeholders for their views on whether two continuous-use oral contraceptives – HRA Pharma’s Hana and Maxwellia’s Lovima, both as 75mcg film-coated tablets in 28-count packs – should become pharmacy medicines and available OTC, without a medical prescription (although, in parallel, desogestrel 75mcg will also remain available on prescription, with women potentially able to switch between prescription or pharmacy supply at different times). The agency notes that if the products are reclassified, pharmacists will have access to training materials and a checklist to help them to identify women who can receive the two medicines safely. Two separate consultations are open until 5th March (Hana link; Lovima link).

Following the switch of Adamed’s Maxon Forte (sildenafil 50mg) in Poland in early 2020, the rollout of OTC Viagra (Viatris) to Norway and Ireland in 2020, plus the EU centralised Rx-to-OTC switch of Fortacin (Recordati for Plethora Solutions) for premature ejaculation – formulated with lidocaine 150mg + prilocaine 50mg – in September 2020, the past year has seen a rapid expansion in the availability of OTC sexual health & fertility medicines. With OTC ED on the near horizon in the US market, the UK approval of the daily contraceptive pill as an OTC medicine could lead to a wave of similar approvals worldwide, and inject substantial growth into the global CHC market over the coming years.

CHC.NewDirections Consulting Editor, Nina Stimson adds: This really is an exciting proposal – not only a first for the UK, but also the first significant bid to offer oral contraceptives without prescription outside the Asia Pacific region – China and South East Asian markets lead the way, although sales in most markets are relatively small. If the proposal is approved, will UK pharmacists actively support the switch and help build OTC supply (and will the pharmacy protocol be sufficiently user-friendly not to push women back to the doctor)? And will any price differential between Rx or OTC supply be a factor? Not all ambitious switches in the UK have succeeded in the past, but we have high hopes for this one. Time will tell …

You can save up to GB£1,350 when you pre-order our forthcoming report from CHC New Products Tracker, Innovation in CHC: 2020’s NPD & Launch activity under the spotlight before 31st March! As well as looking in more depth at the latest OTC sexual health & fertility developments, the report also showcases the top 100 innovations in 2020 and features major ingredient trends, delivery format trends and much more. For more information, or to pre-order your copy, please contact melissa.lee@NicholasHall.com.

Historically slow cough, cold & flu season

Now that four (P&G, J&J, GSK and Sanofi) of the world’s Top 6 consumer healthcare marketers have reported their latest quarterly results, two of the key takeaways are that 1) industry growth has proven very resilient in the face of the challenges posed by the pandemic, and 2) we are in the middle of an historically slow cough, cold & flu season in 2020-21, and CHC marketers with portfolios that skew heavily towards CCA products will continue to feel the impact of this trend on overall growth.

Figures from the WHO’s FluNet service show the quasi-total wipeout of flu at a global level. Despite some signs of very low levels of flu circulation in certain regions tracked by WHO, including Africa and the Western Pacific, the overall picture at a global level is stark, with an almost complete drop-off in global infections since Q1 2020. The data shown in the WHO chart below are provided remotely by National Influenza Centres (NICs) of the Global Influenza Surveillance and Response System (GISRS) and other national influenza reference laboratories collaborating actively with GISRS, or are uploaded from WHO regional databases.

Source: FluNet (www.who.int/flunet), GISRS

This trend is backed up by recent reports at a country level too. According to data obtained by The Times newspaper, UK flu cases are down by 95%; in the second week of January – the peak of the season – the number of reported influenza-like illnesses was 1.1 per 100,000 people vs a 5-year average rate of 27. This reflects similar trends in many other countries, including USA. While a billion people typically get flu globally each year, “much less than a tenth” of that figure will do so, according to leading expert John McCauley. There are a number of theories for the decline; lockdown restrictions, social distancing and the wearing of masks, and an increased focus on good hygiene practices have helped to prevent Covid, but also reduce the spread of other contagious illnesses. A major fall in international travel has curbed infections, while there has also been a huge take-up of the influenza vaccine. Meanwhile, some experts believe the spread of Sars-CoV-2 may have raised immunity against other viruses.

Nicholas Hall said: “Before Covid, we thought we knew the dynamics of consumer healthcare very well. I’ve given endless presentations quoting the three practical drivers of demand: Switch, the Emerging Markets and very importantly Cold & Flu pandemics. It’s fair to say that, without Covid, we would by now be lamenting a year of poor CHC sales. The actuality is that, with the exception of Voltaren Arthritis Pain and Differin in USA, there have been no significant switches in the past 3-4 years. The Emerging Markets still deliver, of course, but not at the stellar levels of the recent past; and we would by now be reading of the low impact on sales of the cough, cold & flu season.”

Explore the impact of lockdown on cases of cold & flu, and what the implications may be for CHC medicines, in our recently published Cough, Cold & Allergy report. For more information, or to order your copy, please contact melissa.lee@NicholasHall.com.

Innovation: CES 2021 Health & Wellness Roundup

As our infographic this week indicates, health & wellness led the way in terms of high-quality innovation at this year’s CES (Consumer Electronics Show). Here, we highlight some of the new health & wellness products that were rewarded by judges for the key criteria of excellence in engineering, aesthetics and design, uniqueness, and the innovation they bring to the consumer market.

The winner of the Best of Innovation award in the health & wellness category was Epsy Health, a leading digital health platform for the management of epilepsy that “empowers patients, caregivers and healthcare professionals”. The Epsy app is free to download on both Apple and Android platforms, currently in the USA only, and helps in managing epilepsy by “creating a data rich diary to track seizures, medication compliance and triggers”.

The other level of recognition in each CES category is “Honorees”, i.e. products that score above the threshold in terms of innovation criteria for any given category, and there were several digital healthcare tools here, including Algocare, an IoT (Internet of Things) solution that provides personalised nutrition management at home and at work. Algocare Labs, based in South Korea, claims that the health questionnaires on the Algocare app and its unique algorithm, which analyses thousands of scientific journals, combine to deliver a tailored VMS mix to be dispensed via Algocare’s innovative device. Another CES Honoree was Oova, a high-tech home diagnostic fertility test, which measures luteinising hormone and progesterone in the urine, thanks to its cutting-edge test pads and supporting smartphone app.

Other notable consumer health & wellness innovations at CES 2021 included Flō, a handheld device for managing allergic rhinitis (or hayfever). When placed in the nose and activated, the company says the product projects lights to trigger reactions in the body which limit uncomfortable allergy symptoms. Marketer Fluo Health said it is seeking OTC approval from the FDA, and expects the device to be available to consumers later this year. Another medical device of note was Temp Pal, a smart thermometer from Taiwan-based iWEECARE, which is designed to be placed under the armpit of small children and transmits its readings wirelessly for remote monitoring – according to the company, it measures a child’s temperature within an accuracy of 0.05 degrees Celsius.

Explore the latest cutting-edge consumer healthcare devices, as well as major delivery format and ingredient trends, in our upcoming report from Nicholas Hall’s CHC New Products Tracker, Innovation in CHC: 2020’s NPD & Launch activity under the spotlight! Pre-order your copy before 31 March to save with a generous pre-publication discount. To find out more, please contact melissa.lee@NicholasHall.com.

Switch: 2020 Review and 2021 Prospects

According to our CHC New Products Tracker tool, which covers 20 key markets globally, 2020 was a relatively good year for Rx-to-OTC switch activity, not quite at the level of particularly active years like 2018, but above average in terms of switch-related launch developments, and with some notable breakthroughs such as GSK’s switch of Voltaren Arthritis Pain (diclofenac) in the USA and Glenmark’s Momate Rhino Advance Nasal Spray (mometasone + azelastine) switch in Russia.

Thanks to the Rx-to-OTC reclassification of Voltaren Arthritis Pain, as well as eye allergy itch relief range Pataday (Alcon), the US market led the way in terms of switch developments in 2020, along with Poland, Germany and China. As for category switch trends, looking at Tracker data for the past 8 years (2013 to 2020), allergy remedies has been by far the most active OTC subcategory in producing new products following switch activity, with double the amount of NPD activity as the next nearest subcategory, cough remedies.

Looking ahead to 2021, one of the first switch developments this year will again be an allergy remedy. The UK’s Medicines & Healthcare products Regulatory Agency granted GSL status to Sanofi’s Allevia tablets for seasonal allergic rhinitis (fexofenadine 120mg; 12+ years; 1 tablet per day) in late December 2020. Once Allevia and other OTC fexofenadine products are launched, they will enjoy mass market distribution from the outset (it is more common in the UK for switched ingredients to be granted pharmacy-only OTC status). This is the second Rx-to-GSL UK allergy remedy switch in as many months, following approval for J&J’s Rhinocort Aqua budesonide 64mcg nasal spray in November 2020 (to be marketed as Benacort Hayfever Relief).

In addition, Poland remains at the forefront of global switch activity, with the country’s medicines agency (URPL) recently approving the Rx-to-OTC switch of Famotydyna Ranigast film-coated tablets (Polpharma; famotidine 20mg). Claimed to relieve indigestion, heartburn and hyperacidity for up to 12 hours, this is the first famotidine option available OTC in Poland. Meanwhile, Australia’s TGA is seeking comments until 27th January 2021 on proposed amendments to the Poisons Standard, which will be discussed at the March 2021 meeting of the Advisory Committee on Medicines Scheduling, including adding the following pharmacist-only medicines to Appendix H to permit consumer advertising: prochlorperazine and metoclopramide for the treatment of nausea associated with migraine; and chloramphenicol for ophthalmic use.

We are delighted to announce that our annual European e-Conference 2021 will take place online on 28 & 29 April! With options for individual and corporate site or global access, take the chance to keep up with what’s happening in consumer healthcare today and contact elizabeth.bernos@NicholasHall.com

Allergy: NPD, switch & naturals power growth

While many of the leading CHC marketers reported declines for their cough & cold portfolios in Q3 2020, the performance of allergy remedies was more mixed, with notable variability by region. For example, Bayer reported rising sales for its Allergy & Cold portfolio in North America in Q3, partly driven by increasing sales for key allergy brand Claritin, which was boosted in early 2020 by the US launch of Claritin Non-Drowsy Chewables in a new cool mint flavour.

Likewise, Perrigo reported a strong performance for its Consumer Self-Care Americas unit in Q3, with increased OTC demand powered by allergy, pain and digestive health products. For Sanofi, while overall Allergy, Cough & Cold sales declined in Q3, portfolio sales were up in the USA, thanks to key allergy brands Allegra and Xyzal. Sanofi also launched its drug-free AllerLife range in the US market in early 2020, adding further fuel to the fast-growing naturals niche among allergy remedies.

Outside the USA, by far the world’s largest market for OTC allergy remedies, two countries that are performing very well are Germany and Brazil. Rx-to-OTC switch has been the driving factor in both markets, with various allergy ingredients – fexofenadine, ebastine and desloratadine – switched to OTC status in Brazil in recent years. As for Germany, after the switch of levocetirizine, which led to several OTC launches in April 2019, desloratadine was subsequently also approved for Rx-to-OTC switch in February 2020.

In October 2020, the EMA’s Committee for Medicinal Products for Human Use adopted a positive opinion recommending a change to the terms of the marketing authorisation for Ratiopharm’s desloratadine, potentially paving the way for an EU-centralised switch to non-Rx status for the allergy ingredient in the near future. Indications will be limited to adults only and the urticaria indication will be restricted to chronic idiopathic urticaria as initially diagnosed by a doctor.

Discover which marketers and brands stand out and how Covid-19 is impacting sales in our newly published Cough, Cold & Allergy report! Allergy remedies are just one of the many categories covered, alongside profiles of 10 major markets, forecasts and much more. For more information, or to order your copy, please contact melissa.lee@NicholasHall.com.

OECD: Covid’s impact on e-Commerce

A new report published last month by the OECD, entitled e-Commerce in the time of COVID-19, explores how the pandemic has caused an expansion of e-Commerce towards “new firms, customers and types of products, likely involving a long-term shift of e-Commerce transactions from luxury goods and services to everyday necessities”. Below we pick out some of the highlights that relate to medicines.

In the opening summary, the OECD says that, “while e-Commerce in the past for many consumer groups was centred on high tech goods, toys or books, it now increasingly involves goods for which availability is critical to a large share of the population, including groceries, medicine and other necessities.” There were two examples given by the OECD from Brazil and Germany showing how e-Commerce has disrupted the medicines market.

In Brazil, “around 54% of Internet users had bought food or food products over the Internet in 2020, substantially up from only 22% in 2018. Significant increases were also observed for cosmetics, toiletries and medicines. As convenience has always been one of the key drivers of e-Commerce participation, it is likely that many of the new users will keep ordering at least some goods online in the future.”

As for Germany, “online sales grew significantly for medicines and groceries, historically laggard sectors in terms of e-Commerce, while overall online sales contracted by around 18% in March 2020 in comparison to the previous year.” The OECD report also highlighted the impact of Covid-19 on e-Commerce’s share of total retail sales in the UK, USA and EU.

Writing in last Friday’s CHC.Newsflash, Nicholas Hall said: “Let’s take the best case point-of-view, that the incidence of Covid-19 will shrink dramatically during the middle of 2021, with a significantly lower death rate. How do we get back to normal? Will personal and professional life pick up where it left off? I doubt that very much. It seems to me that, at the very least, working from home is here to stay, which could mean the revival of suburban shopping, with lower footfall in city centres and out-of-town shopping malls. One impact on consumer health could be a marked revival in community pharmacy and online purchases growing from 9% to 19% of total CHC sales globally in the next 10 years, and from 11% to 27% in Asia. Another fascinating statistic courtesy of Eurostat is that, uniquely, the over-55 cohort is the largest purchasing group for medicines online, which runs counter to the theory that digital equals youth.

Don’t miss out on the chance to save up to 50% on selected reports with our Q4 promotional event, which will run until the end of the year! Stay tuned for new deals coming in December! To find out what promotions are available, or to make a purchase, please contact melissa.lee@NicholasHall.com

Market Movers in MAT Q2 2020

To mark the publication of our latest Market Movers update, which picks out 6 brands driving growth in the global CHC market in the MAT Q2 2020 period, as well as 6 brands in fast decline, our blog this week examines the trends that are driving these exceptional changes.

Among the fastest-growing brands, one common thread is immunity positioning, with at least four of the six products highlighted below – Dabur Chyawanprash (India), Yiling Lianhua Qingwen (China), Airborne (USA) and Arbidol (Russia) – boosted by heightened demand for products that boost immunity during the pandemic.

TCM Yiling Lianhua Qingwen, available in China as capsules and granules, was listed in 2020 in the country’s Novel Coronavirus Pneumonia Diagnosis and Treatment Scheme, while in April 2020, the National Medical Products Administration of China approved a new indication for “mild and common Covid-19” to be added on the basis of its originally approved indications. Sales for the brand in the MAT Q2 2020 period were up 68%.

Ayurvedic formulation Dabur Chyawanprash (Dabur) saw sales more than double (+169%) in MAT Q2 2020, driven by strong Covid-related demand and the launch of Dabur Immunity Kit in Q2 2020, to become India’s No.1 CHC brand. Likewise, umifenovir-based medicine Arbidol (OTCPharm), which is positioned for flu as well as acute respiratory and viral infections, also saw sales more than double (+103%) in the MAT Q2 2020 period and the brand now ranks in the Top 5 in Russia.

As for products that suffered falling sales in MAT Q2 2020, notable examples were tonics & cure alls in China – such as Dong-e E-Jiao – hit by rising raw material costs and falling demand, as well as ranitidine-based antacids – such as Sanofi’s Zantac 150 – owing to concerns around NDMA and Takeda’s Alinamin EX vitamin B supplement in Japan, affected by demographic changes and a fall in tourist spending.

If you would like to review the latest launches and NPD surrounding all the leading brands in the global CHC market, take a look at CHC New Products Trackerthe ultimate competitive intelligence tool! Featuring 26,000+ launches and innovations, products are graded with a star rating, and you can search according to your specific requirements. Please contact waisan.lee@NicholasHall.com to set up your demo.