OTC SURVEY - WHAT PHARMACISTS PRESCRIBE

IRA P. SCHNEIDERMAN

Customers are most likely to seek the recommendation of a supermarket pharmacist when it comes to choosing a product for indigestion or diarrhea, compared with other gastrointestinal ailments. Pharmacists recommend a liquid or effervescent antacid an average of 8.5 times a week and a diarrhea remedy 7.8 times.

Of products used to treat oral health conditions, supermarket pharmacists were most likely to recommend a fever blister/cold sore product, doing so an average of 5.7 times weekly.

These were some of the major findings of a national survey conducted by Supermarket Pharmacy on gastrointestinal and oral care products recommended by supermarket pharmacists. This is the second-annual study covering these two product categories, allowing for comparison with last year's results. Three more survey installments covering other OTC categories are planned for later this year.

A questionnaire was mailed to 800 pharmacists working in food stores, with 185 surveys returned, for a 23% response rate. Forty-four percent of the respondents were pharmacy managers, with the reminder split between chief and staff pharmacists.

Respondents were drawn from both large and small-volume chains. Almost half of the respondents (49%) were from supermarket chains with more than $1 billion in annual sales; 26% were from chains with between $50 million and $1 billion in annual sales, and 5% were from chains with less than $50 million in sales.

Other categories in which pharmacists frequently make product recommendations include: antacid tablets, 6.4 recommendations per week; laxatives, 5.3 recommendations weekly; anti-flatulents, 5.2 times; fiber supplements, 4.4 times, and canker sore products, 3.8 weekly recommendations.

Supermarket pharmacists' preferences for specific OTC medications have not changed much since last year's survey.

All of the brands ranked first in 1993 in pharmacist recommendations for gastrointestinal and oral care products maintained their leadership positions. The percentage of recommendations for gastrointestinal products varied by no more than 7%, plus or minus, compared with last year's survey. Oral care was only slightly more volatile.

Surprisingly, store brands made no inroads during the past year in either category in terms of pharmacist recommendations, and even lost share in two categories. Among gastrointestinal products, store-brand fiber supplement recommendations lost ground to brands and dropped out of the top-three rankings. Although store brands garnered 6% of last year's anti-plaque rinse recommendations, they were pushed out of the top-three rankings in this year's survey.

This year pharmacists were also asked how far product displays for gastrointestinal and oral care products are from the pharmacy. The average for gastrointestinal products was 22 feet 4 inches. Oral care products were farther away from the pharmacy, an average of 28 feet 6 inches.

The importance of having OTC product displays near the pharmacy was underscored by a chief pharmacist who wrote, "When OTC was located near pharmacy, we made 20 times the recommendations, and they were followed in most cases."

Supermarket pharmacists report that, on average, almost 60% of gastrointestinal product sales are based on their recommendations. Pharmacists' recommendations for diarrhea remedies account for the highest proportion of sales, 64.5%, with 63.5% for antiflatulents, followed by laxatives, 56.2%, antacid tablets, 56%, antacid liquids/effervescents, 55.9%, and fiber supplements, 51.8%.

Supermarket pharmacists' influence was somewhat less for oral care products, accounting for 61% of canker sore product sales, according to pharmacists, followed by 58% of sales of fever blister/cold sore products, 55% of oral anti-septic cleansers, and 49% of anti-plaque rinses, for an average of 55%.

Pharmacists' reasons for their product choices were nearly the same as they were last year. Product factors for gastrointestinal products were, in order of ranking: product quality; confidence in manufacturer; previously a prescription item; professionally promoted; prices/buying terms; profit margin, and finally, advertised on TV. The one change was that "profit margin" moved up to sixth place, displacing "advertised on TV." Product factors for oral care, in rank order, were: product quality; confidence in manufacturer; prices/buying terms; professionally promoted; previously a prescription item; profit margin, and advertised on TV.

Emphasizing the importance of product quality in making such recommendations, one pharmacist wrote on the questionnaire: "The single most important reason for recommendations is knowing that patients will be satisfied with the promised results."

Other pharmacists expressed similar opinions: "The most important factor is whether the product will work," wrote one. Another agreed: "The main reason why I choose a product is if it works or not. You can't replace pharmacological sense with advertising or promotion."

Four out of six pharmacists reported that space allocations for gastrointestinal OTC products increased from 1992 to 1993, though more than half maintained current space. Two-thirds of respondents said their stores made no change in space allocations for oral care OTC products in the last year, while nearly a quarter (24%) said they increased space.

Gastric Distress

Pharmacists were significantly more likely to recommend antacids and diarrhea remedies than fiber supplements.

NUMBER OF RECOMMENDATIONS PER WEEK

Antacid liquid 8.5

Diarrhea remedy 7.8

Antacid tablet 6.4

Laxative 5.3

Antiflatulent 5.2

Fiber supplement 4.4

Speaking of Oral Care

Pharmacists were most likely to recommend fever blister/cold sore products.

NUMBER OF RECOMMENDATIONS PER WEEK

Fever blister/cold sore product 5.7

Canker sore product 3.8

Oral antiseptic cleaning agent 3.2

Anti-plaque rinse 2.6

GASTROINTESTINAL PRODUCT RECOMMENDATIONS

Following is a breakdown of the over-the-counter gastrointestinal products survey respondents said they recommended. Half of the respondents were pharmacy managers, with the remainder split between chief pharmacists and staff pharmacists.

% of Pharmacists % change

Who Recommend from '93

Antacid Liquid

Mylanta 50% -4

Maalox 31.9% -0.1

Gaviscon 7.2% 1.7

Other 10.9% 2.4

Diarrhea Remedies

Imodium A-D 88.6% 3

Pepto 3.4% 1.5

Kaopectate 2.3% -2.5

Donagel 2.3% -3.9

Other 3.4% 2

Antacid Tablets

Mylanta 37.8% 1.8

Maalox 22.4% -1.9

Tums 22.4% 2.8

Other 17.4% -2.7

Laxatives

Dulcolax 29.1% -7.4

Doxidan 13.5% 2.2

Metamucil 10.8% 7

Colace 10.1 -0.1

Other 36.5% 8.9

Anti-flatulents

Mylicon 33.4% -6.1

Mylanta 24.8% 3.3

Gas-X 18.8% 5

Other 23% -2.3

Fiber Supplements

Metamucil 54.9% 3.2

FiberCon 29.2% 1.9

Citrucel 10.4% 3.6

Other 5.5% -8.7

ORAL CARE PRODUCT RECOMMENDATIONS

Following is a breakdown of the over-the-counter oral care products survey respondents said they recommended.

% of Pharmacists % change

Who Recommend from '93

Fever Blister/Cold Sore Products

Carmex 30% 1.1

Zilactin 23.5% 4.9

Herpecin 11.8% 1

Campho Phenique 8.2% -2.6

Other 26.5% -4.4

Canker Sore Products

Orabase B 24% -1.5

Cankaid 16.4% -3.1

Zilactin 14% 3.5

Gly-Oxide 12.9% -0.6

Other 32.7% 1.7

Oral antiseptic cleansing

Gly-Oxide 31.5% 2.8

Peroxyl 19.7% -12

Listerine 18.1% -0.2

Other 30.7% 9.4

Anti-plaque Rinses

Plax 57.5% -14.9

Listerine 12.5% 4.7

Act 11.2% 6.9

Viadent 6.3% 1.1