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With a variety of analgesics available, from NSAIDs to paracetamol-based products, and a whole host of ‘extra’ and ‘plus’ labelled compounds, the analgesics market is pushing back the pain barrier. And this could be thanks to changes in the way we buy analgesics – research shows that shoppers bag around nine packets of analgesic treatments over an average of six shopping occasions per year.

The UK analgesics category is valued at £505 million and makes up 23 per cent of over the counter (OTC) sales. ‘Adult oral analgesics’ is the largest category sector, with £354 million in sales. This should come as no surprise, with the British Pain Society reporting that 10 million people in the UK are in pain every day. A recent survey for Mentholatums Deep Heat reveals that six out of 10 people rely on pain relief for regular aches and pains.

As this market grows with more product choices, so do its complexities and the call for pharmacy staff to be well equipped with the right support and resources.

Quick access

The OTC analgesics category seems to be addressing the need for ‘quick access’ information and training in pain management for pharmacy staff. Reckitt Benckiser (RB), manufacturer of Nurofen, focuses on pain management in its new online portal for community pharmacy staff, https://rbforhealth.co.uk/. The portal has been built for easy access and includes training modules and videos.

There is a clear section on ‘understanding headache’, with learning objectives for headache management and helping headache patients, and a section on appropriate OTC medicines use. Mark Pearson, RB category marketing director, explains: “We want to deliver a resource that meets the needs of the pharmacy community but it also means that patients get the best advice they can. It gives access to the views of patients, experts and other community pharmacists, meaning that it can be a unique resource for use in the pharmacy. We hope that we can start addressing some of the gaps that community pharmacists have identified in training and help them improve their businesses through product, as well as wider business, knowledge.”

The new portal follows RB’s ‘Breaking the Pain Barrier’ initiative for pain management, launched in March 2013 to educate pharmacy staff. Mr Pearson says: “Breaking the Pain Barrier was part of what we see as a fundamental focus on education and training about pain and pain relief. It is designed to start a conversation that can lead to better pain relief management for patients in the UK.”

More pain relief learning resources come from GlaxoSmithKline (GSK) as part of its mypharmassist.co.uk package. ‘What a Relief’ modules help pharmacy assistants understand different types of pain, the ingredients found in OTC analgesics, and help them ask the right questions before recommending products. Sarah Peel, marketing manager for allergy, cold and flu, and pain at GSK Consumer Healthcare, emphasises this vital role: “Consumers often go to a pharmacy for advice and support about painful conditions, such as headaches, back pain and toothache. It is extremely important for pharmacy staff to ask questions to ensure that they make a suitable recommendation to relieve the pain,” she says.

Ceuta Healthcare follows suit with a new support pack for pharmacists, inspired by migraine treatment Imigran Recovery. It includes a flowchart reference tool for staff, a training module called ‘Managing Migraine’ accredited by the National Pharmacy Association, and a consumer booklet endorsed by Migraine Action called ‘Don't be in the dark about migraine’.

Medicines traffic wardens

Independent community pharmacist and English Pharmacy Board member Sid Dajani says the Ceuta support pack is important for pharmacists in their role as “medicines traffic wardens”. He says: “There is no one out there refreshing pharmacists’ memories about migraine or training support staff about presenting conditions, or treatments and lifestyle changes that can cause and help migraine. Many pharmacists also need training around migraine as a condition and when to counter prescribe for it.”

Mentholatum, the UK’s biggest topical analgesics manufacturer, responsible for Deep Heat, Deep Freeze, Deep Relief and Deep Heat Muscle Rescue, has produced a new pharmacy leaflet for staff called ‘Topical Pain Relief’. Senior product manager for topical analgesics at Mentholatum Lynn McGinness explains that it is important for pharmacists and counter staff to keep their knowledge up to date: “The key is to offer confident, professional advice tailored to the individual patient.” Good signposting and informative POS material also help direct customers to the appropriate products for their individual needs, she says.

“When people are self-selecting they may be baffled by the range of topical products which can be used to help relieve pain. As well as the different formats – such as gels, creams, rubs, sprays, pads and patches – they may be faced with a display offering warming products, freeze products and topical NSAIDs, so it’s not surprising that they often need guidance on which to choose for their particular needs.”

Painful facts

• 25 million work and school days are missed every year because of headache and migraine (World Health Organisation)
• 4.9 million workdays are lost due to back pain (TUC)
• 48 per cent of all UK adults who suffer from pain have experienced headaches and 54 per cent have experienced back, neck or muscle pain (YouGov Study for GSK)
• Women are more likely to suffer from general aches, pain, cold or flu (YouGov Study for GSK)
• Two out of five pain sufferers do not discuss pain with their GP (Deep Relief survey) </box>

 The year 2013 was a busy one for RB’s number-one-selling analgesic brand, Nurofen, with the launch of a topical range in March and a cold and flu range in September. The newly packaged Nurofen Cold and Flu range kicked off with a £3.5 million TV campaign last October, advertising the GSL adult range containing 5mg of phenylephrine and 200mg ibuprofen. The range also has a pharmacy only ‘maximum strength’ line containing ibuprofen and pseudoephedrine. The Nurofen for Children Cold, Pain and Fever treats infants aged from three months to nine years.

Mr Pearson sees potential cross-category growth: “With 27 per cent of cold and flu sufferers reaching for an analgesic for their cold and flu this is a massive opportunity for Nurofen and for retailers. At RB we anticipate that our new range, which is on target to deliver against customer need, and our promotional strategy could see Nurofen grow the cold and flu category by £3 million (+4 per cent) and the kids’ pain category by £0.5 million (+1 per cent) in the 2013/14 season, which is really exciting.”

Panadol advances

Panadol – GSK’s paracetamol brand – is another example of new product development driving growth. The Proprietary Association of Great Britain (PAGB) describes paracetamol as “the most widely used and prescribed drug in the United Kingdom”.

Sarah Peel from GSK explains that Panadol is suitable for a wide range of people with mild to moderate pain. “The Panadol range includes a variety of formats to suit different patient needs and includes tablets and soluble tablets. A number of products are also available in ‘compack’ packs, which are ideal for handbags and use whilst on the go.” Panadol Extra Advance Tablets containing paracetamol and caffeine were launched in April 2011 in response to a demand for products offering ‘speed and strength’.

Solpadeine solutions

Omega Pharma, the maker of Solpadeine, is investing £4 million in a campaign to help pharmacy staff provide the right pain relief. The support package includes training booklets and online tools for staff.

Louise White, Solpadeine’s marketing manager, explains: “Engaging the customer in a discussion about their symptoms and lifestyles will supply pharmacists with the necessary information to confidently recommend the most suitable pain relief for any step on the pain ladder. This information will also help pharmacy teams tackle some of the challenges facing the pain relief category, such as reluctance to treat, selecting the wrong treatment, sub-therapeutic dosage and incorrect or overuse of treatments.”

The brand has also appeared on TV for the first time in four years. Ms White says: “This significant pharmacy support is backed by the return of Solpadeine to primetime TV, with advertising that aims to raise awareness of the importance of selecting the most suitable pain relief. The 30-second advert, which featured on prime time TV slots, also highlights that Solpadeine Plus Soluble Tablets contain a triple-acting set of ingredients which work twice as fast as ordinary paracetamol tablets.”

New topicals

There are several topical analgesic brands on the market offering targeted pain relief and emerging as an alternative to tablets. The pain relief patch Salonpas, containing methyl salicylate and levomenthol, for example, was launched in the UK in February 2013.

Suzanne Potter, marketing manager at Ceuta Healthcare, says there is a move towards applying analgesic and anti-inflammatories through the skin. She says: “Salonpas is a medicated patch featuring a transdermal drug delivery system (TDDS), whereby the medication is spread across an ultra-thin and highly stretchable piece of cloth with a soft adhesive backing, which makes it extremely discreet and allows it to stick firmly to any shape of the body. When applied to the skin, it enables two pain-relieving ingredients to be delivered directly to the site of pain.”

RB launched its Nurofen Topicals range in March 2013 with four new products, including heat patches and penetrating gels, supported by a £2.5 million marketing campaign. Mr Pearson says: “The topicals market is massively underdeveloped in the UK and there is still a need for real education for both consumers and pharmacists. Our research has shown that body pain sufferers are often dissatisfied with their regular treatment options and some as a result are following a dual regime of oral and topical analgesia to treat pain.”