It's been called "one of the worst in recent memory." But could direct-to-consumer be more appropriate in describing the current flu season?
Retailers polled by SN presented their views on the season. They attempted to shed some light on whether or not the "worst" perception is purely hype created by marketing and direct-to-consumer advertising, especially by the manufacturers of two new prescription flu drugs -- Tamiflu, produced by Nutley, N.J.-based Hoffman-La Roche and Relenza, marketed by Glaxo Wellcome, Research Triangle Park, N.C.
Most confirmed that consumer demand for all flu products has been big this season with prescriptions in particular up.
"A couple of stores have mentioned that they're out of Relenza and can't get it in," said John Rupert, pharmacy supervisor, A&P's Farmer Jack Division, Detroit. "McKesson's telling me the 'manufacturer can't supply'."
Mike Halliwell, pharmacy coordinator for Balls Food Stores, Kansas City, Kan., told a similar story. "We're having a very difficult time getting the drugs in stock," he said. "The problem basically is that because there's such a high demand for the new drugs, the different manufacturers weren't ready. Thus, they're out of stock all the time. It's mainly been Relenza."
"They're blowing them out of the store," said Paul Schneider, director of pharmacy operations for Middletown, N.J.-based Food Circus Supermarkets. "We can't get enough."
While the media has been reporting epidemic outbreaks of flu around the country, the reality of the situation is probably near normal, said retailers and the U.S. Centers for Disease Control and Prevention, Atlanta. Rupert observed that the season itself in terms of the actual number of flu cases may not be all that much bigger than in prior years. "I wouldn't say it's any more than normal," he stated. "People are looking at the market and seeing that there are products they can use. So people are turning to their physician more than they have in the past."
Two weeks ago the Centers for Disease Control reported that the frequency of flu sickness does not seem to be greater or more serious than in previous years. "But we are getting many more media calls about the flu than usual," said spokesman Tom Skinner for the agency.
Retailers partially attributed the current state of the cold/flu season to successful marketing of Tamiflu and Relenza. The campaigns being waged to publicize the two drugs have been estimated at $50 million, according to media reports. It's been reported that Roche is sending out press releases to local reporters around the country about outbreaks of flu in their area. In New York City earlier this month, Roche representatives were handing out freeze-dried chicken soup on street corners with the message that "Grandma's chicken soup may be good for symptoms of the flu, but a new drug, Tamiflu, can disable the virus."
Such promotional campaigns may have prompted the the U.S. Food and Drug Administration to issue a warning this month urging patients and doctors caution in recommending and taking drugs to combat colds and flu. The new class of antiviral agents, Tamiflu and Relenza, are known as neuraminidase inhibitors, which stop the spread of the flu virus. "The FDA has received several reports of patients with serious bacterial infections who initially had influenza-like symptoms and whose bacterial infection progressed during treatment with antiviral drugs alone," the FDA advisory said. Antiviral products have no affect on bacterial infections.
Since Relenza, approved last July, was on the market first it has a head-start advantage. Retailers reported more prescriptions for it over Tamiflu, released in October. "Tamiflu didn't get the marketing play that Relenza got early on," said Rupert. "There's not as much customer awareness of Tamiflu."
"Relenza has really been the big one that doctors in our area have been writing for," said Halliwell.
According to Schneider, however, it's "mostly the Tamiflu." Asked why he believed the drugs are so hot, he said, "Promotion to physicians and consumers."
In West Sacramento, Calif., Jody Stewart, director of pharmacy operations at Raley's & Bel Air Supermarkets, there, noted the form in which the two medications are available. "They're both getting quite a bit of coverage and quite a few hits. I would think that people would be more inclined to take the Tamiflu because it's a tablet rather than taking an inhaler -- just because it seems like it would be easier." Some industry observers have also noted this issue.
IMS Health, the Plymouth Meeting, Pa. firm that tracks prescription volume, puts Relenza a few lengths ahead in sales. For the quarter ending Dec. 31, 1999, total prescriptions for Relenza reached 216,304. For Tamiflu during the same period, the number was 159,907.
Tamiflu may be narrowing the gap, however, as awareness of the drug increases. The last week of December, Tamiflu prescriptions surpassed Relenza scripts in number -- 77,677 for Tamiflu compared to 74,492 for Relenza.
Although they acknowledged there was the potential for the two new prescription medications to affect the over-the-counter market, several retailers said they have not observed it due to the cost of the new drugs, which retail between $45 to $50. "Maybe a little but I don't think significantly," said Halliwell. "The people who are buying are still getting your traditional cough and cold medications in addition." Schneider agreed. "I don't think anybody's going to use it unless they have a third-party prescription plan because it's so expensive."
Retailers said that although sales of the prescription flu drugs have been strong, other remedies have also been hot. And the whole-health marketing strategy has played a big part, they said. Retailers frequently mentioned echinacea, vitamin C and zinc products as selling well.
"We've set up a complete cold and flu headquarters in our store, in which we have all the popular national brands but we also carry all of the alternative homeopathic and natural products," said Schneider, whose chain has been moving in the direction of whole health for a year-and-a-half now. He said the natural supplements and homeopathics have been selling well. "We've been selling all the things we would be selling for flu, especially a lot of homeopathic products like Oscillococcinum (from Boiron), lots of echinacea and products by Tom's of Maine."
Said Halliwell, whose stores contain the Hen House Naturals whole-health destination, "We're putting displays out on our pharmacy counters to get people aware of the different health and natural items that are used for cough and cold." He mentioned Phyto-Pharmica EchinaCare, zinc lozenges.
