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Cough-cold category recuperating in 2021

After pantry loading and a soft flu season last year, manufacturers say consumers will soon return to the aisles.

As people go back to work, school and socializing, they might find themselves facing the once common but not terrifying threat: the bug going around. For most, it won’t be the coronavirus that caused the global COVID-19 pandemic, but a minor malady. As masks come off and social distancing becomes less stringent, people are becoming reacquainted with the germs they managed to avoid over the last year and a half. So just like in pre-pandemic times, consumers are again thinking about how to prevent or treat routine colds, flus and other respiratory ailments. 

Last year, sales of cough and cold remedies decreased dramatically when people stayed home, many with their stash of OTC medicines purchased during the initial pantry-loading phase of the pandemic. Now routine respiratory ailments are making a comeback, as consumers are becoming less strict with their own protocols. That is driving an uptick in illnesses, and boosting sales in the cough-cold category. 

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“What’s happening is people are being more relaxed with their behaviors,” said MaryEllen Tefft, vice president of sales for food, drug and mass at Newtown Square, Pa.-based Boiron USA. “What we’re seeing, anecdotally, is there are a lot of common colds going around. People have gotten themselves tested, but they are finding it’s not COVID but other viruses circulating out of the winter season.” 


Tefft noted that there has also been an increase in flu-like illness, referencing the CDC’s Influenza Surveillance Reports. As a result, sales of Boiron’s homeopathic cough-cold and flu remedies have increased by nearly 50% in recent weeks, compared with 2020. That includes the brand’s flagship product, the homeopathic multisymptom flu medicine Oscillococcinum, as well as ColdCalm, ThroatCalm and SinusCalm symptom relief products. “Natural and complementary medicines are really now the focus for the consumer,” Tefft said. “Consumers want to be more proactive in their self-care journey.” 

Retailers can benefit by communicating with and educating shoppers. That includes installing shelf strips that show information about natural remedies, updating the store’s online presence to include relevant information about when and where to use homeopathic remedies and having pharmacy staff speak with people in the aisle or by appointment. “Retailers can engage with consumers where they are by anticipating and being ready to answer questions,” she said. 

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Many stores are merchandising the category early this year to counter a possible twin-demic of influenza and COVID-19. “We’ve learned in the past 18 months that you can’t predict anything now,” Tefft said. “Years ago we could predict whether we would have a heavy season based on the opposite hemisphere. If Australia and South America had a bad cough-cold and flu season, we would as well. Now there is no real way to predict it.”

Return of the Sniffles 
One thing suppliers are predicting is that sales will rebound from last year, and may even increase compared with 2019. “With a somewhat normal back to school, a reduction of mask use and people going back to work, we are seeing illness track up higher than usual,” said Art Rowe-Cerveny, vice president of marketing at San Diego-based PharmaCare US. “It’s a higher velocity than two years ago at this time of year.”  


Influenza, the common cold and RSV are not the crisis that COVID-19 is, but they still make consumers think about their health. “People realize they can get sick again,” Rowe-Cerveny said. Manufacturers, meanwhile, realize they need to remain flexible. “That’s hard to do, but that’s going to be the mission for us and the retailers we’re working with.” The key, he said, is to gather data often and act on it quickly.

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PharmaCare US makes the Sambucol Black Elderberry line of immune system support products in adult and kids offerings. Retailers have been seeing success with off-shelf merchandising, such as displaying kids’ products with back-to-school items. “You wouldn’t think wellness or cough-cold products belong there, but they do,” Rowe-Cerveny said. “People know when you get back to school and back to work, germs get traded.” 

According to the Centers for Disease Control and Prevention, flu activity was unusually low for the 2020-2021 season. The CDC reported that from Sept. 28, 2020, to May 22, 2021, 1,675 (0.2%) of 818,939 respiratory specimens tested by U.S. clinical laboratories were positive for an influenza virus. For comparison, the CDC noted, during the last three seasons before the pandemic, the proportion of respiratory specimens testing positive for influenza peaked between 26.2% and 30.3%.

Shifting the Focus to Prevention
Others agree that back-to-school season heralds a return to cold and flu season. COVID-related masking policies vary, and children are notoriously uninterested in the proper mechanics of handwashing. “They touch something, then touch their eyes, and that’s the most common way to get a cold,” said Lou Machin, managing director of Lifelab Health. “It’s not that there is not going to be a season. It’s what kind of season.” 


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While it might be difficult to predict what kind of season the cough-cold category will have, certain trends have emerged. Retailers closely follow the trends, Machin said, and they know that consumers want organic products without additives. The Coconut Creek, Fla.-based Lifelab makes the HoneyWorks line of soothing throat sprays and syrups with USDA-certified organic dark honey. The kids’ line is attractive to moms looking for organic, natural, GMO-free solutions. “We check off a lot of boxes,” Machin said. “We don’t have anything that is bad for you.” 

Retailers are also aware of the proactive and preventive trend. That means in addition to the usual array of symptom relief products for coughs and colds, stores are stocking up on immunity-related products. Lifelab recently launched the BerryWorks brand of black elderberry products that can help with immune system support and other benefits. The liquid, chewable tablets and adult tablets are high in antioxidants and vitamin C. 

“Retailers sink or swim based on understanding where the market is going,” Machin said. “They know there was a drain on inventory at first, then a glut because of pantry loading. Now … they try to make sure they are ready with more inventory in stores.” 

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Other companies are also counting on the self-care trend to drive sales. “We expect this to be a big year for cough-cold, especially for immune support products,” said Tyler Bare, EZC Pak brand manager at Los Angeles-based PPC Group. “People are more health conscious now than probably ever before and looking for brands and products that help them take control of their health.”


Not only are colds and flus returning, but news of new variants of the virus that cause COVID-19 are causing consumers to look for ways to support their immune system, Bare said. “Retailers understand this trend. They are adding more immunity products and using endcaps and displays to highlight immune support brands.”  

PPC Group launched EZC Pak 5-Day Tapered Immune Support, which Bare said fills a void within the immunity space. 

“Most immune support products are for daily use or designed to provide a short-term boost,” he said. “However, when maximum support is needed, it’s often unclear how much to take and for how long. With EZC Pak, we’ve taken the guesswork out of immune support via the five-day tapered system.” The product is designed so that the delivery system starts off strong on day one and tapers down during days two through five, all in one pack. 

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Prevention, long a major theme in healthcare, became top of mind during the pandemic. According to Mintel in its report, “Managing Common Illness – US April 2021,” the COVID-19 pandemic and consumers’ resulting focus on prevention opened the door for a new segment in the illness management market. The increases in sales of immune support supplements, hand sanitizer, face masks and other products were well-documented during the health crisis, and there is evidence that consumers will continue to buy prevention-related products. The report also noted that 28% of U.S. consumers said they feel less in control of their health since January 2020. As consumers seek at-home solutions, illness management brands can benefit by “positioning recovery and relief as pillars of self-care,” according to the report. 

Another company that focuses on proactive health is American Fork, Utah-based Xlear, which makes products for sinus care and oral health. “Our product sales were up last year because our products are more hygiene products,” said owner and president Nathan Jones. “You use it before you get sick, to wash all the stuff out of the outer airway.” 

He said there have been several studies indicating that nasal irrigation reduces symptoms related to SARS-CoV-2, the virus that causes COVID-19. For example, xylitol, one of the ingredients in Xlear nasal spray, blocks receptor cites of the SARS-CoV-2 virus, which inhibits it from attaching to the cell wall of its host, according to some of the studies. Consumers are finding out about the science, and that is driving sales. “I think people are going out and reading a bunch of research studies out there, and they are reading the literature,” Jones said. “Saline irrigation is effective across the board. We’ve been saying nasal hygiene matters.” 

Retailers can benefit by staying up to date on the research. “If pharmacists pay attention to what the people want, and read up on it also, pharmacists are going to continue with that higher level of trust,” Jones said. “If they keep up with all these alternative things that are out there, they have an opportunity to help people.”