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Somewhere over the counter

The OTC drugs market is poised for growth, and the packaging industry's opportunities and responsibilities are very much a part of the script reports Des King

The UK market for readily available drugs and medicines over the counter is estimated to hit £2.5bn by 2005. Current estimates indicate that growth is running at a rate of around 9% every year. Even so, the OTC sector represents the smaller portion of an overall £9.3bn revenue earned by pharmaceuticals manufacturers last year, and itself expanding at a comparable annual pace.

The revenue imbalance between prescription and OTC drugs, however, is set to change. So far the transition from prescription to pharmacy shelf has been constrained to a narrow band of remedies for readily treatable complaints such as hayfever, allergies, colds and ‘flu. It is estimated that analgesics and painkillers currently represent a quarter of all OTC sales.

But in the context of a pre-dominantly ageing and, by implication, ailing population highly likely to overwhelm the NHS’s already stretched resources, there’s a need to extend the remit of self-doctoring beyond the resolution of something as commonplace as a headache to include condi-tions of a more serious nature.

Over the counter availability of cardio-vascular medicines, for example, would have a marked impact upon both state and industry.

The Government’s desire to take some of the pressure and a significant proportion of the patients out of the doctor’s surgery is wholly understandable. Increasingly, political expediency is also running in tandem with the pharmaceuticals industry’s commercial requirement to maintain product life cycles. Once prescription drugs extend beyond patent protection, they are inevitably exposed to intense competition from other manufacturers’ generic alternatives.

Consumer compliance is the third driver determining the further growth of the OTC sector, typified by a willingness to take personal responsibility for health and welfare. The abandonment of re-sale price maintenance and the rash of products appearing on the general sales list – and consequently available in most retail outlets – is helping to redefine a growing number of pharmaceutical products into as much a convenience purchase as snacks.

Whereas prescription charges are likely to remain high, regulatory relaxation within the OTC sector is correspondingly predicted to bring costs down.

One way or another then, game on. With a 23% share of the UK adult analgesics market, Nurofen – managed by the Boots’ subsidiary Crookes Healthcare – is largely credited with establishing and subsequently dominating the OTC Ibuprofen sector.

Launched as a pharmacy product in 1983, Nurofen has since successfully extended into the grocery healthcare sector and is also widely available in 43 different countries.

Distinctively strong branding has underpinned a well-deserved level of consumer confidence in the product, which has evolved into a broad portfolio of variants including muscular and paediatric pain relief.

In addition to awareness building campaigns aimed directly at the consumer, the instigation of the Nurofen Pharmacy Solutions pain training programme for pharmacy assistants has been further instrumental in maintaining market share.

Specialist pharmaceuticals design consultancy Tutssels Enterprise IG created the brand identity and packaging for GlaxoSmithKline’s Eumovate eczema and dermatitis cream in support of its switch to OTC status.

This has been followed by development of an educational and marketing web site, enabling sufferers to learn more about their complaint in lay language and to purchase online.

This sufferer-focused initiative is very much in keeping with the brand identity itself that features a series of red and blue dots – raised on the box itself, which was produced by GSK’s in-house packaging department – sym-bolic of eczema and dermatitis sufferers’ itchy red dry sore skin. A blue vignette behind the mark, merging into white represents the soothing relief and eventual resolution of the condition.

The branding additionally features on all doctor, pharmacy and consumer communications. Eumovate Eczema and Dermatitis Cream has been available in UK pharmacies since autumn last year.

Branding strategies conducted outside of the consumer field of vision are becoming increasingly evident in association with prescription drugs. As Tutssels director of consumer branding Beverley Law points out, this would be of enormous advantage if already in place to support the ultimate switch to OTC. Lengthy though the patent time frame would appear to be, in reality a drug might only have a few years protection left once it actually becomes available for prescription.

All too often the necessary ramifications of branding – identification of core values, product positioning and style of packaging – aren’t given proper consideration until a late stage in the trialing process.

In the pharmaceuticals manufacturer’s defence, many pipeline pro-ducts fail to make it through to final approval. And to date, probably less than 1% of the 3000 or so OTC products currently available within the UK exceed sales of £10M a year – so why bother?

In the States, where broad-based GSL availability has been established practice for some time, there is a clearer appreciation of the need for brand identity to be in place way ahead of a product’s shelf appearance.

The abolition of RPM has sent something of a wake-up call to the pharmaceuticals industry as far as existing OTC brands are concerned, confirms Nick Verebelyi of Design Bridge. However, he still questions the time frame allowed by UK drugs manufacturers to set in place the necessary branding building blocks prior to that initial switch from prescription.

Design Bridge’s consumer branding techniques have undoubtedly improved shelf sales of Roche’s Feminax and Cystopurin OTC products – in the case of the latter by over 70% within one year of re-launch.

Key to the revitalisation of Cystopurin was the inclusion of cranberry extract that Design Bridge was able to draw to the attention of potential users with an existing knowledge of traditional herbal remedies while maintaining the product’s underlying pharmaceutical efficacy.

Dew Gibbons has walked the tightrope of balancing consumer appeal with medical efficacy with similar success in redesigning Infacol, the UK’s leading treatment for infant colic with a 49% market share valued at £4.2M per annum.

Packaged for Forest Laboratories by MY Healthcare and Galloways Print and Packaging, Infacol was facing increasing competition from both generic alternatives and own-label treatment.

While the original pack format was seen as a positive point of difference, focus group research threw up an incipient feeling of guilt associated with administering medi-cine to babies among parents.

According to Steve Gibbons, the branding solution was play up more positive feelings of caring without losing sight of the product’s healing benefits – hence the introduction of a visual image of a baby wrapped in a blanket onto the outer pack to project the characteristics of a gentle, soothing remedy.

As a design ploy it strikes right to the heart of a mounting difficulty faced by pharmaceuticals manufacturers in the OTC sector – namely squaring the inherent ambivalence of a medicinal product being marketing within the FMCG framework.

This itself leads on to the tricky matter of providing patient information. The response of the drugs industry to date has been to cram as much literature as possible into or onto the pack itself.

No tangible research exists into how well received this information is by consumers. The reality, however, is that its likely benefit is geared far more towards protecting the interests of the manufacturer than ensuring appro-priate usage by the patient.

According to Sebastian Mullin, GSK marketing manager for skin care and allergy products, packaging’s most notable contribution to product take-up is in providing top-line reassurance. When it comes to interrogating the product’s medicinal properties, inter-net access allows for a far greater degree of patient/manufacturer interactivity.

In the absence of a freeserve account, the pharmacist is the best available line of support. The vagaries of consumer response are always likely to misconstrue instructions however simply advice on recommended usage is communicated.

In Brazil, where the ill-famed morning sickness drug Thalidomide is now being used to treat leprosy sufferers there have been cases of incorrect use as a birth-control pill in response to the on-pack icon of a foetus scored through with a red cross.

Determining the best form of dispensing information is going to be a long time in coming. Meanwhile, the pre-eminent role for packaging in this growing market will be to establish brand differentiation rather than explanation.

According to Steve Kelsey of PI3, structural pack design is now poised to enter into the branding equation.

“As more and more drugs go over the counter, the market will inevitably become littered with strong icons whose main achievement will be to cancel each other out.

“Visual branding might be calling the shots right now but, as consumers increasingly relate to the purchase of over the counter medicines in the same way, they tend to approach any other product all packaging factors will come into play.”

Structural packaging has been largely employed to protect rather than to promote – for example, CRC squeeze and turn closures produced by leading suppliers to the pharma industry such as RPC Containers.

But what the general sales list is really crying out for is some aisles-stopping shape and format design. It’s to be hoped that the labyrinthine regulations of the FDA and similar European agencies allow it to actually happen.