Homeopathic remedies, H1N1 to heat up flu season

For all the typical volatility associated with projecting a cough-cold season, there is one statement that can be made this year with a definite degree of certainty—it’s going to be an interesting year.

The wild card this year, of course, is the novel H1N1 influenza pandemic that’s as sure to make its return to U.S. schools and workplaces this fall as it is to snow in Alaska. In fact, Alaska, along with Maine, already is reporting widespread activity of influenza-like illnesses, thanks primarily to the novel H1N1 virus. And that’s the earliest in a season that any predominant flu virus has ever become this active this early. “Reports of widespread influenza activity in August are very unusual,” said Jay Butler, director of the H1N1 Vaccine Task Force for the Centers for Disease Control and Prevention during an Aug. 22 press conference. “It’s best that we plan and prepare for lots of flu activity, and that’s a good assumption, given that we expect to see both the 2009 H1N1 virus and the seasonal influenza viruses causing illness this fall.”

To a lesser extent, there are a number of still-developing side stories that may not have quite the impact as H1N1 on cough-cold product sales this year, but have the potential of significantly altering the planogram space in years to come: for example, the growing prominence of homeopathic cough-cold remedies.

Homeopathic cough-cold remedies have been gaining shelf space and dollar volume because of their safety profile in pediatric patients—though homeopathic suppliers still are not recommending use in children under 2 years in compliance with a Food and Drug Administration ruling on pediatric cough-cold remedies—and now also should garner extra attention around some clinically proven claims, such as reducing the severity and duration of the common cold. Sales of Matrixx’s Zicam tablets, which are not impacted by the recall of two SKUs earlier this year, were up 10.2% to $42.4 million for the 52 weeks ended July 12 across food, drug and mass (minus Walmart), according to Information Resources Inc.

And within pediatric cough-cold, both Hylands and Boiron have climbed into the No. 9 and No. 10 spots, respectively, in sales of cough syrups (excluding private label).

With regard to the story around the safety and efficacy issues around nonprescription pediatric cough-cold formulations, there have been no updates from the Food and Drug Administration of late, but the Consumer Healthcare Products Association expected to have results around pediatric pharmacokinetic studies for antitussive, nasal decongestant, expectorant and antihistamine ingredients in the first half of 2010.

Another story that could have some impact on the sale of cough-cold medicines is the groundswell of late—California state legislature and several local municipalities throughout Missouri—toward moving pseudoephedrine products from their current behind-the-counter/ signature-and-photo-ID-required status to prescription-only status—not because PSE products ought to be administered under a doctor’s supervision out of any safety concerns, but because law enforcement agencies still are struggling to curb illegal methamphetamine production.

But the real impact on the coming season will be the novel H1N1 virus. On a positive note, there has been no mutation of the H1N1 virus in the influenza season coming to a close in the southern hemisphere. And that means that overall, the H1N1 flu is comparable to the seasonal flu in terms of severity.

The novel H1N1 strain also continued to disproportionately affect younger persons—with 75% of the hospitalizations occurring in those under the age of 49.

That was of particular concern as children began populating school desks late last month. “Most younger people do not have much, or any, cross-reacting immunity to this virus, so even though…the overwhelming majority [of infections] have been mild, a lot of people are getting infected…and as people come together, that’s a factor that increases infection,” said Jesse Goodman, acting chief scientist and deputy commissioner at the FDA, during the CDC press conference.

So the prognosis to date: a relatively mild influenza season in terms of severity but a busy season in terms of the number of people expected to “catch” the flu this year. And that means a potentially significant lift in sales of cough-cold-flu symptomatic relievers from the $4 billion generated across food, drug and mass channels (minus Walmart) for the 52 weeks ended July 12, which was up 2.4% compared with the year-ago period, according to IRI. Likewise, sales of hand sanitizers, which typically had not been tied to cough-cold sales in the past, already may be up significantly because of the novel H1N1 virus. For the same period, sales of hand sanitizers were up 13.3% to $112.4 million.

And if an endcap featuring nothing but hand sanitizers top to bottom that recently was put into play leading into the cough-cold section at CVS is any indication, retailers are expecting significant demand around hand sanitizers. And with good reason; just about every government healthcare official on the airwaves today is imploring Americans to practice good cold-flu etiquette.

“We at CDC are very impressed at how powerful some simple measures like hand hygiene, regular washing of hands with soap and water or alcohol-based hand sanitizers…how powerful all those things are actually at preventing spread of disease to others,” said Toby Merlin, deputy director of the Influenza Coordination Unit at the CDC, during a mid-August press conference with Secretary of Commerce Gary Locke.