Canada  top  brands’  share  of    topical  decongestants  sales  2016    

(MSP,  $mn)  

Canada  topical  decongestants  sales  2012-­‐16  (MSP,  $mn)  

Canada  –  Topical  decongestants  

�  Leading  saline  brand  hydraSense  (formulated  with  French  sea  water)  posted  the  most  dynamic  performance  in  2016  (and  solid  +6%  CAGR    since  2012),  claiming  a  quarter  of  category  sales  

�  The  range  includes  differing  strengths  of  spray  including  Gentle    Mist,  Medium  Stream  and  Full  Stream,  while  SKUs  posi�oned  for    specific  health  condi�ons  (such  as  hydraSense  Specialty  Nasal    Care  Allergy)  are  available,  alongside  paediatric  versions  

�  The  brand  is  posi�oned  as  a  preventa�ve  measure  as  well  as    a  decongestant  

Key  topical  decongestants  trends    More  dynamic  than  systemic  cold  &  flu  remedies  thanks  to  well-­‐supported  upper-­‐�er  entries  

  Natural  and  saline-­‐based  remedies  increasingly  popular  among  consumers,  with  Bayer’s  hydraSense  driving  topline  sales  

  Saline  segment  (over  60%  of  sales)  grew  by  9%,  ahead  of  the  smaller  oxymetazoline  /  xylometazoline  segment  (over  30%  of  sales)  which  declined  by  5%  in  2016  

  Very  li�le  in  the  way  of  new  product  development,  with  launch  ac�vity  limited  to  a  handful  of  line  extensions;  por�olios  are  primarily  differen�ated  via  differing  strengths  and  delivery  formats  

  Private  labels  generate  around  18%  of  sales,  growing  by  9%  in  2016  

2012 2013 2014 2015 2016

49.1(+7%)

45.9 48.9(+0%)

50.0(+2%)

52.4(+5%)

25%

20%

13%8%

7%

27%

NeilMed

OtrivinDristan

Drixoral

Others hydraSense

Cold & Flu 89

  The  Juvamine  vitamin  C  range  –  which  includes  presenta�ons  formulated  with  addi�onal  guarana  and  magnesium  –  is  mainly  posi�oned  for  the  treatment  of  fa�gue,  although  also  has  a  posi�oning  for  the  normal  func�on  of  the  immune  system  

  Mass-­‐market  brand  Vitarmonyl  is  presented  in  “vitality”  op�ons,  posi�oned  to  reduce  fa�gue  and  maintain  normal  func�on  of  the  immune  system  

  Arkopharma’s  Acérola  1000  is  posi�oned  to  reduce  fa�gue  and  contribute  to  the  normal  func�on  of  the  immune  system  

  Arkopharma  highlights  that  acerola  is  a  type  of  cherry  excep�onally  rich  in  vitamin  C  

  The  leading  brands  in  immune  supplements  are  homeopathics    L52  and  Homéomunyl  

  Adver�sing  for  L52  highlights  that  the  product  has  no    known  side-­‐effects,  can  be  used  by  the  whole  family    (from  age  2+  years)  and  has  been  a  recognised  cold    &  flu  treatment  for  around  65  years  

  TV  &  print  ads  2015-­‐16  stressed  efficacy  when  used  from  the  first  symptoms  of    cold  &  flu,  ending  with  the  message  “L52.  Free  yourself  of  flu  symptoms”  

  Boiron’s  Homéomunyl  is  a  homeopathic  product    posi�oned  for  the  preven�on  of  cold  &  flu  

  Arkopharma  fields  a  propolis  supplement,  but  this  has    a  weak  posi�oning  for  immune  support  

  Meanwhile,  in  November  2016  Pierre  Fabre  launched  Imuvitalose  (imunoglukan)  for  immune  support  

  The  supplement  is  recommended  to  be  used  all  year  round  but  is  claimed  to  be  most  beneficial  in  winter  

France  –  Immunity-­‐boos�ng  supplements  

France  immune  supplements  sales  2012-­‐16  (MSP,  $mn)  

2012$ 2013$ 2014$ 2015$ 2016$

10.4$(+0%)$

10.4$ 10.2$(.1%)$

10.7$(+5%)$

11.2$(+5%)$

Brand &$mn 2016/15 CAGR&16/12

1 L52&(Lehning) 3.3 +0% +3%2 Homéomunyl&(Boiron) 1.6 21% 23%3 Propolis&(Arkopharma) 0.5 +2% +1%

Others 5.8 +10% +3%

France&leading&immune&supplements&2016&(MSP,%$mn)

Cold & Flu 145

Italy–Overview

Italycold&flusalesbypharmacychannel2016(MSP,$mn)

Distribu�on:OTCsavailableinpharmacies,parapharmaciesandinspecialisedareasinmassmarket

retailersunderpharmacistsupervision

Adver�sing:Consumeradver�singofcertainOTCspermi�ed

OTCpricecontrols:Pricecontrolsonallnon-prescrip�onmedicineswere

abolishedin2008

Pharmacy90%

Non-pharmacy10%

Ingredient Status Additionalnotes

brompheniramine –

chlorphenamine OTC Pharmacy-only

codeine Rx

dextromethorphan OTC Pharmacy-only.AvailableOTCaloneorincombinationpresentations

diphenhydramine OTC Pharmacy-only.OTConlyincombinationpresentations

ibuprofen OTC

Pharmacy-only.200mgand400mgdosesareOTCwhenusedforadultsandchildrenaged12+.SOPstatuswhenusedforchildrenundertheageof12

naphazoline(nasal) OTC Pharmacy-only

oxymetazoline(nasal) OTC Pharmacy-only.OTCfortopicaluse

paracetamol OTC Pharmacy-only

phenylephrine OTC Pharmacy-only

pseudoephedrine OTC OTConlyincombinationpresentations

tramazoline(nasal) OTC Pharmacy-only.AvailableOTCaloneorincombinationpresentations

xylometazoline(nasal) OTC Pharmacy-only

Legalstatusofkeycold&fluingredientsinItaly

Cold & Flu 206

  At  taisho.co.jp/pabron,  promo�on  also  includes  a  recipe  page,    featuring  meals  to  aid  recovery  and  relieve  cold  symptoms,  and    informa�on  about  healthy  ea�ng  to  aid  immunity  and  recovery  

  Current  A+P  focuses  on  ambroxol  and  ibuprofen  combina�on    Pabron  AX,  posi�oned  for  “11  symptoms  of  cold”  and  marketed  to    young  professional  demographic  groups,  and  Pabron  S  Gold  W,    promoted  with  family-­‐themed  ads  showing  a  mother  and  child  

  Pabron  range  also  includes  tonic  presenta�ons,  combining  ginger  and  taurine  in  a  caffeine-­‐free  drink  that  can  be  used  alongside  medicated  presenta�ons  and  is  available  to  buy  in  supermarkets  and  convenience  stores;  product  is  posi�oned  to  restore  energy  and  aid  recovery  

  Lulu  range  comprises  general-­‐purpose  cold  remedy  line  Lulu  A,  extended  in  2015  with  New  Lulu  A  S  and  Lulu  A  Gold  S,  and  specialised  presenta�ons  Lulu  A�ack,  extended  in  2015  with  A�ack  NX  

  All  Lulu  A  presenta�ons  contain  paracetamol,  clemas�ne,  dihydrocodeine,  DL-­‐methylephedrine,    caffeine  and  vitamin  B1:  Lulu  A  Gold  DX  adds  tranexamic  acid  for  sore  throat,  belladonna  for  nasal    conges�on  and  expectorant  bromhexine;  Lulu  A  Gold  S  adds  belladonna,  bromhexine,  an�tussive    noscapine  and  a  higher  dose  of  caffeine,  while  New  Lulu  A  S  contains  potassium  guaiacol  sulfonate    and  noscapine  

  TV  ads  promote  Lulu  A  Gold  DX,  with  summer  and  winter-­‐themed  ads;  summer  ads  promote  it  as  a    treatment  for  allergy  and  hayfever  symptoms,  while  winter  ads  focus  on  its  cold  symptom  relief    posi�oning,  including  relief  from  sore  throat  and  fever  (see  right)  

  New  Lulu  A  S  is  the  fastest-­‐growing  presenta�on,  taking  sales  of  $17mn  annually  in  2016  following  its  2015  launch  

Japan  –  Systemic  cold  &  flu  

Cold & Flu 228

USA  –  Overview  

Memorable  TV  ads  

Day  /  night  combina�ons  

Preserva�ve-­‐free  launches  

Private  labels  

PSE  restric�ons  

Rela�vely  low    levels  of  NPD  

Growth  drivers  &  nega�ve  factors  

  Day  /  night  packs  and  value  sizes  may  have  encouraged  consumers  to  stock  their  medicine  cabinets  

  Key  brands  such  as  Tylenol,  Theraflu  and  Sudafed  have  made  a  strong  recovery  from  manufacturing  problems  and  recalls  in  recent  years  

  Owing  to  methamphetamine  abuse  in  the  US,  pseudoephedrine  is  restricted  to  behind  the  counter  sale;  restric�ons  are  likely  to  have  affected  sales  performance  of  brands  formulated  with  PSE  

  Topical  decongestants  generate  under  15%  of  total  cold  &  flu  sales,  which  is  low  compared  to  the  global  average  

Marketer $mn 2016/150CAGR016/12

%0share

1 Procter0&0Gamble 496.6 +3% +5% 192 Bayer 269.9 (9% +2% 103 RB 201.2 +13% +36% 84 Johnson0&0Johnson 184.7 (2% +12% 75 Pfizer 132.8 +5% (3% 56 GlaxoSmithKline 109.6 +17% +18% 47 Matrixx 79.2 +12% +2% 38 NeilMed 55.3 +9% +1% 29 Standard0Homeopathic 40.3 +11% +20% 210 Church0&0Dwight 27.3 (1% +4% 1

Others 998.7 +0% +2% 38

USA0leading0cold0&0flu0marketers020160(MSP,%$mn)

Cold & Flu 369

Scien�ficstudies

Lifestyleandcold&flu�  Whensufferingfromcold&flu,mostindividualslooktothebestremedytheycanfindon

shelvestospeeduptheirrecoveryandeasetheirsymptoms;researchshowsthatthereareseverallifestylefactorsthatmayinfluencevulnerabilitytocolds&flu

�  Aresearchle�erpublishedinJAMAInternalMedicinein2016reportedthatpeoplewhosleepforfivehoursorlesshaveanincreasedriskofdevelopingcoldsandinfec�ons;theresearchersanalysedself-reportedsleepinrela�ontoincidencesofcold&fluinthe30daysprior,usingdatafromnearly23,000par�cipants

�  Thefindingsrevealedthathavingfivehoursorlesssleepanightwasassociatedwitha17%increasedriskofahead/chestcoldanda51%riskofaninfec�on,comparedtoresultsfromseventoeighthourssleepanight;par�cipantswithasleepdisorderdiagnosishadan18%increasedriskofacoldandan88%increasedriskofinfec�onvspar�cipantswithoutsleepdisorders

�  A2015studyalsofoundthatpeoplewhosleepforlessthansixhoursaremorelikelytocatchacoldthanpeoplewhosleepforlonger;164healthypar�cipantsweregivennasaldropscontainingtherhinovirusa�ersevenconsecu�vedayswheretheirsleepwasmonitored,thenmonitoredoverthenextfivedaysfordevelopmentofaclinicalcoldwhereresearchersfoundthatashortersleepdura�onwasassociatedwithanincreasedriskofdevelopingacold

�  Astudyin2013foundthatstresscanweakentheimmunesystemandrenderindividualsmoresuscep�bletoillness;theexperimentaskedgroupsofwomentothinkaboutastressfultaskthey’drecentlycompletedfortheresearchers(anervousjobinterviewscenario)orneutralthoughts(e.g.groceryshopping)

�  Thosewhowereaskedtorememberthenega�vetaskhadhighlevelsofC-reac�veprotein,amarketerof�ssueinflamma�onandusuallyusedbyHCPstodetectinfec�on

�  Astudyin2012foundthatindividualswhohadbeenunderstressweretwiceaslikelytodevelopacold;theirimmunesystemswerefoundtobelesssensi�vetocor�sol,allowingtheinflammatoryimmuneresponsetopersistandplacetheindividualsatgreaterriskofinfec�on

Cold & Flu 395