Last year’s hay fever season was particularly severe and, with a media health scare to counter, pharmacy teams could be equally as busy supporting and advising allergy sufferers this season. Victoria Goldman reports

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In January 2015, a media scare warned that taking over-the-counter antihistamine tablets might significantly increase the risk of developing dementia. The University of Washington study, published in JAMA Internal Medicine, revealed that taking a daily dose of antihistamines for at least three years could increase the chances of developing Alzheimer’s disease by more than 60 per cent.

Thanks to scaremongering headlines, some pharmacy customers may be worried about taking antihistamines over the coming hay fever season. According to NHS Choices, many of these news reports were “somewhat misleading”, so it’s important that customers are aware of the facts.

The study was based on prescribed medicines, rather than those bought over the counter, and concentrated on medicines with anticholinergic actions. The antihistamines involved were those known to cause drowsiness (which aren’t usually taken daily for hay fever) and the association was seen only in people over 65. The increased risk was found in people who took these medicines once every day for more than three years. No link was found at lower levels.

According to Allergy UK, nearly 18 million people in the UK suffer with hay fever.

Many sufferers need more help to find a solution that works for them

Antihistamines are often the first-line treatment, as they can ease a broad range of mild to moderate hay fever symptoms. If customers choose to take antihistamines, they should be advised to use non-sedating once- a-day tablets or syrups, such as BecoAllergy, Zirtek, Clarityn or Piriteze, rather than the sedating versions. Many customers may be unaware that there are also several other management options that can be tailored towards specific symptoms and their severity.

“Generally consumers make the assumption that tablets are the best treatment,” says Ash Soni, president of the Royal Pharmaceutical Society. “This is the case when they don’t speak to a pharmacy team member, as they have a lack of understanding about symptom control. Eye drops and nasal sprays can deal with specific symptoms and, in many cases, are more effective because of their application at the symptom site.”

Symptom severity

Last year’s hay fever season was particularly severe. Figures released by the Royal College of General Practitioners show that 11,873 people visited GP surgeries in England and Wales with hay fever or allergy symptoms in the week beginning June 9, compared with 5,560 in the same week in 2013.

Lindsey McManus, deputy CEO of Allergy UK, says that hay fever “can be extremely debilitating for many sufferers and has a huge impact on their daily lives for long periods of the year.” In the 2014 Allergy UK report on hay fever, the top three symptoms were a runny nose, sneezing and itchy/watery/red swollen eyes. The report revealed that 89 per cent of hay fever sufferers’ daily routines were affected by their symptoms, while 87 per cent said that their symptoms caused sleepless nights.

“We are aware there are a lot of sufferers who are not managing their symptoms well, often due to the lack of understanding on how to use medication and treatments correctly,” says Ms McManus. “To keep symptoms under control, sufferers need to be armed with the knowledge on how to combine treatments with practical lifestyle changes to form an effective allergy management plan. Many sufferers need more help to find a solution that works for them and are reaching out for support to manage these debilitating symptoms.”

Pharmacy advice

Omega Pharma’s hay fever range grew at three times the rate of the total category last year, and will be supported in 2015 by a two- tiered TV campaign and £2 million investment. The campaign will position hay fever as a condition that should be taken seriously, highlighting the role of pharmacies as the first port of call. “Omega Pharma knows how debilitating seasonal allergic rhinitis can be when treated incorrectly – that’s why it’s so important for sufferers to find a treatment that works for them,” says Stuart White, the company’s marketing manager.

Omega Pharma’s Prevalin non-drowsy nasal sprays have a unique thixotropic gel formulation, “getting to work in just three minutes, which is five times faster than antihistamine tablets”. And it is expanding its Prevalin portfolio this year, with Prevalin Allergy 20ml Kids and Prevalin Allergy 30ml Pharmacy pack.

The addition of the kids pack means that fast-acting protection is now available for children from six years, and frequent users or those in need of year-round support will benefit from the larger pharmacy pack size. Omega Pharma recognises that pharmacy staff are critical in helping sufferers get the help they need to manage their symptoms quickly and effectively. The company has revised its training booklet and quick guide, which will be distributed through key trade titles and will also be available via their training portal.

Maximising P lines

According to GlaxoSmithKline, the UK allergy category is currently worth over £100m and is growing strongly. In total, 4.49 million new consumers entered the allergy category in 2013 and Piri, worth £23.5m, is continuing to drive the success of the category.

“We encourage pharmacists to start promoting the category from April onwards to inspire and remind consumers to be prepared with appropriate products,” says Julia Bauer, allergy brand manager at GSK. “By doing so, pharmacists can communicate the message of treating symptoms as soon as they start, ensuring that consumers understand how best to use allergy and hay fever treatments.”

The largest proportion of allergy sales during the 2013 season came from the general sales list (GSL), which accounted for 62 per cent of the market. Pharmacy sales continue to be valuable, but GSK research reveals that 41 per cent of shoppers are unaware of the additional behind-the-counter pharmacy offerings. “Dummy packs for low awareness P lines are an effective way of  driving awareness and allowing the shopper to browse the whole range before making a purchase decision with the pharmacist’s approval that the P product is appropriate,” says Ms Bauer.

Within the Piri range, there is a choice of treatments to suit different consumer needs, including one-a-day treatments, tablets and sprays and products suitable for both adults and children. “As tablets and capsules are the prime volume drivers for the category, they should be well spaced accordingly.”

New formats such as nasal sprays are driving growth and incremental purchase in the category and should be allocated their fair share of space towards the top of the fixture to ensure desirable visibility, says Ms Bauer. The decision on brand is likely to be made before reaching the fixture. “Therefore it’s recommended the fixture is merchandised by format. This allows less visible formats (sprays and drops) to have a presence on the fixture. Also, syrups should be grouped together to create a visible children’s offering.”

Link sales

Decongestant nasal sprays, such as new formulation Otrivine Congestion Relief, can be used as a temporary measure to clear a blocked nose. This will then make it easier for customers to use corticosteroid nasal sprays, such as Otrivine Allergy Relief Nasal Spray, Beconase or Pirinase Hayfever Nasal Spray, more effectively. “In the summer season, decongestants should be placed at the forefront of the cold and flu bay (at eye level) as some of these products can be used to help clear allergy-related congestion.”

Customers who experience mainly eye symptoms are likely to benefit from products such as Opticrom Hayfever Eye Drops and Murine Hayfever Relief Eye Drops (both of which contain sodium cromoglicate).

According to Prestige Brands, supplier of Ultra Chloraseptic Throat Sprays, a sore throat is one of the most forgotten yet painful hay fever symptoms. This may be caused by mouth breathing, due to a blocked nose and sinuses, but also by post-nasal drip (a build-up of mucus at the back of the throat).

Not everyone wants to use conventional hay fever treatments and there are many natural alternatives that customers can try, such as Nelsons Pollenna, NasalGuard AllergieBLOCK gel and HayMax barrier balm. New Stérimar Stop & Protect Allergy response is “proven to provide rapid and effective relief from the symptoms of allergic rhinitis, including blocked, runny, itchy nose, sneezing and tingly, watery eyes”. Max Wiseberg, HayMax MD, suggests hay fever sufferers also try a daily drink of nettle tea, take two vitamin C & quercetin capsules a day and inhale with a salt pipe for 10 to 25 minutes daily.