The Covid-19 pandemic has had a drastic effect on the OTC market so the call for a national strategy on self care, building on the Community Pharmacist Consultation Service, is timely, says Jeremy Holmes.

Community pharmacy should draw confidence from how it has responded to the pandemic and the level of appreciation patients have shown — but the future of the OTC market hangs in the balance if changed shopping habits become the norm post-Covid. 

While some categories, such as multivitamins and sleep aids, blood pressure monitors and oximeters, have done very well, there is a big question mark over pharmacy footfall, says Janice Perkins, superintendent pharmacist at Well.

Some categories – such as home delivery and online provision – obviously work against that and Perkins says some patients are hesitant to spend time in the pharmacy, especially in a consultation room. New medicine service consultations over the phone may exacerbate the footfall challenge even when other things return to normal, she says.

Supermarket threat

Roger Scarlett-Smith, UK president at Thornton & Ross, agrees saying many patients are now limiting their shopping expeditions so may decide to buy all their OTC and other health products at the supermarket, although there is no sign of trading down to cheaper versions. 

Thornton & Ross has seen double digit growth of natural supplements and triple digit growth of Zoflora disinfectant, and Scarlett-Smith believes there has been a real shift to greater awareness of health maintenance issues. He thinks Covid is a “habit-changing event” which has prompted that, and the shift is sustainable over the longer term.

That may be good news for the OTC market as a whole, but what does it mean for pharmacy? Is it now most people’s first port of call for minor ailments, given how difficult it is to see any other health professional in person? Or is pharmacy losing out in a big way to supermarkets in the OTC space? 

The market for products such as cough and cold remedies, head lice and travel sickness, which have all taken a dip, will come back... but will they come back to pharmacy? Boots reported a 2.5 per cent increase in pharmacy sales over September- November 2020, but that was mainly due to the timing of NHS reimbursement, and the multiple said there was a reduced demand for pharmacy services. The rise of one-stop grocery shopping means it has lost market share in all categories except beauty.

Leyla Hannbeck, chief executive officer at the Association of Independent Multiple Pharmacies, confirmed OTC sales at Christmas for many of her members were lower than the previous year, while Deborah Evans, who works in a village pharmacy in Hampshire, says she has seen OTC sales “drop off a cliff ”. Many of the measures pharmacies put in place to support and protect their patients – such as home deliveries and screens in-store – actually work against OTC sales, she says. 

Patients are now very specific about what they want when they come into the pharmacy, says Evans, who thinks their shopping habits may have changed for good. She doesn’t see any real increase in health awareness and feels that it will be very difficult for pharmacy to regain the OTC market it is losing.

Silver lining 

Donna Castle of the PAGB thinks there may be a silver lining for pharmacy self care coming out of the pandemic, having seen only modest rises in OTC sales prior to Covid-19. The PAGB reported last August that almost a third of people (31 per cent) who wouldn’t normally consult a pharmacist as their first option said they would now be more likely to do so. The report also supported pharmacists having appropriate access to patients’ medical records, and the enabling of referrals in and out of pharmacy. 

In October there was a Covid-19 Clinical Consensus Statement on Self Care by the PAGB, CCA, NPA, PSNC, Royal College of Nursing, NHS Clinical Commissioners and the Self Care Forum. This called for a national strategy on self care, building on the Community Pharmacist Consultation Service.

One argument put for such a strategy is its potential to reduce pressure on the NHS, which is critical right now and for the foreseeable future. Pharmacy could be central to that strategy but it is clear the sector will have to work hard to secure its share of any resurgent growth in the OTC market.