Eye and Earcare

It's easy to overlook eye and earcare in favour of larger categories. After all, their combined value of just over £80 million1 is just a fraction of larger markets, such as analgesics and oral care.

But, despite their size, both categories are registering value growth and also offer some unique selling points for pharmacy. As our analysis of the categories' strengths, weaknesses, opportunities and threats shows, they're an area that contractors cannot afford to ignore.

Strengths

Chloramphenicol proves competitive advantage

Both the eye and earcare categories have grown in value in pharmacies,2 data from market research company IRI shows. Earcare registered value growth of 2.2 per cent in the year leading up to December 2013, while eyecare performed more modestly with growth of 0.9 per cent, bolstered by the return of the full GoldenEye range to the market.

But this trend was at least as apparent in supermarkets, so what are the particular strengths for pharmacy? Pharmacy-only products, of course, offer an obvious advantage. Numark says eye and earcare lines can offer a surprising amount of revenue. "Among Numark members, eyecare is the fourth largest sub-category within the P medicine section, taking 5.4 per cent of the category," the group's director of marketing Lynne Armstrong tells C+D. "It is larger than sleep and women's health."

• Eyecare is 75p more expensive in pharmacies than in supermarkets

• Earcare value grew four times faster in supermarkets than pharmacies last year

• Own label is the second best-selling "brand" in eyecare

Being able to supply chloramphenicol has proven a particular benefit, says Tehmena Farhat, manager of the Midcounties Co-operative Pharmacy's branch in St John's, Walsall. "That's been really good for us in pharmacy since [customers] can have that without going to the GP," she reports.

Advice, as always, is another key selling point of pharmacies over their supermarket competitors. Most customers with eye and ear complaints are looking for a recommendation rather than to simply select a product from the shelf, says Ms Farhat. "I don't know many people who come in and request a particular brand," she explains. "They say, ‘I've got these symptoms, what can you give me?'."

Weaknesses

Unfavourable price comparisons

Unsurprisingly, price is a weak point for pharmacies. IRI data shows supermarkets3 sell eyecare products at an average price of £3.84, compared to an average pharmacy price of £4.59. The price difference is less pronounced in earcare, but pharmacies are still 27p more expensive overall.

Pharmacies may not be able to compete with supermarkets on price, but they can tailor their stock to cater for local needs. Midcounties Co-operative's Ms Farhat recalls stocking one eye spray in her Walsall pharmacy that was generating interest through advertising, only to lose interest at the selling point. "Although the technology was innovative, it was just too highly priced for the everyday person," she remembers.

• Cerumol, Earol and Care brands showed strongest growth in earcare

• GoldenEye and Murine drove eyecare growth last year

Numark's Lynne Armstrong suggests capitalising on the popularity of own brands. "In the past year, Numark-branded eyecare products have grown 11 per cent in the GSL sector and a staggering 32 per cent in the P sector excluding chloramphenicol eye drops, which had a national supply issue," she reveals. "Own-label equivalents should be positioned directly next to their branded counterpart to offer customers choice and a value alternative."

Ms Armstrong says merchandising often proves a weak point for the eyecare category in particular. "As a category, eyecare is probably one of the most under-promoted in pharmacy and yet, for customers, a pharmacist is possibly one of the most common destinations for advice when they have an eye irritation or issue," she points out.

Opportunities

Merchandising potential is yet to be realised

The current lack of merchandising around eye and earcare presents an opportunity for contractors who are keen to promote the categories. Promotional activity can work well around the peak summer season, when Ms Farhat reports a "lot of products" are sold.

In eyecare, sales tend to peak between May and July and Ms Farhat caters for the upturn in allergy-related conditions. "When hayfever is starting, we try to make [the products] more prominent on the shelf edges so they stand out more," she says. Reckitt Benckiser, manufacturer of leading eyecare brand Optrex, suggests focusing on itchy eye treatments during this period, either by placing them on additional display or on the counter itself.

Best-selling brands

Eyecare

1 Optrex 2 Own label 3 Blink 4 GoldenEye 5 Murine

Earcare

1 Otex Express 2 Cerumol 3 Cirrus Air Technologies 4 Earex 5 Earol

Once eyecare season is over, then it's time to focus on earcare, which reaches its sales peak in July and August. During this time, Ms Armstrong advises stocking brand leader Otex alongside traditional ear wax treatments such as olive oil.

There is also an opportunity to link sell to the supplements category, says Rohit Narayan, an optometrist at Boots' Nuneaton branch. He names Omega-3 as a "cure-all", as it can reduce inflammation in the eye and reduce the likelihood of macular degeneration. Keratonids, especially lutein, can also help prevent the "wear and tear" that contributes to macular degeneration, he says.

Threats

Supermarkets are stealing share

Supermarkets pose an obvious threat and are growing their share in the earcare market more rapidly than pharmacies. Value sales have shot up by 9 per cent in supermarkets over the past year, compared to just 2.2 per cent in pharmacy.

When it comes to eyecare, there's little difference between the two, but competition is tough at a time when volume sales of eyecare are actually in decline – showing a 1.7 per cent fall in the past year.

Pharmacies can fight back by playing to their strengths of pharmacy-only medicines and advice, as well as capitalising on the opportunities for merchandising and link sales. Investing in eyecare should reap rewards for the future, says Cambridge Healthcare, suppliers of the Golden Eye brand. It believes PR campaigns such as National Eye Health Week, which began in 2010 and will run from September 22 to 28 this year, are working to raise the profile of eye health.

"Public awareness of the importance of eyecare can only increase the performance of the sector over the coming year," forecasts the company. "Pharmacists are the main direct contact point with the public so are fundamental to the continued growth of the category."

References: 1. Unless specified otherwise, all quoted data is provided by IRI (value sales, 52 weeks to November 30, 2013). 2. Pharmacies excluding Boots and Superdrug. 3. Including Boots and Superdrug.

Case study: Should you supply chloramphenicol as a precaution?

A customer is going on holiday and wants to buy chloramphenicol eye drops in case he gets an eye infection after swimming. He has taken them before and they have helped.

What should you do?

Leyla Hannbeck, head of pharmacy services, NPA

Chloramphenicol eye drops and ointment are only indicated in the treatment of acute bacterial conjunctivitis and should not be sold over the counter as a precautionary measure.

Instead, the customer should be advised to wear goggles and to use lubricating eye drops if required. Infective conditions of the eye are usually self-limiting and do not normally require treatment with antibiotics.

If the customer does develop an eye infection after swimming, he should be advised on good eye hygiene, such as removing contact lenses, washing hands regularly and gently cleaning away sticky discharge. Lubricant eye drops can also be used to help ease soreness and stickiness in the eyes.

Expert comment

‘Dry eyes can indicate a wide range of conditions'

Dry, gritty eyes are the most common complaint that pharmacists come across. But not all cases are treatable with a straightforward dose of hypromellose drops, explains Rohit Narayan, optometrist at Boots, Nuneaton.

"There are two types of dry eye – the more common form is evaporative dry eye, when the tears aren't lasting long enough, and the other form is tear deficiency, when you don't make enough tears."

Artificial tears are the first line of therapy in patients with dry eye. In cases of evaporative dry eye, a lipid replacement artificial tear is more appropriate. "Maybe try one or two treatments and, if that doesn't work, suggest visiting a local optometrist," Dr Narayan advises.

Of course, if it's a problem that only occurs in the spring and summertime and is accompanied with a complaint of itching, this indicates that it's more likely to be an allergy and is best treated with an antihistamine eye drop.

Patients complaining of dry, sore eyes could also be suffering from blepharitis – inflammation of the eyelid margin. Dr Narayan says this is ideally diagnosed by an optometrist, but can be easily spotted by a pharmacist.

"The patient often complains of a burning, sore sensation rather than grittiness," he says. There are also visible signs. "Generally the eye lid margin will look inflamed and a bit crusty – you may actually see what looks like flakes of dandruff on the eyelash," Dr Narayan explains. In this case, Dr Narayan recommends warm compresses coupled with lid preparations specifically designed to treat the condition.