The allergy remedies category has the potential to be a key component of community pharmacy’s offering, with hayfever treatments a driving force. Charity Allergy UK estimates that 21 million adults suffer from at least one allergy, and each year the number of people affected rises by 5%.

Yet the market for hayfever products – worth £73.2 million* last year – does not reflect this, with pharmacists seeing a decline of 7% in 2015. So, how can the sector reverse this trend and maximise its allergy offering?

 

Strengths: products

There is a wide variety of over-the-counter products to help people with allergies, so finding the right combination can be a case of trial and error. This is where the expert advice of a pharmacist can be invaluable to consumers. “Community pharmacists are uniquely placed to help customers and patients navigate their way through the broad range of over-the-counter medicines,” says Boots UK pharmacist Tom Khallis.

“Pharmacists can take into account any drug interactions or pre-existing conditions before making recommendations, and they can identify when a severe allergic reaction will need to be signposted for treatment by a doctor.”

Nada Baki, superintendent pharmacist for the Chorley branch of MedicX Pharmacy, says he receives at least one query a day about an allergy. “The most important advice we can give [pharmacists] is to discuss the symptoms and how they are affecting the patient. [If they have] itching eyes or nasal symptoms, we can recommend the best product – or combination of products – for them.

“This is an issue that affects a large proportion of the population, but they don’t necessarily know the best treatment,” he says.

 

Weaknesses: predicting demand

Anticipating demand for hayfever remedies might be trickier than expected. Last summer ended up being cooler and wetter than either of the two previous summers, with the average temperature 0.4C lower than usual, yet sales of hayfever remedies were boosted by the late arrival of the season.

Cathy Crossthwaite, Numark’s marketing co-ordinator, says this is where savvy independent pharmacists can get ahead and make the most of the opportunity: they are not constrained by the requirements of a head office having agreed to a certain promotion. “Do not limit your allergy promotions to one month in the spring/summer,” she advises. “Feature allergy as a category for a minimum of six months – and start early.”

As a key category for pharmacy, it is worth being single-minded about promoting allergies – and it can be tied in with holidays and first aid, she says.

“Pharmacies should also prepare for the uplift in stock. Review sales data from base months when hayfever isn’t in season, and increase stock levels based on forecasted sales for the upcoming season. This will help you to avoid going out of stock during this critical time,” she says.

 

Opportunities: promote different treatments

Omega Pharma – which this year launched Prevalin Allergy Plus, a spray designed to treat the acute symptoms of hayfever and reduce sensitivity to allergies – is planning a £900,000 TV campaign to promote the new product, plus a £2 million spend on its Beconase nasal spray.

According to brand manager Bea Warner, Omega Pharma’s research shows that not everyone is affected by hayfever in the same way, and it is important to recommend products based on patients’ specific symptoms.

In addition, Omega Pharma discovered there is a huge opportunity for pharmacy to promote treatments other than the bog‑standard antihistamine tablet.

The organisation found that 76% of consumers request tablets only, but it claimed they are rarely satisfied – with many resorting to odd or old‑fashioned ways of treating their symptoms, including cold and flu remedies. According to Omega’s research, if half of consumers bought a nasal spray as well as tablets, the category would grow by 44%.

It is not only about treating the symptoms, but also about finding the cause. As pharmacy moves to a service-led agenda, why not consider easily accessible allergy testing? Mr Baki believes this would be a sensible move. “It is definitely a service pharmacy should be involved in,” he says.

 

Threats: supermarkets cutting prices

A decline in the pharmacists’ share of the market in 2015 limited the overall market growth to 1.8%, while switched-on customers are becoming increasingly aware of the value of own-brand products. And, with more and more P lines switching to GSL, supermarkets are stealing a share of the business by cutting prices.

“With this in mind, it is vital that pharmacists stock a comprehensive range of products to accommodate all types of allergy sufferers, including tablets, oral solution, nasal sprays and eye drops,” says Ms Crossthwaite. “This helps your customers choose the most appropriate treatment for them without having to venture elsewhere,” she adds.

And don’t forget to stock a range of children’s products, she advises. “Critically, pharmacies should ensure they have a value equivalent to offer the customer an alternative to the brand, both out on open display and behind the counter.”

One way to boost business could be to run a hayfever event to encourage customers to discuss symptoms and remedies with each other. “As symptoms can vary far and wide, customers may find it beneficial to discuss their troubles with others and work out other ways to try to reduce their symptoms,” says Ms Crossthwaite.

As always, it is about going the extra mile for the patient – as Simon Hall, pharmacist at Well Pharmacy in Keele University discovered. “I recently had to deal with a case of anaphylaxis caused by peanut allergy. It involved a dash across the university campus armed with adrenaline pens and Piriton [chlorphenamine].

“Thankfully, the student whom I treated was fine; they returned to thank me later and are now a regular patient. Cases such as these are rare, but it highlighted to me the importance of being prepared for such emergencies.”

*Unless otherwise specified, all quoted data is provided by Kantar Worldpanel; value sales, 52 weeks to January 3, 2016

 

Expert view: what should you advise?

A patient has requested a supply of a nasal decongestant for a blocked, stuffy nose. On questioning, you learn that the patient has been suffering from congestion most days for a few months and has been using a decongestant for the last seven days.

Victoria Knowles, member relationship manager (Northern Ireland), National Pharmacy Association

A congested nose can be a symptom of rhinitis (inflammation of the nose), which can be caused by the common cold and may also cause symptoms such as sneezing, an itchy nose and nasal discharge.

Rhinitis symptoms last for about seven to 10 days in adults; if they persist long-term, they may be caused by an allergy. Common allergens include dust mites; pollen from grass, trees and weeds; allergens carried in the hair of pets; and workplace allergens, such as wood dust.

An accurate patient history can help ascertain the type of allergic rhinitis and the cause of the symptoms. For example, if rhinitis occurs during the summer months or seasonally, the symptoms may be the result of hayfever. If the patient has hayfever, they may also complain of itchy, red or watery eyes. Year‑round symptoms may be due to allergens from house mites or pets and is known as perennial rhinitis.

To manage allergic rhinitis, the allergen should be identified and avoided - this may be done by examining the patient’s history.

Drug treatment may also be necessary. The choice of treatment will depend on the frequency, duration and severity of the symptoms. The pharmacist should also consider the patient’s daily routine and the effects of the symptoms on their quality of life. Asking them about treatments they have already tried, and whether or not they were effective, will also help determine the appropriate treatment.

If the patient prefers to take oral treatment as and when required, antihistamines such as loratadine or cetirizine may be recommended. If the patient’s symptoms appear to be more frequent, consider recommending an intranasal corticosteroid as a preventative measure. It is important to counsel the patient on how to use this treatment effectively. Taking an oral antihistamine in addition to an intranasal corticosteroid will provide more rapid relief from symptoms than waiting for the preventative treatment to take effect.

Intranasal decongestants are not recommended for regular use, because of the risk of developing rebound congestion. Explain to the patient that using a decongestant for longer than seven days should be avoided.