This cough, cold and flu season, and later the allergy season, will be different from previous seasons. As the tripledemic of viral infections, Respiratory Syncytial Virus (RSV), influenza and COVID-19 took hold even before winter began, consumers went online and into stores to seek advice and relief. Manufacturers say that while COVID-19 made people think about proactive self-care, many were unable to avoid getting sick. So even as inflation is making consumers rethink their budgets, people are still looking for products that offer fast relief, provide multiple benefits and are easy to take.
“The cough, cold, flu and allergy category continue to see solid growth,” said Sameer Rabbani, vice president of marketing, respiratory, for Haleon USA in Warren, N.J. “Overall, it has been a very dynamic year for the category.”
In the first half of this year, Rabbani said, cough and cold product sales increased as consumers took medications to treat symptoms of the omicron variant of COVID-19. In the second half of the year, Haleon saw the impact of a severe flu season. “We expect this to continue but anticipate a higher spike than we have seen in the past few months in COVID infections, notwithstanding any new variants, in combination with both adult and pediatric RSV infections,” he said.
In its Weekly U.S. Influenza Surveillance Report, the Centers for Disease Control and Prevention estimated that as of Nov. 18, 2022, there had been at least 6.2 million illnesses, 53,000 hospitalizations and 2,900 deaths from flu for the 2022-23 season. Nationally, the percentage of specimens testing positive for influenza in clinical laboratories had increased.
“The cold and flu season has started early this year along with the resurgence of COVID,” said MaryEllen Tefft, vice president of sales, FDM, for Newtown Square, Pa.-basedBoiron USA. “The flu season started in November when normally it starts much later in the winter months.”
The CDC reported there were 305,082 flu cases the week ending Nov. 23, 2022. That’s lower than the 669,179 for the week ending Nov. 24, 2021. RSV is also surging. The CDC reported that each year, RSV leads to approximately 58,000 to 80,000 hospitalizations among children younger than 5 years old, and 60,000 to 120,000 hospitalizations among adults 65 years and older. That number might increase this season, as more people are getting sick with the virus. For the week ending Nov. 26, 2022 more than 12% of PCR tests were positive for RSV, compared with around 7% the same week in November 2021
Consumers are responding by seeking products with pure active ingredients, Tefft said, and Boiron’s Oscillococcinum, ColdCalm, ThroatCalm, SinusCalm and Chestal cough syrup all saw high double- and triple-digit growth. “They are discovering and enjoying the benefits of more holistic products, especially homeopathic ones, which is continuing to grow as a category,” he said.
Certain shoppers are especially interested in natural products. “Natural OTC medications are more appealing to millennial parents to treat less serious cough and cold symptoms for their children,” said Angela Ho, director of brand marketing for Orchard Park, N.Y.-based Mentholatum. There has been a shift to topical cough and cold products, and that market continues to grow. In general, consumers of all ages are seeking fast relief, Ho said, and it is critical for manufacturers and retailers to maintain availability throughout the season.
One trend affecting the category is that people are hesitating to get vaccinated against the flu. According to an August 2022 survey by the National Foundation for Infectious Diseases, 69% of respondents agreed that annual flu vaccination is the best preventive measure against flu-related deaths and hospitalizations, but only 49% planned to get a flu vaccine during the 2022-2023 flu season.
Vaccinated or not, consumers are seeking products that they hope will prevent illness, and for products that can offer relief when they do get sick. “People learned about prevention, but people are getting colds and flu,” said Jason Pellegrini, president and CEO of Quantum Health. “They are buying both sides of what used to be two distinct segments.”
Eugene, Ore.-based Quantum Health offers natural products in immune support supplements, cold sore medicine and treatments, and other categories. Pellegrini predicts the cold and flu season will see a late spike in illnesses as people travel and get together for holidays. “Our immune systems got weaker from wearing masks and not being around people,” he said. “Before, people thought a cold was no big deal, and now people know colds aren’t something to be trifled with.”
One way to predict the flu season is to look at the southern hemisphere as winter ends there. “It remains to be seen, but the flu that came out of Australia is the most virulent they’ve had in decades,” said Art Rowe-Cerveny, executive vice president of marketing, Americas, for PharmaCare US. “We generally follow what happened there.”
Perhaps counterintuitively, consumers don’t seem worried. During the fall the public was inundated with election news, not health news, so they might not be thinking about health issues. Also, Rowe-Cerveny said, people’s attitudes have changed after two years of COVID-19 protocols. “It appears Americans are not afraid anymore,” he said. “They kind of accepted that various illnesses will be with us.”
That acceptance means consumers are shopping for immunity-related products as well as products they hope will bring immediate relief. That has boosted sales of tried and true OTC cough/cold remedies, Rowe-Cerveny said, while the immunity side has seen a smaller lift in sales. “We make sure people understand our products can be used for both,” he said. San Diego-based PharmaCare US makes the Sambucol Black Elderberry line of products.
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A pent-up demand for togetherness is driving an increase in respiratory ailments. “As consumers are moving forward with their lives post COVID, there is more of an openness to socialize and return to normal activities,” said Joe Juliano, vice president of sales and marketing for Applied Biological Laboratories. “As a result, cough/cold incidence is expected to rise this season.”
Juliano also said the natural solutions trend continues to grow in the cough/cold and allergy category. The company launched Biovanta Dual Action Spray and Lozenges, and plans to launch Biovanta Immunity in 2023
Sales of nondrug natural products are also increasing in the nasal spray segment. “People are looking for something outside of the pharmaceutical realm,” said Nathan Jones, founder and owner of Xlear. “People are looking for other solutions.” American Fork, Utah-based Xlear makes sinus care products such as nasal sprays that contain xylitol.
As with many other categories, consumers are searching online for information about cough, cold, flu and allergy remedies. Manufacturers are responding by offering educational content, such as Xlear’s website with information about studies indicating nasal spray with xylitol can help block adhesion of bacteria to epithelial cells. “People are going into the drug store or pharmacy more educated now about what they’re looking for than they were in the past,” Jones said.
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Xlear launched a campaign that focuses on the science of proactive health and the importance of maintaining nasal hygiene, because viruses and bacteria enter the body through the nose. “We’re the only ones talking about nasal hygiene,” Jones said. “I think that’s going to change.”
Having a digital presence can help drive sales in the category. Applied Biological Laboratories invests in search, social, influencer and geo-marketing to drive consumers to retailer partners. “Additionally, we invest in CRM to not only build a relationship with our consumers but also to direct them to where to buy Biovanta,” Juliano said.
While it’s difficult to predict how the rest of the cold and flu season will fare, allergy season is coming soon. An innovation from Johnson & Johnson Consumer Health helps make it easy for consumers to take allergy medication. Zyrtec Allergy Dye-Free Chewables do not need water. “We know consumers are more apt to stay on top of their necessary medications the easier they are to take,” said Adam Ricciardone, vice president of global self care, Johnson & Johnson Consumer Health. “Our goal is to help consumers manage their health in the most convenient ways possible.”