OTC SURVEY 1994-09-19

IRA P. SCHNEIDERMAN

Pharmacists continue to recommend analgesics for over-the-counter use, although not quite as often as they did a year ago. Store brands are gaining the confidence of pharmacists, as are some new products.

Pharmacists recommend diagnostic test kits less than half as often as analgesics, but these recommendations account for a larger portion of the sales of these big-ticket items. Pharmacists are making more recommendations of test kits. Most also favor OTC availability of a test to detect the presence of HIV, the virus that causes AIDS, though no such test has been approved for marketing.

These were some of the major findings of a national survey on analgesics and diagnostic products recommended by supermarket pharmacists conducted by Supermarket Pharmacy. Results are compared with the results of a similar study published last year.

A questionnaire was mailed to 800 pharmacists working in food stores for a 22% response rate. Forty-three percent of the respondents were pharmacy managers, 21% were chief pharmacists and 33% were staff.

A majority (55%) of pharmacists responding to the survey work in a supermarket chain with sales of more than $1 billion. Another third of responses were from chains with sales between $50 million and $1 billion. Chains with sales of less than $50 million made up 11%, with independents accounting for the balance.

Pharmacists say they recommend an adult analgesic an average of 15.4 times a week, down from the 19 times reported in last year's survey. Pharmacists also frequently recommend a headache remedy, 11.5 times a week, down from 14; pediatric analgesic, 11.2 times down from 13.5; arthritis pain remedy, 10.5 times, down from 14.2; external analgesic, 6.7 times, up slightly from 6.6; and aspirin to prevent heart attack, 6.6 times, down from 7.2.

Of all analgesic purchases, the pharmacist's recommendation is the most influential for aspirin to prevent heart attack, with such recommendations accounting for 56.4% of sales of these products, according to pharmacists. In terms of specific analgesic brands, pharmacists continue to favor Tylenol as a general-purpose analgesic, accounting for 24.4% of recommendations.

Among headache remedies, Tylenol again leads with 28.9% of recommendations, down from last year's 36.4%. Tylenol continues to dominate recommendations for pediatric analgesics, with 62% of recommendations.

Advil gained in recommendations of arthritis remedies to 23.4%, while other ibuprofens declined. Aleve, marketed only for a month or so before this survey was conducted, made a strong showing, tallying 18.9% of recommendations.

Among external analgesics recommended, Ben-Gay nosed out Myoflex for the top spot, with 21.1% of recommendations.

Pharmacists continue to favor Bayer when recommending low-dose aspirin to prevent a heart attack, which led with 24% of recommendations.

When it comes to diagnostic products, pharmacists receive the most questions concerning pregnancy test kits. Pharmacists say they recommend a pregnancy test kit 5.9 times a week. The next most frequent recommendations are for diabetes screening test, 3.1 times weekly.

Pharmacist recommendations influence the purchase of half to two-thirds of diagnostic test kits, say pharmacists. Pharmacist influence is greatest concerning tests for urinary tract infection, with recommendations accounting for 72.6% of sales, followed by blood glucose meters, 66.9%.

EPT nudged out Clearblue Easy to be the top pregnancy test recommended by supermarket pharmacists, garnering 31.4% of recommendations. Biotel continues to lead in pharmacist recommendations among diabetes screening tests, with 36.4%.

One Touch still dominates the blood glucose meter recommendations, with 40.2%, although the gap has narrowed with Accu-Chek gaining 30.8%.

Sunbeam is the preferred manufacturer of blood pressure monitors, with 23.9% of recommendations.

Among ovulation predictor tests, First Response widened its lead to 29.4%. Clearplan Easy also gained to 27.5%. Selfcare Bioself, a new fertility indicator, garnered a surprising 9.8% of pharmacist recommendations after less than a year on the market.

Another new product, Advance Care, took 71.9% of pharmacist recommendations for cholesterol screening tests, a new category in this year's survey.

Pharmacists had the most to say about a test that is not yet on the market, a test to detect the presence of HIV, the virus that can lead to AIDS. A majority, 62.1%, favor OTC availability of such a test vs. 37.9% who do not.

Comments from pharmacists who favor an OTC test: "Early detection could result in better treatment." "It is a must for the 1990s for people to check themselves in a private home setting."

Some pharmacists added the test kit should be sold only in pharmacies. "No exceptions. Patients need counseling," wrote one pharmacist. Another pharmacist offered an additional reason for keeping such a kit behind the pharmacy counter, "otherwise [it would be a] shoplifter's paradise."

Most pharmacists who responded "no" to OTC availability of a HIV test explained they were concerned the test might not be completely accurate, or could be improperly used, and that any false positive or false negative results could have dire consequences. Many felt that professional counseling needs to immediately follow a positive test result. Some also said an OTC test would make it impossible for the U.S. Centers for Disease Control to track the spread of HIV.

Ironically, a few pharmacists cited lack of privacy as a problem, explaining someone could be seen in the supermarket purchasing the test. Despite the importance of pharmacist recommendations to both categories, some pharmacists say product placement makes it hard for them to offer advice . "Most test kits are in the aisles away from us," wrote one pharmacist. Some pharmacists also say their efforts to make recommendations and advise customers are not necessarily appreciated by store and supermarket management.

"Although we spend considerable time assisting customers with their Rx-to-OTC purchases, management does not always appreciate our contribution to the whole store," penned one survey respondent. The seriousness with which pharmacists make their recommendations was evident in this comment: "The perfect recommendation fits the product to all factors at the time. Product recommendations could vary, based on patient experience, allergies, cost factors and other medications."

Analgesic Product Recommendations

Following is a breakdown of the analgesic products that survey respondents said they recommend. Percentages labeled "other" include those pharmacists who say they have not recommended products in this category.

PERCENTAGE OF PHARMACISTS WHO RECOMMEND

% CHANGE

FROM '93

ADULT ANALGESICS

-7.6 Tylenol 24.4%

9.3 Store brand 23.6%

3.9 Advil 15.7%

-3.2 Ibuprofen 15%

-2.3 Other 21.3%

HEADACHE REMEDIES

-7.5 Tylenol 28.9%

16.1 Store brand 25.4%

6.2 Ibuprofen 7%

3.2 Percogesic 7%

2.6 Execedrin 7%

-8.2 Other 24.7%

PEDIATRIC ANALGESICS

-16.5 Tylenol 62%

10 Store brand 17%

-0.3 Acetaminophen 11%

6.8 Other 10%

ARTHRITIS PAIN REMEDIES

3.6 Advil 23.4%

-12.9 Ibuprofen 19.8%

5.9 Store brand 19.8%

NA Aleve 18.9%

-15.5 Other 18.1%

EXTERNAL ANALGESICS

9.5 Ben-Gay 21.1%

-4.7 Myoflex 17.9%

4.3 Flex-All 454 14.7%

-9.1 Other 46.3%

ASPIRIN (to prevent heart attack)

.1 Bayer 24%

11.9 Store brand 20.7%

7.8 Ecotrin 18.5%

-1.7 Halfprin 14.1%

-18.1 Other 22.7%

Space for Pain Remedies

More than three-quarters of supermarkets increased the space allocated to analgesics between 1993 and 1994.

Increased 79%

Decreased 3%

Remained the same 18%

Common Advice for Common Pain

Consumers frequently seek advice from pharmacists about analgesics. The survey found that recommendations account for half of all analgesic sales.

NUMBER OF RECOMMENDATIONS PER WEEK

Adult Analgesic 15.4

Headache Remedy 11.5

Pediatric Analgesic 11.2

Arthritis Pain Remedy 10.5

External Analgesic 6.7

Aspirin (for heart attack) 6.6

Diagnostic Test Kit Recommendations

Following is a breakdown of the diagnostic test kits that survey respondents said they recommend. Percentages labeled "other" include those pharmacists who say they have not recommended products in this category.

PERCENTAGE OF PHARMACISTS WHO RECOMMEND

% CHANGE

FROM '93

PREGNANCY TEST KIT

1.3 EPT 31.4%

-5.3 Clearblue Easy 29.4%

4.3 Fact Plus 8.8%

-0.3 Other 30.4%

DIABETES SCREENING TEST

17.4 Biotel 36.4%

3.9 Chemstrip 18.2%

6.3 TesTape 18.2%

NA Clinitest 9.1%

-36.6 Other 18.1%

BLOOD GLUCOSE METER

-8.4 One Touch 40.2%

8.9 Accu-Chek 30.8%

2.8 Glucometer 15.9%

1.5 Exactech 3.7%

-4.8 Other 9.4%

BLOOD PRESSURE MONITOR

6.8 Sunbeam 23.9%

4.3 Marshall 14.9%

3.6 Lumiscope 13.4%

-8.1 Omron 9%

-6.6 Other 38.8%

OVULATION PREDICTOR TEST

7.5 First Response 29.4%

8.7 Clearplan Easy 27.5%

NA Selfcare Bioself 9.8%

-13 Ovu Quick 7.8%

-13 Other 25.5%

URINARY TRACT INFECTION TEST

18 Biotel 69.6%

-18 Other 30.4%

CHOLESTEROL SCREENING TEST

NA Advance Care 71.9%

NA Biotel 3.1%

NA Other 25%

To Test for HIV

Should a home test that could detect presence of the virus that can lead to AIDS be available for OTC purchase?

Yes: 62.1% No: 37.9%

Kit Recommendations: Few but Compelling

Pharmacists are asked for advice about slow-moving, high-ticket diagnostic kits far less frequently than other OTC items, but these recommendations account for half to two-thirds of sales.

NUMBER OF RECOMMENDATIONS PER WEEK

Pregancy 5.9

Diabetes Screening 3.1

Blood Glucose 3

Blood Pressure 2.3

Ovulation Predictor 2

Cholesterol Screening 1.9

Urinary Tract Infection 1.1

Diagnostic Test Kit Space Allocation

A majority of supermarkets increased space given to diagnostic test kits between 1993 and 1994.

Increased 61%

Decreased 2%