Consumer Health in India

CONSUMER HEALTH IN INDIA
Euromonitor International July 2013
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LIST OF CONTENTS AND TABLES

Executive Summary ..................................................................................................................... 1 Increased Awareness of OTC Products Fuels the Growth of Consumer Health ....................... 1 Increasingly Fast-paced Lives Drive the Growth of Weight Loss Supplements ........................ 1 the Competitive Environment Continues To Be Highly Fragmented ......................................... 1 Grocery Retailers Carve A Niche in the Distribution of Consumer Health Products ................. 1 Consumer Health Is Expected To Maintain Strong Growth Over the Forecast Period.............. 1 Key Trends and Developments .................................................................................................... 1 Self-medication Picks Up Amongst the Urban Population ........................................................ 2 Herbal/traditional Products Attract Consumers ......................................................................... 2 Bollywood Celebrities and Sports Stars Are Recruited To Drive Sales..................................... 4 Lifestyle Changes Drive the Growth of Unconventional OTC Products .................................... 5 Distribution of Consumer Health Products Continues To Be Dominated by Chemists/pharmacies ............................................................................................................... 7 Territory Key Trends and Developments ...................................................................................... 8 East and Northeast India .......................................................................................................... 8 North India ................................................................................................................................ 9 South India ............................................................................................................................. 10 West India ............................................................................................................................... 11 Rural Vs Urban Key Trends and Developments ......................................................................... 12 Market Indicators ........................................................................................................................ 13 Table 1 Table 2 Table 3 Table 4 Table 5 Table 6 Table 7 Table 8 Table 9 Table 10 Table 11 Table 12 Table 13 Table 14 Table 15 Consumer Expenditure on Health Goods and Medical Services 20072012 ........................................................................................................... 13 Life Expectancy at Birth 2007-2012 ........................................................... 13 Sales of Consumer Health by Category: Value 2007-2012 ........................ 13 Sales of Consumer Health by Category: % Value Growth 2007-2012 ....... 14 Sales of Consumer Health by Region: Value 2007-2012 ........................... 14 Sales of Consumer Health by Region: % Value Growth 2007-2012 .......... 14 Sales of Consumer Health by Rural-Urban % Value Analysis 2012 ........... 15 Consumer Health Company Shares 2008-2012 ......................................... 15 Consumer Health Brand Shares 2009-2012 .............................................. 16 Sales of Consumer Health by Distribution Format: % Analysis 20072012 ........................................................................................................... 17 Sales of Consumer Health by Category and Distribution Format: % Analysis 2012 ............................................................................................. 17 Forecast Sales of Consumer Health by Category: Value 2012-2017 ......... 19 Forecast Sales of Consumer Health by Category: % Value Growth 2012-2017 .................................................................................................. 19 Forecast Sales of Consumer Health by Region: Value 2012-2017 ............ 19 Forecast Sales of Consumer Health by Region: % Value Growth 2012-2017 .................................................................................................. 20
Market Data ................................................................................................................................ 13
Appendix .................................................................................................................................... 20 OTC Registration and Classification ....................................................................................... 20 Vitamins and Dietary Supplements Registration and Classification ........................................ 22 Self-medication/self-care and Preventative Medicine ............................................................. 23 Switches ................................................................................................................................. 23
Euromonitor International
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Sources ...................................................................................................................................... 23 Summary 1 Research Sources ...................................................................................... 23
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EXECUTIVE SUMMARY Increased Awareness of OTC Products Fuels the Growth of Consumer Health
In 2012 consumer health witnessed continued strong growth, as awareness of OTC medication increased substantially amongst urban consumers. Aggressive marketing and promotional activities by various companies via television, electronic and traditional print media helped to increase awareness of these products amongst consumers.
Increasingly Fast-paced Lives Drive the Growth of Weight Loss Supplements

In the last couple of years, due to changing lifestyles urban consumers witnessed an increase in the number of weight-related health disorders, such as high cholesterol, obesity, heart conditions and more. This, combined with the increased desire to attain the perfect body amongst the young consumer base, resulted in strong growth for weight loss supplements in 2012.
the Competitive Environment Continues To Be Highly Fragmented

In 2012 consumer health continued to be fragmented, and eight of the 10 leading companies were international. This was observed due to the categories which performed particularly well in 2012, such as weight management and cough, cold and allergy (hay fever) remedies, amongst others. Domestic companies continued to lead herbal/traditional vitamins and dietary supplements and emergency contraception.
Grocery Retailers Carve A Niche in the Distribution of Consumer Health Products

Chemists/pharmacists continued to be the leading retail channel in consumer health in 2012, as the availability of such products in this channel is the highest. However, modern grocery retailers such as hypermarkets and supermarkets, and small grocery retailers such as convenience stores and independent small grocers, amongst others, saw strong performances in 2012.
Consumer Health Is Expected To Maintain Strong Growth Over the Forecast Period
Growth in consumer health in the forecast period 2012-2017 is expected to be driven by weight management, sports nutrition and emergency contraception. These categories are expected to witness the strongest growth due to changes in lifestyle amongst Indians in urban areas; this was already witnessed in 2012, and is expected to continue in the forecast period. Consumers are becoming increasingly westernised in their lifestyle choices, for instance in terms of attaining the perfect body, and are opening up to new life choices.
KEY TRENDS AND DEVELOPMENTS
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Self-medication Picks Up Amongst the Urban Population

There is increasing demand for health and wellness products amongst urban consumers. As urban consumers are pressed for time in their busy schedules, they are increasingly seeking healthier products to build immunity, as well as opting for self-medication for milder ailments, such as cough and cold remedies, digestive remedies and analgesics. Current impact The demand for products to self-medicate is especially high in urban centres and metro areas, where consumers have stressful and demanding lifestyles. Self-medication products are available across healthcare categories such as analgesics, cough and cold remedies and digestive remedies. In addition, there was an increase in awareness of preventive healthcare products, which led to strong demand for vitamins and dietary supplements over the review period. Increasing self-medication led major players such as Emami, Dabur India, Amrutanjan Health Care and GlaxoSmithKline Consumer Healthcare to introduce new products to the market, as well as to spend heavily on promotions for their offerings in order to drive sales. As self-medication surged in the last two years, major players came up with a number of rapid relief products, which could be bought easily by consumers over the counter without a prescription. Some prominent self-medication products during the review period included Crocin, Calpol, Anacin, Disprin, Saridon, Amrutanjan Pain Balm, Vicks VapoRub, Strepsils, Hajmola, Eno, Zandu Balm, Iodex and many more. Outlook Demand for OTC products to self-medicate is expected to remain strong over the forecast period, as consumers in urban areas have busy lifestyles, and are always on the lookout for quick relief products. Consumers in metro areas do not find sufficient time to visit a doctor for a consultation about minor ailments such as colds, coughs and flu, and instead prefer to selfmedicate. Self-medication consumer health products are easily available over the counter in all chemists/pharmacies in India without a prescription or hassle. The convenience of buying these products, which are perceived to provide immediate relief, will continue to drive sales, as consumers prefer to buy these products rather than standing in long queues and paying high consultation fees to doctors. Future impact The strong demand for products for self-medication over the forecast period will ensure that the major players within consumer health will launch a number of products across categories such as analgesics, vitamins and dietary supplements, cough, cold and allergy (hay fever) remedies, digestive remedies and other lifestyle-related products. Companies are expected to spend heavily on promotions by using famous celebrities as brand ambassadors to promote their products and increase awareness amongst consumers. In addition, along with self-medication products, the demand for preventive healthcare products is also expected to remain strong over the forecast period. Consumers will continue to drive sales of self-medication and preventive healthcare products due to growing awareness of, access to and availability of these products.
Herbal/traditional Products Attract Consumers

The trend of self-medication picked up in urban regions of India in recent years. Along with this, there was also growing awareness about the side-effects of some allopathic medicines.
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Companies recognised these concerns and came up with products based on traditional medicines. Consumers believe that traditional and herbal products have no side-effects, and the campaigns carried out by companies emphasised this point. Current impact Growing demand for herbal/traditional products led to launches across categories by healthcare companies over the review period. Herbal/traditional products are available in several consumer health categories, such as analgesics, cough, cold and allergy (hay fever) remedies, digestive remedies, dermatologicals and vitamins and dietary supplements. Growing health awareness and concerns regarding the side-effects of allopathic products resulted in increased demand for herbal/traditional products. Companies came up with numerous products across categories to cater to this demand. Some of the popular herbal/traditional cough, cold and allergy (hay fever) remedies available in India are Dabur Honitus Cough Syrup, DCold Natural Cough Syrup, Himalaya Herbals Throat Drops and Sualin. Brands in other herbal/traditional dietary supplements include Dabur Chyawanprash, Himani Sona Chandi Chyawanprash and Zandu Kesari Jivan. There was an increasing trend of consumers preferring to use herbal, traditional and ayurvedic remedies for their skin-related problems over the review period, as they consider these products to have no side-effects. Increasing awareness of the benefits of natural and traditional products amongst consumers led to an increase in OTC products claiming to be herbal and traditional. Companies came up with a number of launches catering to this demand, and some of the prominent launches included Elder Pharmaceuticalss Elder Balm Strong and Elder Balm White, Mee Natural Herbal Balm by Sepra Natural, and the relaunch of the brand Amrutanjan by Amrutanjan Health Care. The new launches were accompanied by increased media spending by the bigger players, leading to higher sales. Outlook The increasing popularity of ayurvedic products in the last couple of years, with the growing popularity of yoga across regions of India, led to strong demand for herbal/traditional products. Demand is expected to remain strong over the coming years, as companies are expected carry out numerous product launches which cater to the demand for herbal/traditional products across healthcare categories over the forecast period. Major players are also expected to come up with innovative products with better formulations and better packaging over the forecast period, in order to encourage younger consumers to start using such products. A prime example was Emamis Fast Relief, which claims to be formulated to provide instant relief from body aches. The company claims that the product possesses special ayurvedic active ingredients of special herbs, such as Nilgiri oil, Lavang and Gaultheria, which help to swiftly penetrate the area of pain and act quickly. This trend will continue to be strong over the forecast period. Future impact A number of herbal/traditional products are expected to be launched over the forecast period, as companies aim to increase their consumer base and penetration. Better formulations leading to quick and instant relief will be one area of strong activity for the major players. Companies are also expected to launch herbal/traditional preventive medicines, which are gaining popularity in urban centres, as consumers are concentrating on increasing their level of immunity. Demand for herbal/traditional products is expected to be strong, especially in herbal dietary supplements, as dietary supplements are demonstrating strong demand. Demand for
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herbal/traditional products in other categories, such as analgesics, cough, cold and allergy (hay fever) remedies, digestive remedies and dermatologicals, is also expected to remain strong over the forecast period.
Bollywood Celebrities and Sports Stars Are Recruited To Drive Sales

Companies used a number of Bollywood celebrities and sports stars to increase brand awareness amongst consumers during the review period. This trend picked up as companies aimed to increase sales through increased distribution and brand awareness. In order that consumers could easily identify with their brands, companies opted to bring in new faces and celebrities to endorse their products. Current impact Choosing celebrities to endorse their products was a strategy adopted by all the prominent players in the market over the review period. Companies looked at expanding their sales through increased promotion and distribution. In order to overcome the slowdown in the economy and consumers conservative spending habits, companies adopted the strategy of increasing their consumer base through increased distribution. Manufacturers such as Emami, Dabur India, GlaxoSmithKline Consumer Healthcare and Amrutanjan Health Care used a number of celebrities and sports stars in 2012 to endorse their brands and increase awareness. This trend was prominent across various consumer health categories, including analgesics, cough remedies, digestive remedies, vitamins and dietary supplements and dermatologicals. Most of the major players were able to attract consumers and register their brands in the minds of consumers through these initiatives. Apart from television and print media advertising, companies also conducted a number of programmes, such as Dabur Indias campaigns during the year, aimed at spreading awareness about strengthening immunity in order to fight a variety of cold, flu and other illnesses. The campaign emphasised that just two spoonfuls of Dabur Chyawanprash every day can strengthen a persons immunity three times. The brand also initiated a strong school contact programme in East India to take forward its Immune India initiative. A sustained campaign was run to educate consumers about how building immunity can help them to protect themselves from various illnesses. Under this programme, the brand reached out to large numbers of school children across East India, educating them about the need to build immunity. The company plans to roll out these campaigns in more states across the country, using celebrities to create brand awareness. Over the review period, Indian cricket team captain MS Dhoni was signed as brand ambassador for Emamis Zandu Pancharishta and Dabur Indias popular product Dabur Chyawanprash. Emami recruited popular Bollywood star Shahrukh Khan as brand ambassador for its Sona Chandi Chyawanprash. Padma Vibhushan Pandit Birju Maharaj was signed as the brand ambassador for Emamis Zandu Pancharishta and Zandu Kesari Jivan. Aggressive promotions and branding measures by manufacturers ensured there was increased awareness of their brands and the benefits these products can offer consumers. Outlook The trend of using celebrities to drive sales is expected to gain greater traction over the forecast period, as companies will look to increase brand awareness and distribution across the country. Major players such as Emami, Dabur India, Amrutanjan Health Care and GlaxoSmithKline Consumer Healthcare will continue to increase their spending on promotions and brand awareness campaigns in order to increase their sales.
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Innovative campaigns involving the participation of end consumers will help manufacturers to drive sales, as consumers will be much more aware about the specific brands and their health benefits. Over the forecast period manufacturers are expected to indulge in promotional activities highlighting fast-acting solutions to mild lifestyle disorders. Future impact There is growing awareness amongst Indian consumers about health and wellness, and, increasingly, people are seeking healthier products. Due to the stress and health issues faced by the urban population in India due to lifestyle-related problems, consumers will increasingly turn to products which offer faster relief and more convenient solutions. Manufacturers will use celebrities to create awareness of their brands and convey the message of faster and safer solutions to the health issues faced by consumers over the forecast period. Vitamins and dietary supplements and topical analgesics/anaesthetic are the two categories which are likely to benefit the most from the high level of promotion and advertising in the forecast period. Celebrities will definitely play an important role in brand-building and creating awareness of brands over the forecast period. However, the quality of the products offered, as well as the health benefits that they ultimately deliver to consumers, will be the factors which will determine the success of products over the forecast period.
Lifestyle Changes Drive the Growth of Unconventional OTC Products

Urban Indians witnessed changes in their lifestyle choices in the review period 2007-2012, which were also observed in 2012. The changes in lifestyle choices in metropolitan areas were most prominent in terms of physical appearance, eating habits, consumption of health-related products, jobs and overall personal choices made by consumers. This resulted in an increase in the consumption of weight management products and emergency contraception, both of which witnessed strong growth in 2012. Current impact Urban India witnessed a paradigm shift in lifestyle in the last decade, with increasing work-life pressure, lack of time and increased health concerns. Weight management witnessed significant growth of 56% in 2012 in current value terms. The primary reason for such strong growth was weight loss supplements, which witnessed growth stronger than overall weight management, at 69% in current value terms. The increase in weight loss supplements was observed due to increased obesity amongst consumers. Due to the extremely busy lives of consumers, the shift towards weight loss supplements to aid in weight loss was inevitable. Companies realised this growing demand and enhanced their product portfolios to benefit from this trend. Another lifestyle change helped in the growth of yet another unconventional OTC product, emergency contraception, which witnessed steady growth in the review period. This growth was driven by the changing lifestyles of Indians, whereby the age of becoming sexually active witnessed a decline, the concept of pre-marital sex became acceptable, and there was a distinct change in societal norms, especially in cities. Emergency contraception witnessed growth of 24% and 13% in value and volume terms respectively in 2012. Growth was driven by the increased consumption of the emergency pill amongst the age group 16-24. The average age of consumption of the emergency pill decreased to 16-18 years from 20-21 years in urban areas of the country.
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Outlook Consciousness regarding health and body image is expected to increase rapidly across the country, particularly in metropolitan areas, second-tier and third-tier cities. However, lifestyle choices are expected to deteriorate in the forecast period; a larger proportion of the population will lead sedentary lifestyles and will prefer to eat out rather than cooking at home, with an increase in smoking and drinking. In urban areas, changes in lifestyle, increased acceptance of pre-marital sex and more information and knowledge available about these products from the internet will facilitate the growth of emergency contraception. In rural India, in order to decrease the number of illegal abortions, juvenile pregnancies and control unwanted pregnancies amongst both married and unmarried women, consumers will open up to the use of the pill. Weight management is expected to see a constant value CAGR of 18% in the forecast period 2012-2017. This growth will be driven by weight loss supplements and meal replacement slimming, which are expected to increase by constant value CAGRs of 30% and 14% respectively. The growing need to look good more than being healthy amongst the younger consumer base aged 15-30, combined with changing lifestyle choices, will make weight loss supplements the only way for consumers to opt for weight loss. Furthermore, companies will increase their retail channel presence across the country and increase the availability of these products in hypermarkets, supermarkets, convenience stores, chemists/pharmacies and other independent retailers, which in turn will encourage consumers to try these products. In 2012, weight management was primarily dominated by direct selling companies such as Herbalife and Amway. However, The Himalaya Drug Co made its weight loss supplement Himalaya Ayurslim available in store-based retail channels; sales of this brand will definitely pick up over the forecast period, as this will provide greater shelf-space and reach a larger consumer base compared with direct selling. Future impact The forecast period 2012-2017 is expected to witness a change in terms of the consumer base, from the current urban-centric consumer base to semi-urban and rural. Direct selling companies such as Herbalife and Amway will foray into untapped second-tier and third-tier cities with weight management products. Increased awareness and consciousness of attaining the perfect body will drive sales in weight management in the forecast period. The average age of consumption of these products is expected to decrease to teenagers aged 14-15 in order to avoid obesity. The growth potential of emergency contraception is enormous in the forecast period. The category remained relatively small in 2012, accounting for only a 4% share of value sales in overall consumer health. With the birth rate in India still steady at 22% in 2012, and an increasing number of people indulging in pre-marital sex, emergency contraception is expected to grow in the huge untapped market. Semi-urban and rural India will be a big market for emergency contraception, firstly because majority of the population reside in these areas of the country and are awareness regarding the side effects of these medicines is low. Also, the birth rate is higher in these parts of the country; due to lack of knowledge regarding the ill effects of immediate pregnancies and emergency contraceptive are the most convenient method to avoid pregnancy in the first place. Hence, companies will exploit this market and sales will benefit.
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Distribution of Consumer Health Products Continues To Be Dominated by Chemists/pharmacies

The distribution of consumer health products continued to be dominated by chemists/pharmacies in 2012. The lack of proper awareness of OTC medicines and the continued preference of consumers to buy medicines from chemists/pharmacists resulted in companies, manufacturers and distributors continuing to sell healthcare products via this particular retail channel. Current impact 83% of total sales of OTC medicines in 2012 occurred through chemists/pharmacies. The entire healthcare system in 2012 and in the review period continued to be dominated by the prescription-based channel. As a result of this, despite a certain brand being OTC in India due to lack of awareness regarding OTC status and utmost trust on doctors, consumers still bought these medicines only when a doctor prescribed it. This attitude towards medicines resulted in the majority of consumers buying medicines, whether OTC or otherwise, only from chemists/pharmacies. Hence, this retail channel is recognised as the main source of sales by all manufacturers and distributors. Another reason for chemists/pharmacies being the primary retail channel is better availability of all brands, including both generic and named brands of medicines. This allowed consumers to have the option to discuss with the pharmacist if a cheaper alternative to a certain medicine prescribed by the doctor was available, which made it easier for the consumer to purchase. Furthermore, easy access and billing at chemists/pharmacies added to continued popularity amongst consumers as the primary channel for all healthcare products. Such dominance gives chemists the opportunity to also launch private label products in certain consumer health categories. For example, Apollo Pharmacy launched a series of products within analgesics, such as Apollo Pharmacy Pain Balm and Apollo Pharmacy Sprays in 2012. Outlook The distribution and marketing of OTC products and other non-prescription health supplements will gradually witness a move towards other retail channels in the next 3-5 years. However, the change is expected to be slow and gradual. The change is expected to come along with the increasing knowledge regarding OTC medicines amongst consumers. Consumers across both urban and rural populations will realise the availability of options and no requirement for a prescription, which in turn will also help them to save on consultation fees. Manufacturers and retailers will also start expanding their retail channel presence across hypermarkets, supermarkets, beauty specialist retailers and other retail channels. Certain OTC products, such as sticking plasters in wound care, digestive remedies and topical analgesics/anaesthetic, amongst others, have already made their way into other retail channels. This is expected to grow further in the forecast period 2012-2017. Future impact Weight management is expected to witness an increase in the retail channels through which it is distributed. The Himalaya Drug Co has started to push sales of its vitamins and dietary supplements through hypermarkets, supermarkets and beauty and personal care specialists and beauty and personal care specialists. More pharmaceutical companies are expected to come up with their own weight management supplements and push sales via store-based retailers. As chemists stock 80-90% of their drugs as prescription-based medicines, the shelf-space and visibility of OTC products continues to be low amongst chemists/pharmacists.
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Manufacturers and distributors are likely to realise this, and push sales through other retail channels. Products which are not consumed, and instead are topical in nature, are most likely to do the best via other retail channels, as consumers are more likely to try such products without a doctors prescription over medicines which work sys temically.
TERRITORY KEY TRENDS AND DEVELOPMENTS East and Northeast India

Trends East and Northeast India witnessed the strongest growth in consumer health in 2012, at 17% in current value terms. This was driven by weight loss supplements, which witnessed massive growth of 71% in current value terms in 2012. This was followed by emergency contraception, which witnessed an increase of 31% and chyawanprash (within other herbal/traditional vitamins and dietary supplements) at 20%. The size of weight loss supplements in East and Northeast India was the smallest in 2011, at Rs210 million. As a result of this, despite the strong growth of 71% in 2012, the size of the category continued to be the smallest, with sales of RS359 million. Consumers in East and Northeast India continued to prefer homeopathic rather than allopathic medicines, due to the lack of side-effects of the former. Also, the consultation fee continued to be lower for homeopathic doctors, resulting in this becoming the preferred form of medication in the region. Calcutta is one of the only metropolitan cities in this region, and the growth rate for annual disposable incomes in the city in 2012 witnessed a slowdown, at 13%, from 22% growth in 2010-2011. This encouraged consumers to move towards OTC options, which are cheaper than prescription-based medicines. Competitive landscape Consumer health was quite fragmented in East and Northeast India in 2012, with no one absolute market leader. This was also because the size of the overall consumer health market in this region was the smallest, as the majority of consumers prefer homeopathic medicines, so sales were distributed amongst the large number of national brands present in the region. Daiichi Sankyo, Procter & Gamble, GlaxoSmithKline and Dabur were amongst the leaders in consumer health in East and Northeast India in 2012, with a strong presence in vitamins and dietary supplements, analgesics and decongestants. Both international and domestic players have a strong hold in the market, which varies by category. Prospects Consumer health in East and Northeast India is expected to increase by a constant value CAGR of 10% in the forecast period 2012-2017. This growth will continue to be driven by the growth in weight loss supplements, sports nutrition and emergency contraception. These categories are expected to witness rapid growth due to the changing lifestyles of urban consumers, who are the primary consumers of consumer health products in India. Consumer health will continue to face serious competition from homeopathic medicines in the forecast period. Homeopathy had the strongest consumer base in this region in 2012 and during the review period, and as this system of medicine is cheaper, with no side-effects, consumer health will witness major competition in the forecast period.
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Chemists/pharmacies will face competition from hypermarkets and supermarkets in the forecast period as the preferred channel for sales of consumer health products, as in 2012 these channels became quite popular amongst urban consumers.
North India
Trends Consumer health in North India witnessed growth of 16% in current value terms in 2012. This was primarily driven by weight loss supplements, emergency contraception and multivitamins, which grew by 69%, 20% and 20% in current value terms respectively in 2012. In 2012 North India witnessed an increase in sales of pharmaceutical products through organised retail chains such as Apollo, Guardian and 98.4 degrees by Global Health Line, amongst others. This was strongest in the National Capital Region (NCR) of Delhi, namely Gurgaon in Haryana, and Noida and Ghaziabad in Uttar Pradesh. Demand for OTC medicines witnessed growth in North India due to rising medical care costs (such as doctors consultation fees) for common ailments, which encouraged people to self medicate and eventually opt for OTC products. The acceptance and use of new OTC products is quite strong in North India, especially in urban areas. North India witnessed the second strongest growth in consumer health in current value terms in 2012, at 16%. Competitive landscape International players such as Reckitt Benckiser, Abbott Laboratories, Johnson & Johnson and Daiichi Sankyo, amongst others, had a very strong foothold in North India in 2012, especially in analgesics, digestive remedies, dermatologicals, vitamins and dietary supplements and wound care. GlaxoSmithKline Consumer Healthcare was one of the leading players in overall consumer health in 2012. The company owns some of the biggest brands, namely Crocin, Eno, Calpol and Iodex, amongst others, which are almost synonymous with their action, such Crocin for colds, fevers and allergies; hence they have extremely high brand recall amongst the target consumers. Ayurvedic, homeopathic and unani medicines also gained popularity amongst the ageing population, as these products are supposed to be free from side-effects, and government also ran mass awareness campaigns for these alternative systems of medication. The leaders in ayurvedic and homeopathic medicines were The Himalaya Drug Co, Dabur India, Bakson and SBS; these companies registered very high growth, and over 90% of products fall in the OTC category. Direct selling companies, including Herbalife and Amway, also registered high growth in sales in North India. Prospects North India is expected to witness high growth in overall consumer health products and services. The constant value CAGR for overall consumer health in the forecast period 20122017 is expected to be 10%. This will be driven by weight loss supplements, sports nutrition and emergency contraception. The growth of consumer health will also be attributed to the extreme weather conditions in North India, especially in cities such as Delhi, Chandigarh and Kanpur, amongst others. The entire northern region is gripped by many seasonal diseases due to these extreme weather conditions, and consumers are likely to shift towards consumer health products in order to avoid the consultation fee every time.
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North India is one of the leading medical tourism hubs in the country, due to companies/hospitals such as Medicity, Fortis and Apollo, amongst others. These offer best-inclass medical care, and demand for pharmaceutical products is therefore expected to increase rapidly across the region.
South India
Trends A shift was observed amongst doctors in South India, whereby they preferred to prescribe OTC medicines. Doctors started to prescribe OTC medicines, as these medicines are considered to be weaker and hence have fewer side-effects than prescription medicines. Companies in South India increased their marketing efforts via promotions through the internet, mobile phone messaging, television commercials and more. This was primarily done in order to increase awareness amongst consumers, especially of vitamins and dietary supplements. Weight loss supplements saw the fastest growth in South India in 2012. This was due to the Westernisation of urban lifestyles. A substantial increase was observed in the number of consumers eating out and eating fast food in 2012 compared with 3-5 years earlier. This, combined with little to no exercise, helped weight loss supplement to witness an increase. Consumers who primarily opted for ayurvedic medicines started opening up to the idea of OTC medicines. This was observed due to the low prices of the majority of OTC medicines, combined with low side-effects, which is the primary reason for such consumers to prefer ayurvedic medicines. The use of ayurveda continued to be strongest in the southernmost states of the country, namely Kerala and Tamil Nadu. In 2012 the state government focused on improving the infrastructure and awareness regarding healthcare in general in semi-urban and rural parts of South India. Awareness regarding OTC medication continued to be low amongst consumers in third-tier cities and rural areas of South India. This opened up new market opportunities for manufacturers of consumer health products in South India. The majority of manufacturers started to focus on core competencies such as research and development into new products, and outsourcing of manufacturing and distribution. Third party distribution is commonly used in rural areas for the supply of OTC medicines to small chemists/pharmacies and dispensaries. These pharmacies acted as the primary source of information and sale of OTC medicines in rural India in 2012. Competitive landscape Consumer health in South India is highly fragmented. Each category has multiple players, both domestic and international. Johnson & Johnson and Dabur India were the leading manufacturers and suppliers in consumer health in South India in 2012. Johnson & Johnson was the leading regional player across dermatologicals, wound care and cold, cough and allergy (hay fever) remedies in 2012. Dabur India was the leader in digestive remedies and vitamins and dietary supplements. Both international and domestic companies have strong footholds in South India in different categories. In the case of analgesics, dermatologicals and a few other categories, international players such as GlaxoSmithKline Consumer Healthcare, Amway India Enterprises and Johnson & Johnson were the leaders in 2012. However, in the case of digestive remedies, dietary supplements, emergency contraception and a few other categories, domestic players led.
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Prospects Consumer health is expected to witness a CAGR of 8% in South India in the forecast period 2012-2017 in constant value terms. Weight loss supplements, with a constant value CAGR of 31%, emergency contraception with a CAGR of 20% and sports nutrition with a CAGR of 18% are expected to see the fastest growth in the forecast period. These categories are expected to grow due to the lifestyle changes made by urban consumers regarding food, health and overall lifestyle choices. Chemists/pharmacies is expected to remain the largest distribution network across South India; however, virtual stores will enhance their regional presence in Bangalore, Hyderabad and Chennai in the long term. Pure online players and diversified websites such as bigbasket.com, healthkart.com and otcpharmacy.com will also start to make a niche for themselves. Fastmoving lifestyles, along with the aggressive expansion of digital healthcare catalogues, will enhance consumers confidence in digital purchases. The majority of online OTC healthcare websites will further expand offline distribution networks, such as warehouses and distribution hubs, across second-tier cities such as Mysore and Mangalore, amongst others, to improve sustainability. Manufacturers of herbal and ayurvedic consumer health products are expected to witness strong demand in the next 2-3 years. Cosmopolitan cities such as Bangalore, Hyderabad and Chennai, with fast-moving lifestyles and a strong affiliation for quick pain relief without side effects will witness an increase in the number of strong herbal and ayurvedic-based consumer health brands. The majority of manufacturers of products based on allopathic ingredients will focus on herbal and ayurvedic medication to improve customer segmentation and retention rates.
West India
Trends Weight loss supplements, emergency contraception and chyawanprash (within other herbal/traditional dietary supplements in vitamins and dietary supplements) saw the fastest growth in West India in 2012, with current value increases of 68%, 24% and 20% respectively. Increasing overweight and obesity issues due to fast-paced lives, low to no exercise and eating out drove sales of weight loss supplements and vitamins and dietary supplements in India. Consumers prefer herbal/traditional supplements, as they provide the necessary nutrition without any side-effects. In 2012 consumers underwent a distinct shift in preference towards OTC medication, due to increased awareness regarding these products compared with 2-3 years ago, and combined with the convenience of purchasing them without a prescription. However, this change was observed for a small percentage of the total population of West India, as the majority of consumers continued to prefer prescribed medicines. Domestic companies such as Dabur India, Paras Pharmaceuticals and The Himalaya Drug Co were amongst the leaders in other herbal/traditional vitamins and dietary supplements and dermatologicals in 2012. Indian consumers continued to prefer herbal/traditional vitamins and dietary supplements, as consumers strongly believe in their efficacy, with no side-effects. Competitive landscape Johnson & Johnson and Dabur India were the leading companies in consumer health in West India in 2012, especially in cough, cold and allergy (hay fever) remedies, digestive remedies and vitamins and dietary supplements. Dabur India was the leading company in digestive remedies and vitamins and dietary supplements. Johnson & Johnson was the leading company in dermatologicals and wound care in West India.
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Consumer health in West India is equally dominated by international and domestic players. Companies such as GlaxoSmithKline Consumer Healthcare, Cipla and Piramal Healthcare are amongst the leaders. Piramal Healthcare was the leader in emergency contraception in 2012. Prospects Consumer health is expected to increase by a constant value CAGR of 9% in the forecast period 2012-2017. This will be driven by weight loss supplements, sports nutrition and emergency contraception, which are expected to increase by CAGRs of 30%, 22% and 21% respectively in the forecast period. Lifestyle changes amongst consumers in urban areas and first-tier cities, such as eating out, fast-paced lifestyles and the lower age of becoming sexually active will drive the growth of these categories. The majority of the demand for OTC medicines will continue to come from the urban population in the western part of the country, as the rural population will most likely continue to prefer ayurvedic medicines. Consumers in rural areas still give preference to no side-effects over quick relief, which is not likely to change in the next five years; hence the demand amongst rural consumers will continue to be low for OTC medicines. The primary retail channel for OTC products in the forecast period will remain chemists/pharmacies. Also, hypermarkets and supermarkets, along with health and beauty specialist retailers, will witness growth in sales of OTC products, as companies will push to increase their distribution networks in order to reach out to a larger consumer base.
RURAL VS URBAN KEY TRENDS AND DEVELOPMENTS

Trends Urban consumers accounted for a 75% share of overall value sales in consumer health in 2012. This is because knowledge about the majority of consumer health products, such as emergency contraception, weight management, mouth care and ear care, is concentrated in urban parts of the country. However, consumer health categories such as analgesics, digestive remedies, wound care and cough, cold and allergy (hay fever) remedies have a better rural presence. Lack of knowledge regarding these medicines in rural India is the primary reason for the low penetration of consumer health. The literacy rate in rural India continues to be low, so the knowledge of medicines is spread via primary and community healthcare centres (PHC and CHC) which are run by the government. As the government was still in the process of running campaigns to increase awareness of OTC medication, in 2012 the rural contribution continued to be low. Rural healthcare in India in 2012 continued to have a huge gap between supply and demand. Rural healthcare needs were met either by the limited government facilities and private nursing homes, which were unable to keep pace with the increasing demand, or by a number of quacks who practiced medicine in rural areas. The quality of infrastructure was usually poor, and people ended up going to nearby large cities if they needed high-quality care. In 2012, consumers in rural India continued to prefer home remedies, due to the lack of sideeffects. Also, easy availability of the ingredients required for home remedies helped in their use. However, a gradual change was observed in terms of the usage of OTC products in cough, cold and allergy (hay fever) remedies and analgesics. Competitive landscape Manufacturers of economical products, herbal products and products in small packaging, such as Procter & Gamble Hygiene & Health Care and Dabur India, have strong regional and
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local penetration across rural southern India. As the rural population has lower incomes than the urban population, smaller stock keeping units are popular. Companies which offer such products are preferred over others which do not. Companies are also working towards the improvement of their retail channel distribution, as in 2012, all medicines, irrespective of the company/brand, were available via primary and community healthcare centres, hospitals and chemists. Prospects The government, for the Budget of 2013-2014, increased its expenditure on the National Rural Health Mission and National Urban Health Mission. The government is increasing its focus on providing a better healthcare system for the rural population, which will help to increase awareness regarding consumer health products, as these options are cheaper and more readily available compared with prescription medicines. Chemists/pharmacies will continue to be the preferred retail channel for sales of consumer health products in rural parts of the country, as the presence of hypermarkets and supermarkets will continue to be comparably lower than in urban parts of the country. Companies which offer small stock keeping units are most likely to be successful in rural areas, as consumers in general prefer to buy smaller pack sizes in order to save money and unnecessary wastage. Hence, companies which follow this strategy are likely to do well in rural areas in the forecast period.
MARKET INDICATORS
Table 1 Rs bn 2007 Pharmaceuticals, medical appliances/ equipment Outpatient services Hospital services Total
Source:
Consumer Expenditure on Health Goods and Medical Services 2007-2012
2008 690.5
2009 807.6
2010 992.7
2011 1,161.8
2012 1,335.1
633.5
431.2 223.2 1,287.8
481.7 247.3 1,419.4
572.5 292.6 1,672.7
714.2 363.6 2,070.4
846.2 429.2 2,437.2
981.9 496.7 2,813.6
Euromonitor International from official statistics, trade associations, trade interviews
Table 2 years
Life Expectancy at Birth 2007-2012
2007 Males Females

Source:
2008 63.0 65.9
2009 63.3 66.3
2010 63.6 66.7
2011 63.9 67.1
2012 64.3 67.4
62.7 65.5
Euromonitor International from official statistics
MARKET DATA
Table 3 Sales of Consumer Health by Category: Value 2007-2012
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Rs million 2007 OTC Sports Nutrition Vitamins and Dietary Supplements Weight Management Herbal/Traditional Products Allergy Care Paediatric Consumer Health Consumer Health
Source: Note:
2008 37,076.6 2,883.7 28,009.4 1,733.5 28,091.0 1,371.4 69,703.2
2009 42,138.2 3,100.0 31,275.3 2,859.9 31,030.9 1,706.7 79,373.4
2010 46,803.5 3,385.9 35,522.0 4,737.3 34,826.2 2,037.2 90,448.7
2011 51,739.8 3,917.3 40,067.1 7,761.4 39,115.2 2,355.1 103,485.5
2012 57,624.3 4,661.5 45,230.2 12,078.6 44,139.9 2,676.6 119,594.5
33,558.8 2,695.1 24,962.9 1,558.4 25,228.5 1,084.5 62,775.2
Euromonitor International from official statistics, trade associations, trade press, company research, store checks, trade interviews, trade sources Sum of categories is greater than the market size because allergy care is a duplicate of categories found in cough, cold and allergy remedies, dermatologicals and eye care; paediatric consumer health is an aggregate of paediatric categories in OTC and vitamins and dietary supplements; and herbal/traditional products is an aggregate of herbal/traditional categories in OTC and vitamins and dietary supplements, except herbal/traditional medicinal teas and herbal/traditional smoking cessation aids.
Table 4
Sales of Consumer Health by Category: % Value Growth 2007-2012
% current value growth 2011/12 OTC Sports Nutrition Vitamins and Dietary Supplements Weight Management Herbal/Traditional Products Allergy Care Paediatric Consumer Health Consumer Health
Source: Note:
2007-12 CAGR 11.4 11.6 12.6 50.6 11.8 19.8 13.8
2007/12 Total 71.7 73.0 81.2 675.1 75.0 146.8 90.5
11.4 19.0 12.9 55.6 12.8 13.6 15.6
Euromonitor International from official statistics, trade associations, trade press, company research, store checks, trade interviews, trade sources Sum of categories is greater than the market size because allergy care is a duplicate of categories found in cough, cold and allergy remedies, dermatologicals and eye care; paediatric consumer health is an aggregate of paediatric categories in OTC and vitamins and dietary supplements; and herbal/traditional products is an aggregate of herbal/traditional categories in OTC and vitamins and dietary supplements, except herbal/traditional medicinal teas and herbal/traditional smoking cessation aids.
Table 5 Rs million
Sales of Consumer Health by Region: Value 2007-2012
2007 East and Northeast India North India South India West India India
Source:
2008 13,022.1 20,706.8 18,744.5 17,229.8 69,703.2
2009 14,930.0 23,623.3 21,248.8 19,571.4 79,373.4
2010 17,154.1 27,086.0 24,106.8 22,101.8 90,448.7
2011 19,758.6 31,175.9 27,469.9 25,081.2 103,485.5
2012 23,054.1 36,192.4 31,589.0 28,759.1 119,594.5
11,737.8 18,439.4 17,017.4 15,580.6 62,775.2
Euromonitor International from official statistics, trade associations, trade press, company research, store checks, trade interviews, trade sources
Table 6
Sales of Consumer Health by Region: % Value Growth 2007-2012
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% current value growth 2011/12 East and Northeast India North India South India West India India
Source:
2007-12 CAGR 14.5 14.4 13.2 13.0 13.8
2007/12 Total 96.4 96.3 85.6 84.6 90.5
16.7 16.1 15.0 14.7 15.6
Table 7
Sales of Consumer Health by Rural-Urban % Value Analysis 2012 Urban Rural 25.0 Total 96.1
India
Source:
71.1
Table 8 % retail value rsp Company
Consumer Health Company Shares 2008-2012
2008 8.0 7.4 1.0 4.2 5.8 3.4 4.5 3.3 2.6 2.3 1.1 1.8 1.7 2.0 2.0 1.5 0.2 1.3 1.2 1.1 1.1 1.3 1.1
2009 8.5 7.6 1.8 6.0 5.7 3.6 4.2 3.2 2.6 2.2 1.0 1.8 1.7 1.9 1.9 1.4 0.7 1.2 1.2 1.1 1.1 1.2 1.0
2010 8.8 7.8 3.0 6.3 5.5 3.7 4.0 3.0 2.5 2.3 2.2 1.9 1.7 1.8 1.8 1.3 1.1 1.2 1.1 1.1 1.0 1.1 1.0
2011 9.2 7.9 5.2 6.2 5.3 3.8 3.7 3.0 2.4 2.4 2.2 1.9 1.7 1.7 1.7 1.3 1.1 1.1 1.1 1.0 1.0 1.0 0.9
2012 9.4 8.0 6.7 6.1 5.1 4.0 3.4 2.9 2.3 2.2 2.2 1.8 1.8 1.6 1.6 1.2 1.2 1.1 1.1 1.0 1.0 0.9 0.9
Amway India Enterprises Pvt Ltd Dabur India Ltd Herbalife International India Pvt Ltd Emami Ltd Procter & Gamble Hygiene & Health Care Ltd Ranbaxy Laboratories Ltd Johnson & Johnson (India) Ltd Pfizer Ltd GlaxoSmithKline Consumer Healthcare Ltd Heinz India Pvt Ltd Piramal Healthcare Ltd Paras Pharmaceuticals Ltd Neulife Nutrition Systems Himalaya Drug Co, The GlaxoSmithKline Pharmaceuticals Ltd Abbott India Ltd Mankind Pharma Ltd GlaxoSmithKline Asia Pvt Ltd Amrutanjan Health Care Ltd Cadbury India Ltd Franco-Indian Pharmaceuticals Pvt Ltd Merck (India) Ltd Reckitt Benckiser
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(India) Ltd Plethico Pharmaceuticals Ltd Forever Living Products India Pvt Ltd Cadila Pharmaceuticals Ltd Novartis India Ltd Hamdard (Wakf) Laboratories Alembic Ltd TTK Healthcare Ltd Zandu Pharmaceutical Works Ltd Others Total
Source:
0.2 0.5 0.8 0.8 0.8 0.7 0.7 1.8 33.9 100.0
1.2 0.6 0.8 0.8 0.7 0.6 0.7 32.0 100.0
1.3 0.6 0.8 0.7 0.7 0.6 0.6 29.3 100.0
0.8 0.7 0.7 0.7 0.6 0.6 0.6 28.6 100.0
0.8 0.7 0.7 0.7 0.6 0.5 0.5 28.2 100.0
Table 9 % retail value rsp Brand Nutrilite Vicks
Consumer Health Brand Shares 2009-2012
Company Amway India Enterprises Pvt Ltd Procter & Gamble Hygiene & Health Care Ltd Herbalife International India Pvt Ltd Emami Ltd Dabur India Ltd Ranbaxy Laboratories Ltd Heinz India Pvt Ltd Dabur India Ltd Emami Ltd Neulife Nutrition Systems Dabur India Ltd GlaxoSmithKline Consumer Healthcare Ltd Piramal Healthcare Ltd Herbalife International India Pvt Ltd Mankind Pharma Ltd Johnson & Johnson (India) Ltd GlaxoSmithKline Asia Pvt Ltd Amrutanjan Health Care Ltd Paras Pharmaceuticals Ltd Pfizer Ltd Johnson & Johnson (India) Ltd Cadbury India Ltd Franco-Indian Pharmaceuticals Pvt Ltd Abbott India Ltd Ranbaxy Laboratories Ltd GlaxoSmithKline
2009 8.2 5.7 1.5 3.6 3.1 2.4 2.2 2.3 1.6 1.6 1.2 1.7 0.1 0.7 1.5 1.2 1.1 1.0 1.2 1.1 1.1 1.1 1.1 0.8 0.9
2010 8.5 5.5 2.4 3.7 3.2 2.4 2.3 2.3 1.7 1.5 1.4 1.6 1.2 0.3 1.1 1.4 1.2 1.1 1.1 1.2 1.2 1.1 1.0 1.1 0.8 0.9
2011 8.8 5.3 3.9 3.6 3.3 2.4 2.4 2.2 1.8 1.6 1.5 1.5 1.2 0.7 1.1 1.3 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 0.9 0.9
2012 9.0 5.1 4.7 3.5 3.5 2.6 2.2 2.1 1.8 1.7 1.5 1.4 1.3 1.2 1.2 1.1 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 0.9 0.9
Herbalife ShapeWorks Himani Dabur Revital Glucon D Hajmola Zandu Optimum Nutrition Glucose-D Iodex i-pill Herbalife Cell-U-Loss Unwanted 72 Band-Aid Eno Amrutanjan Moov Becosules Benadryl Halls Dexorange Digene Volini Crocin
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Gelusil Liv 52 Forever Living Emami i-pill Others Total

Source:
Consumer Healthcare Ltd Pfizer Ltd Himalaya Drug Co, The Forever Living Products India Pvt Ltd Emami Ltd Cipla Ltd
0.8 0.9 0.6 0.6 1.0 47.8 100.0
0.8 0.9 0.6 0.7 45.7 100.0
0.9 0.8 0.7 0.7 43.8 100.0
0.8 0.8 0.7 0.7 42.8 100.0
Table 10 % retail value rsp
Sales of Consumer Health by Distribution Format: % Analysis 2007-2012
2007 Store-Based Retailing - Grocery Retailers -- Discounters -- Healthfood shops -- Hypermarkets -- Small Grocery Retailers -- Supermarkets -- Other Grocery Retailers - Non-Grocery Retailers -- Health and Beauty Retailers --- Chemists/Pharmacies --- Parapharmacies/ Drugstores --- Other Healthcare Specialist Retailers -- Mixed Retailers --- Department Stores --- Mass Merchandisers --- Variety Stores --- Warehouse Clubs -- Other Non-Grocery Retailers Non-Store Retailing - Vending - Homeshopping - Internet Retailing - Direct Selling Total
Source:
2008 88.7 12.2 0.0 0.0 2.0 7.0 1.4 1.9 76.5 76.5 75.6 0.0 0.9 0.0 0.0 0.0 0.0 0.0 0.0 11.3 0.0 0.0 0.7 10.6 100.0
2009 86.9 12.1 0.0 0.0 2.2 6.9 1.1 1.9 74.8 74.8 74.0 0.0 0.8 0.0 0.0 0.0 0.0 0.0 0.0 13.1 0.0 0.0 0.7 12.4 100.0
2010 84.6 11.6 0.0 0.0 2.2 6.4 1.0 1.9 73.1 72.2 71.3 0.0 0.9 0.0 0.0 0.0 0.0 0.0 0.8 15.4 0.0 0.0 0.7 14.7 100.0
2011 81.8 11.3 0.0 0.0 2.3 6.1 1.0 1.9 70.4 68.7 67.7 0.0 0.9 0.0 0.0 0.0 0.0 0.0 1.7 18.2 0.0 0.0 0.7 17.5 100.0
2012 78.7 11.1 0.0 0.0 2.4 5.8 1.0 1.9 67.6 65.2 64.2 0.0 1.0 0.0 0.0 0.0 0.0 0.0 2.3 21.3 0.0 0.0 0.8 20.5 100.0
89.3 12.2 0.0 0.0 2.0 7.0 1.3 1.9 77.1 77.1 76.2 0.0 0.9 0.0 0.0 0.0 0.0 0.0 0.0 10.7 0.0 0.0 0.6 10.0 100.0
Table 11
Sales of Consumer Health by Category and Distribution Format: % Analysis 2012
% retail value rsp OTC SN VDS WM HTP AC
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Store-Based Retailing Grocery Retailers Discounters Healthfood shops Hypermarkets Small Grocery Retailers Supermarkets Other Grocery Retailers Non-Grocery Retailers Health and Beauty Retailers Chemists/Pharmacies Parapharmacies/Drugstores Other Healthcare Specialist Retailers Mixed Retailers Department Stores Mass Merchandisers Variety Stores Warehouse Clubs Other Non-Grocery Retailers Non-Store Retailing Vending Homeshopping Internet Retailing Direct Selling Total
100.0 16.9 0.0 0.0 2.0 9.6 1.3 4.0 83.1 83.1 83.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 PCH
72.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 72.7 72.7 50.2 0.0 22.5 0.0 0.0 0.0 0.0 0.0 0.0 27.3 0.0 0.5 20.0 6.8 100.0
70.5 6.7 0.0 0.0 3.0 3.2 0.5 0.0 63.8 57.6 57.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.2 29.5 0.0 0.0 0.0 29.5 100.0
10.0 4.0 0.0 0.0 2.6 0.0 1.4 0.0 6.0 6.0 4.6 0.0 1.4 0.0 0.0 0.0 0.0 0.0 0.0 90.0 0.0 0.0 0.0 90.0 100.0
89.7 14.1 0.0 0.0 2.5 7.8 1.1 2.7 75.6 73.4 73.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 10.3 0.0 0.0 0.0 10.3 100.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Store-Based Retailing Grocery Retailers Discounters Healthfood shops Hypermarkets Small Grocery Retailers Supermarkets Other Grocery Retailers Non-Grocery Retailers Health and Beauty Retailers Chemists/Pharmacies Parapharmacies/Drugstores Other Healthcare Specialist Retailers Mixed Retailers Department Stores Mass Merchandisers Variety Stores Warehouse Clubs Other Non-Grocery Retailers Non-Store Retailing Vending Homeshopping Internet Retailing Direct Selling Total
80.4 11.5 0.0 0.0 2.7 6.8 0.8 1.3 68.9 64.8 64.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.1 19.6 0.0 0.0 0.0 19.6 100.0
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Source: Key:
Euromonitor International from official statistics, trade associations, trade press, company research, store checks, trade interviews, trade sources OTC = over the counter; SN = sports nutrition; VDS = vitamins and dietary supplements; WM = weight management; HTP = herbal/traditional products; AC = Allergy Care; PCH = paediatric consumer health
Table 12 Rs million
Forecast Sales of Consumer Health by Category: Value 2012-2017
2012 OTC Sports Nutrition Vitamins and Dietary Supplements Weight Management Herbal/Traditional Products Allergy Care Paediatric Consumer Health Consumer Health
Source: Note:
2013 60,475.5 5,510.7 49,900.5 14,981.5 46,841.0 2,963.1 130,868.2
2014 64,301.5 6,647.3 54,578.6 17,907.3 49,702.1 3,294.7 143,434.6
2015 68,574.6 8,088.6 59,154.8 20,907.2 52,360.6 3,651.2 156,725.2
2016 73,577.5 9,943.7 63,800.4 23,976.9 55,031.7 4,043.6 171,298.4
2017 78,898.7 12,287.4 68,148.4 26,972.4 57,480.1 4,427.0 186,306.9
57,624.3 4,661.5 45,230.2 12,078.6 44,139.9 2,676.6 119,594.5
Euromonitor International from trade associations, trade press, company research, trade interviews, trade sources Sum of categories is greater than the market size because allergy care is a duplicate of categories found in cough, cold and allergy remedies, dermatologicals and eye care; paediatric consumer health is an aggregate of paediatric categories in OTC and vitamins and dietary supplements; and herbal/traditional products is an aggregate of herbal/traditional categories in OTC and vitamins and dietary supplements, except herbal/traditional medicinal teas and herbal/traditional smoking cessation aids.
Table 13
Forecast Sales of Consumer Health by Category: % Value Growth 2012-2017
% constant value growth 2012-17 CAGR OTC Sports Nutrition Vitamins and Dietary Supplements Weight Management Herbal/Traditional Products Allergy Care Paediatric Consumer Health Consumer Health
Source: Note:
2012/17 TOTAL 36.9 163.6 50.7 123.3 30.2 65.4 55.8
6.5 21.4 8.5 17.4 5.4 10.6 9.3
Euromonitor International from trade associations, trade press, company research, trade interviews, trade sources Sum of categories is greater than the market size because allergy care is a duplicate of categories found in cough, cold and allergy remedies, dermatologicals and eye care; paediatric consumer health is an aggregate of paediatric categories in OTC and vitamins and dietary supplements; and herbal/traditional products is an aggregate of herbal/traditional categories in OTC and vitamins and dietary supplements, except herbal/traditional medicinal teas and herbal/traditional smoking cessation aids.
Table 14 Rs million
Forecast Sales of Consumer Health by Region: Value 2012-2017
2012 East and Northeast India North India South India 23,054.1 36,192.4 31,589.0
2013 25,403.6 39,844.1 34,323.1
2014 28,009.9 43,900.2 37,310.8
2015 30,827.3 48,161.5 40,450.6
2016 33,968.6 52,839.0 43,838.5
2017 37,268.3 57,664.8 47,259.9
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West India India

Source:
28,759.1 119,594.5
31,297.3 130,868.2
34,213.7 143,434.6
37,285.7 156,725.2
40,652.3 171,298.4
44,113.8 186,306.9
Euromonitor International from trade associations, trade press, company research, trade interviews, trade sources
Table 15
Forecast Sales of Consumer Health by Region: % Value Growth 2012-2017
% constant value growth 2012-17 CAGR East and Northeast India North India South India West India India
Source:
2012/17 TOTAL 61.7 59.3 49.6 53.4 55.8
10.1 9.8 8.4 8.9 9.3
Euromonitor International from trade associations, trade press, company research, trade interviews, trade sources
APPENDIX OTC Registration and Classification

In India, the import, manufacture, distribution and sale of drugs is regulated by the Drugs and Cosmetics Act and its subordinate legislation, the Drugs and Cosmetics Rules. The legislation is enforced by the Central Government (Ministry of Health & Family Welfare) in New Delhi. The regulation of drugs in India is based on their positioning in the lists of drugs included in Schedules G, H, and K and X, which are appended to the Drugs and Cosmetics Act. OTC products in India have no official definition. Instead, all the drugs that are not listed by the Act as prescription only drugs are considered as non-prescription drugs (or OTC drugs). The product categories highlighted by Schedules G, H, K and X are as follows: Schedule X: products containing controlled ingredients, such as barbitals, methamphetamines and narcotics. Schedule X drugs must be labelled XRx in red on the top left corner of the packaging. They must also be labelled: Warning: to be sold by retailer on the prescription of a registered medical practitioner only. Schedule H: products restricted to prescription sales. However, topical schedule H products may be sold OTC, with this including ibuprofen. Schedule H drugs have to be labelled Rx in red on the top left corner, and must also carry the words: Warning: to be sold by retailer on the prescription of a registered medical practitioner only. Schedule G: products that can be sold without prescription. The product must carry the following warning: Caution. It is dangerous to take this preparation except under medical supervision. Antihistamines fall into this category. Schedule K: products considered as Household Remedies, including analgesics, antacids, gripe water and inhalant decongestants. These products can be sold by non-drug-licensed stores (non-chemists) in villages with fewer than 1,000 inhabitants. Based on the above regulations, prescription only drugs are those medicines that are listed in Schedules H and X. The Drug & Magic Remedies (Objectionable Advertisement) Act details a list of ailments for which the advertising of remedies is not permitted. It also prohibits misleading advertisements which, directly or indirectly, give false impressions regarding the true character of the drug,
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make false claims, or are otherwise false or misleading in any particular respect. Currently there is no specific law which prohibits the advertising of prescription drugs. However, drugs falling in Schedules G, H, and X are currently not advertised to the public under a voluntary commitment by the pharmaceutical industry in India. In 2011, the Ministry of Health withdrew the ban which it had put on the advertising of emergency contraception in 2010. However, the government is extremely stringent in making sure that companies do not advertise their brand names and use deceptive advertising instead. i-pill by Piramal Healthcare came up with an advertisement whereby the name of the brand was not shown; it only made consumers aware that if more information was required on how to avoid unwanted pregnancy, then they could visit the website. Products registered as Ayurvedic Medicines can be sold by non-drug-licensed stores. Some of the top consumer healthcare brands in India, including Vicks, Eno and Amrutanjan Pain Balm, are registered as Ayurvedic Proprietary Medicines because of their plant-based natural active ingredients. Unlike the prices of other drugs and supplements, which are closely controlled by the National Pharmaceutical Pricing Authority, there are no price controls on ayurvedic medicines. The Drugs (Prices Control) Order 1995 restricts the prices of 74 bulk drugs and their formulations (estimated to cover 40% of the total pharmaceuticals market in India), and is implemented by the National Pharmaceutical Pricing Authority. Most products are only permitted to be sold via licensed pharmacies, thus chemists/pharmacies dominates the retailing of consumer health products. Chemists/pharmacies accounted for a 64% value share in consumer health in 2012, whilst parapharmacies/drugstores accounted for negligible sales. This limited distribution inevitably results in narrower access to consumer health products. It also results in a lack of price competition. Many in the government want to make consumer health products more widely available to the population as a whole, and to allow larger chained grocery outlets to enter the market, thus driving down the prices of many products through their greater economies of scale. In response, representatives of chemists/pharmacies point to concerns regarding the dangers of self-medication and the damage that this increased competition would cause to the pharmacy retail infrastructure in the country. Since 2007, proposals for amendments to Schedule K legislation have been pending review by the central government. These proposals would extend the range of products on sale in nonlicensed outlets, and also extend the range of non-licensed outlets permitted to offer Schedule K health products. During the forecast period, amendments to items 12 and 13 of Schedule K of the Drugs and Cosmetics Act could result in a wider range of consumer health products being available for sale at unlicensed retailers. Product areas which will benefit from expanded distribution include: Analgesics, such as aspirin, acetaminophen and topical analgesics/anaesthetic balms; Digestive remedies, such as antacids, oral dehydration solution and gripe water; Cough and cold treatments, including inhalant decongestants Eye care, in the form of tetracycline-based ophthalmic ointments. OTC sales of these products would be permitted through all outlets according to the proposed legislation, enabling grocery retailers to expand their product ranges, thus making consumer health products available to a wider section of the population. There are concerns over the risks of self-medication, particularly with the low adult literacy rate of around 74% in 2011. Many are concerned that those who are unable to read labels are at risk of overdosing or suffering from drug interactions. Consequently, manufacturers are expected to work closely with the government to educate retailers and salespersons about safe self-medication.
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Under rule 96 of the Drugs and Cosmetics Rules, it is mandatory to provide minimum information on the labels of all medicines other than Indian systems of medicine (ISM such as ayurveda, siddha and unani): Proper (generic) and trade (brand) name; Net contents and content of active ingredients; Name and address of manufacturer, including manufacturing licence number; Batch number, manufacturing date and expiry date; Maximum retail price (inclusive of all taxes). There are no separate labelling requirements for OTC drugs. Under the Standards of Weights & Measures Rules, most packaged consumer products are required to have the Maximum Retail Price printed on the label. The Drugs Controller General of India (DCGI) is set to make it mandatory that prescription formulations of acetaminophen (paracetamol) in combination with other drugs cannot have a weight of more than 325mg of acetaminophen, and to put a label warning of potential liver toxicity if more of the drug is consumed than the recommended daily dose on the box. In April 2011, the DCGI decided to ban over-the-counter sales of the latest generation of antibiotics from general pharmacies, and put around 90 antibiotics under a new schedule, HX, as per the Drugs and Cosmetics Act.
Vitamins and Dietary Supplements Registration and Classification

The manufacture and sale of vitamins is officially legislated under the Drugs and Cosmetics Act 1945, with rules and regulations similar to those covering standard medical products. The government is in talks along with the Drug Controller General of India (DCGI) and Food Safety and Standards Authority of India (FSSAI) to establish regulations which will make companies which use medicinal ingredients for non-medicinal usage need permission from the DCGI as mandatory for the manufacturing and distribution of these products. Vitamins also face strict price ceilings, as the government considers vitamin supplements to be essential in combating the widespread malnutrition amongst consumers who have low purchasing power. The regulatory authorities are in the process of setting up new regulations in order to make sure companies cannot sell drugs or any medicinal composition as a food supplement, as in doing so, these companies avoid the price ceiling set for medicines in India. Consumers in 2012 were moving towards multivitamins to a large extent, as fast-paced lives and a lack of time did not allow most urban consumers to eat a proper diet supplying all the required nutrition. In 2012 the delivery mechanism continued to be tablets and capsules, to be taken like any other medicines, post consumption of a meal. In 2012 drugs continued to be promoted by doctors, as Indians do not inherently have the tendency to buy vitamins and dietary supplements on their own. Hence, companies continued to promote them via doctors and nutritionists. Packaging of supplements did not witness any changes in 2012, and was primarily in hard plastic bottles, with dosage, ingredients and pricing stated on the label. Labelling of all vitamins and dietary supplements continued to include an ingredients list, along with dosage and pricing. No new innovations were observed in this regard. Vitamins and dietary supplements are available via chemists/pharmacies, hypermarkets, supermarkets and health and beauty specialists amongst store-based retailers. In non-store retailing, these products are mainly sold via internet retailing and direct selling. No particular regulations are applicable to the distribution channel.
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Self-medication/self-care and Preventative Medicine

There was an increasing trend of consumers preferring to opt for self-medication in recent years. This trend was prominent mostly amongst urban consumers who have hectic lifestyles and are pressed for time. These consumers find it difficult to take time to visit a doctor for common ailments such as headaches, joint pain, coughs, colds, fevers and digestive issues, and prefer to self-medicate. The number of doctors in India is low compared with the population, and results in long queues at clinics. This also acts as a deterrent for urban consumers to visit a doctor for common ailments, as they are hard-pressed for time. Previously, most families used traditional home remedies for common ailments. However, as nuclear families have become the norm in urban areas, especially in metros, the commonly used traditional home remedies are less frequently being passed on to the younger generation. As a result, these consumers are opting for readily available OTC products for common ailments. The trend of traditional home remedies is still prevalent in rural areas, with consumers not having enough access to OTC products. Manufacturers are aiming to increase the distribution and presence of such products in rural areas in order to make them available to rural consumers. The trend of rural consumers shifting to OTC products will only increase in the coming years. Urban consumers also became more conscious about their health in recent years, and opted for preventive medication such as chyawanprash to increase their immunity. Demand for these preventive medications is also on the rise due to consumers having hectic work lives, and being unwilling to miss any working days. Manufacturers such as Emami, Dabur India, GlaxoSmithKline Consumer Healthcare and Amrutanjan Health Care have recruited a number of celebrities and sports stars to endorse their brands and increase awareness. The prominent brand Zandu Pancharishta has Indian cricket team captain MS Dhoni and Padma Vibhushan Pandit Birju Maharaj as brand ambassadors. Sona Chandi Chyawanprash has popular Bollywood star Shahrukh Khan as its brand ambassador, Zandu Kesari Jivan has Pandit Birju Maharaj as its brand ambassador and Dabur Indias popular product Dabur Chyawanprash also has Indian cricket team captain MS Dhoni as its brand ambassador. Aggressive promotions and branding measures by manufacturers have ensured there is increased awareness of their brands and the benefits these products offer consumers.
Switches
There were no particular switches in 2012. However, in the forecast period more Rx medicines might switch to OTC, in order to reduce UTC sales of these drugs.
SOURCES
Sources used during the research included the following: Summary 1 Research Sources Official Sources
AESGP Department of Chemicals & Petrochemicals Department of Family Welfare, India Government Draft National Policy on Indian System of Medicines Ministry of Health, Government of India National Pharmaceutical Pricing Authority
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Press Information Bureau Trade Associations Association of the European Self-Medication Industry (AESGP) Confederation of Indian Industry (CII) Health & Dietary Supplement Association of India IBEF Indian Drug Manufacturers Association Organisation of Pharmaceutical Producers of India (OPPI) World Self-Medication Industry (WSMI) Trade Press Advertising & Marketing AFAQS! Asian Age, The Bloomberg Business India Business Line Business Standard Business Today Business Week Business World Chemical Weekly Daily News & Analysis Domain-b Drug Today Eastern Pharmacist Economic Times, The Equity Master Express Pharma Pulse Financial Express, The Hindu Business Line Hindustan Times IBN Live India Health News India PRWire India Today Indiabiz News Indian Express MedGuide India
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MyIris Newspolitan.com Outlook India Pharma News Pharmabiz.com Press Trust of India Rediff India Business News Talk Delhi The Economic Times The Hindu The Times of India Thomson Reuters Time World Times of India Tribune, The
Source: Euromonitor International

Consumer Health in India

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Consumer Health in India

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CONSUMER HEALTH IN INDIA

Euromonitor International July 2013