Incontinence is still a taboo subject, yet more than nine million women and four million men in the UK have some form of bladder problem, while bowel incontinence affects 53 million people across Europe, according to the Bladder and Bowel Foundation.
‘There are more people in the UK who experience bladder weakness than suffer from hayfever or migraine. So why is there still a stigma associated with purchasing incontinence-specific products?’ says Numark’s retail marketing executive Jacki Beesley. ‘Customers with incontinence need help and advice to choose the right product and this can be where community pharmacy wins over the supermarkets. Historically, 75 per cent of all incontinence products are sourced through institutions. However, with NHS budgets being squeezed by other ailments, consumers have to rely more on the retail market.’
All areas of the bladder weakness market continue to show growth, says TENA manufacturer SCA. The sector is increasing by one per cent year on year faster than the total intimate care market, and is contributing 10 per cent of the total growth (a value of £1.2 million).
TENA has an 89.5 per cent share of the pharmacy bladder weakness market, with 11.4 per cent growth last year, according to the brand, saying that it has a 76.9 per cent share of the total bladder weakness market. The brand is extending its portfolio of products with the launch of a new night time protection product – TENA Lady Pants Night.
The incontinence products market has grown by 50 per cent in the past five years and this is expected to continue, with the category estimated at £200 million by 2018. ‘The increased value, but decline in volume in pharmacy suggests less promotional activity and a reliance on a distress purchase scenario,’ says Ritu Bhardwaj, senior product manager for Alvita and Almus OTC UK.
The driving forces behind growth, says Ms Bhardwaj, are the ageing population, an increased awareness of products to treat the condition and restriction in NHS funding. ‘By 2018, the volume of NHS products currently being supplied is expected to fall by two-thirds, driving growth into the retail market.’ Alvita is planning to launch a light incontinence range this year to complement its moderate-heavy pants and all-in-ones.
Procter & Gamble believes the market has huge potential for growth and the company has just launched a new range of female incontinence products,
Always Discreet. ‘Adult incontinence is the fastest growing category within the health and beauty sector. Research suggests one-third of women over age 18 have experienced it at some point in their lives,’ says Christina Turner, P&G brand manager for femcare. Always Discreet, for sensitive bladders, is a range of liners, pads and pants. Following ‘nine years’ research and testing on thousands of women’, the liners and pads are said to be ‘up to 40 per cent thinner than the brand leader and absorb two times more than women may need, while the pants give 100 per cent comfort and protection’.
The range includes liners, Light Pads and Moderate Pads and Discreet Pants (in two sizes). Always Discreet Light Pads come in three sizes with increasing absorbency. The absorbent core of Always Discreet in made with absorbent gel material that stores fluid away from the skin. It also uses odour protection technology. The moderate pads and pants feature leak guard barriers around the legs.
A nationwide TV and print campaign goes live from August, encouraging women to ‘just get on with their lives’, illustrated by women dancing in a range of situations with their friends and enjoying life to the full.
Pharmacies can offer customers a more familiar and informal environment, and with the provision of professional advice they won’t get at a supermarket shelf.
Gary Jones, superintendent pharmacist at Borth Pharmacy in Aberystwyth, an Alphega member and Alvita customer, decided to devote 20 per cent of his retail space to incontinence products a year ago. He believes that customers prefer the discretion of the pharmacy environment. ‘I have found over the years, as with all pharmacies, our retail sector is being eaten away by large supermarket chains and we really need to provide products and services that are not available in these large stores. With supermarkets, what a customer buys in the trolley is for everyone to see.’
Ms Beesley at Numark says that pharmacy can offer a quieter place where customers can ask questions. ‘An environment where either the customer is known or is a regular user of the pharmacy may put them more at ease, especially if they have asked for advice in the past for another health issue. Regular purchase can be frequent with these products so the opportunity to have regular ordering and discreet purchasing will give confidence to the customer.’
Debbie Gordon, strategic and clinical manager at the Bladder and Bowel Foundation, agrees: ‘Many people won’t discuss their incontinence needs with anyone, but if they’re buying pads from the pharmacy they may be more willing to talk to staff here.’
Only 38 per cent of bladder weakness sufferers use incontinence specific products, while 45 per cent wait at least five years before seeking any sort of help, says Ms Bhardwaj. The reason for this is that many are simply too embarrassed to discuss the subject. According to Procter & Gamble research, this figure may be slightly higher – 67 per cent of women suffering from sensitive bladder are not using the right product to manage their condition, says P&G.
Tact and discretion are vital. ‘To dispel embarrassment, keep the conversation light and factual, not personal, and use the consultation area. Make it seem normal,’ advises Janice Read, chair of the Association of Continence Advice. ‘If a customer is on medication for an overactive bladder, for example, use this as an opportunity to find out if they’re getting all the help they need. If a customer is buying incontinence pads, ask if they’re aware of specialist services that can give more support/treatment/advice.’
At P&G, Ms Turner, says: ‘Our research confirms that urinary incontinence impacts women’s self-confidence, feeling of femininity and sense of freedom. If a customer is browsing the category and looks like they need help, it’s important to ask discreetly if they need help.’
Donna Wilson, TENA’s brand and training manager, advises: ‘A good opening question is: ‘Is the person you’re buying this for using it for bladder weakness or as sanitary protection? That way you won’t offend the customer and will give them the chance to talk if they wish to.’
Ms Beesley suggests making use of the consultation area: ‘Offering customers a chance to talk in the consultation area and samples to try may also help them decide what may be the best product for them. Many people don’t want to ask for help but prefer to review products for themselves, so they may be more inclined to browse if the category is merchandised in a quieter area of the pharmacy and leaflets are readily available for them to help themselves.’
Use things such as Continence Awareness Week to promote the subject, says Ms Gordon. ‘Normalise the condition as much as you can and train staff so they’re not embarrassed about answering questions. It’s important for staff to know the basic differences between the main types of incontinence and how they impact on daily living so they can give better advice on which products to recommend.’
The Bladder and Bowel Foundation has these tips to pass on to customers:
With the category continuing to be in growth, pharmacies will want to ensure that they are making the most of customer interest. Offer an ordering service so customers can simply collect from the counter. This saves shop floor display space and ensures repeat customers. Use a quieter area of the store for display, so customers can browse in privacy. And take note of older customers, past the age of menopause, who buy high absorbency sanpro products.
Here is advice from the brands on steps to take to maximise the category:
Bladder retraining is advocated by the Bladder and Bowel Foundation as a method for people to use to try to overcome bladder problems such as urgency, frequency and incontinence. People can experience a cycle of discomfort and even panic when they want to go to the toilet, and answering the call on a frequent basis can lead to their problem getting worse. The more they go to the toilet, the more they want to. The retaining technique is based on the person trying to resist the feeling that they want go to the toilet for increasing amounts of time, over weeks, perhaps using a timer and a diary to track their progression. Eventually they will respond differently to the signals from the bladder that tell them they need to go to the toilet, to hold more urine for a longer time. More information on this method is available on the Bladder and Bowel Foundation website.
A lack of targeted exercise, along with pregnancy and childbirth, can weaken the pelvic floor. Regular pelvic floor exercises are important to help women maintain the control and strength of the pelvic floor muscles. Only 10 per cent of women do the exercises daily, says TENA. Customers can download the free ‘my pff’ app from here.
People who regularly need to locate a toilet quickly when they are out might find the ‘Just Can't Wait’ toilet card useful. Produced by the Bladder and Bowel Foundation, the card explains that the holder has a medical condition and needs to use the toilet. Not being able to find facilities when out and about remains one of the reasons why so many people cut down on social activities or even stop going out altogether. The Foundation says that although the card does not guarantee you access to a toilet, it hopes that the places you visit will be willing to help you. The use of the card will help minimise embarrassment. The toilet card is available for £5 to cover the charity’s costs, ordered online or by calling 01536 533 255.
Bina Patel, Kalsons Chemists, Essex ‘I’ve encouraged my staff to carry out the TENA training module because we have noticed an increase in sales in the category, partly because the NHS is not delivering the pads that customers want. I pull the older women aside who come in to purchase bladder weakness products and and show them how we can work together to solve the problem. Simple things like pelvic floor exercises could help. I’ve noticed that for a lot of women bladder problems coincide with vaginitis. Two of my customers had broken their backs and were not getting very much support. When the lower spine is compressed it can lead to incontinence, so I encouraged them to go back to the GP and ask to be referred to a physiotherapist. Both came back happier.’
Pallavi Dawda, Masons Chemists, Coalville ‘This has been one of the fastest growing areas in recent years and we now stock several brands with full ranges for men and women, from more everyday products to those that used to be supplied more through the social services incontinence teams. Our recommendations depend on the customer’s needs. Stocking a range of products that deal with everyday comfort through to night-time pants helps to normalise the category for our customers, and simple advice about suitable bed protection or disposable night pads can help the customer or their family to cope with the condition. We moved our products to a prime wall location and re-merchandised, which really revitalised the sales. Don’t hide these products away.’
Nemesh Patel, AMG Pharmacy, Braintree ‘We have seen substantial growth in the value of sales in the category over the past two years, driven by the TENA brand. Discussing incontinence issues and concerns in the privacy of the consultation room helps to break down barriers, improve customer loyalty and identify the best product for the customer. We merchandise this category close to independent living products to encourage link sales. To support patients, we provide customers with stock product samples and leaflets to help customers find out which products work best for them. Pharmacists are ideally placed to offer lifestyle advice to improve symptoms, such as pelvic floor exercises, and to encourage customers to reduce their alcohol and caffeine intake.’