Drug Store News - March 2019

Page 1

MARCH 2019

Is CBD about to break out?

DSN’s exclusive look at a fledgling category about to take off


Can Independent Retailers Hold onto Their Slice of the Pie? Facing unprecedented pressures, smaller retailers need to get more aggressive

Vol. 41 No. 3 DrugStoreNews.com



24 Industry Issues Summit

68 OTC REX Awards 2019

Highlights from panel discussions focused on chronic care management and “Ideas that Matter”

Breaking down the top-shelf companies in the OTC space

82 News


41 Special Report: CBD DSN breaks down what to know about CBD as it takes off. Plus, a who’s who of companies that stand out in the growing category

84 U.K. Pharmacist Prescribing How pharmacist prescribing works across the pond and how a similar model might be implemented stateside

62 A Piece of the Pie

90 News

How independent pharmacies build out their services to differentiate themselves and keep and attract customers

INSIDE BEAUTY 92 Staying Ahead in Tough Times Beauty brands pull out all the stops as category spending growth starts to slow

COLUMNS 6 Editor’s Note 8 Industry News 20 Products to Watch


GENERAL MERCHANDISE 98 Is This Your Card? Greeting card companies roll out products meant to appeal to muliticutural and younger card shoppers

22 Counter Talk with Apple Diabetes Center’s John Motsko

60 One-On-One with Respario’s Ian Stone

102 Last Word with David Orgel Consulting’s David Orgel

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DSN (ISSN 0191-7587) is published monthly 12 times a year by EnsembleIQ, 8550 W. Bryn Mawr Ave, Suite 200, Chicago, IL 60631. Subscription rates: Manufacturers, schools, libraries and all others allied to the field $119. Canadian subscribers $129. Foreign subscribers $225. Periodicals postage paid at Chicago, IL, and additional mailing offices. POSTMASTER: Please send address changes to DSN, Circulation Fulfillment Director, P.O. Box 3200, Northbrook, IL 60065-3200. Canada Post: Publications Mail Agreement #40612608. Canada Returns to be sent to Bleuchip International, P.O. Box 25542, London, ON N6C 6B2. For change of address, six weeks notice to Drug Store News, P.O. Box 3200, Northbrook, IL 60065-3200 is requested. Give old and new address and zip code. If possible, enclose address portion from cover on previous issue. Subscription changes also may be emailed to drugstorenews@omeda.com, or call 847-564-1468. Vol. 41, No. 3, March 2019. Copyright © 2019 by EnsembleIQ. All rights reserved.





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Rocketing onto Shelves As CBD manufacturers ready for a land rush into retail doors, merchants should tread carefully in the category By Seth Mendelson


BD products have arrived! How do I know? It said so in People magazine. When a category starts getting real coverage in People magazine, you know it is time to take notice. That is just what happened last month. People, which remains the bellwether for many consumers in terms of fashion trends and new fads, featured CBD beauty products in its regular People Beauty page in an issue in mid-February. Seth Mendelson While the magazine focused on just six different prodEditor in Chief/ ucts, it also sent a message out to shoppers — and retailAssociate Brand ers — that CBD is a segment to take heed of, perhaps Director right now, but certainly in the near future. If it shows up in People, many people feel, it has to be on the right side of history. This month, Drug Store News features two major articles on this interesting and complex category. While one article focuses on some of the many players in the marketplace, the other one gives our readers a look at what is happening in the category and what retailers can expect from it over the short and long terms.

An EnsembleIQ Publication 8550 W. Bryn Mawr Ave, Suite 200, Chicago, IL 60631 Vice President, Brand Director Eric Savitch (856) 489-3336, esavitch@ensembleiq.com Editor in Chief /Associate Brand Director Seth Mendelson (212) 756-5160, smendelson@ensembleiq.com EDITORIAL Associate Managing Editor David Salazar (212) 756-5114, dsalazar@ensembleiq.com Senior Editor Sandra Levy (845) 893-9573, slevy@ensembleiq.com Desk Editor Maria Manliclic (212) 756-5093, mmanliclic@ensembleiq.com Online Editor Gisselle Gaitan (212) 756-5138, ggaitan@ensembleiq.com SALES & BUSINESS Beauty Director Laura Fontana (440) 724-4369, lfontana@ensembleiq.com Northeast Manager Alex Tomas (212) 756-5155, atomas@ensembleiq.com Regional Manager Steven Werner (312) 961-7162 swerner@ensembleiq.com Brand Marketing Manager Mary Ellen Magee (856) 419-8411, mmagee@ensembleiq.com Media Production Assistant Betty Dong (212) 756-5134, bdong@ensembleiq.com Director of Audience and Data Gail Reboletti (224) 231-6363, greboletti@ensembleiq.com PROJECT MANAGEMENT/PRODUCTION/ART Vice President Production Derek Estey (877) 687-7321 x 1004, destey@ensembleiq.com Creative Director Colette Magliaro cmagliaro@ensembleiq.com Art Director Amy Kelkenberg PRESIDENT Consumer Goods Retail Business Jennifer Litterick (647) 946-9219, jlitterick@ensembleiq.com CUSTOMER SERVICE

This is a category still very much in its infancy at retail, and that means it is going to be a learning experience for all involved. By no means is this going to be an easy category to merchandise and market. CBD is brand new to the marketplace, and it brings with it a hoopla and loyal customer base. But this is a category still very much in its infancy at retail, and that means it is going to be a learning experience for all involved. As we note, most retailers are still hesitant to get involved with CBD, waiting for more direction from the federal government on further guidance on the legality of selling these products. But, many predict, that guidance is coming soon and the floodgates will open right after. And, when it does happen, it will mean a lot more profits for retailers and suppliers. Still, retailers need to be careful when they do get involved with the category. Most importantly, the retail community needs to be on its collective toes for any type of malfeasance. While most companies in this segment are squarely on the up-and-up, there are always a few that are looking to make a quick buck from a hot market, especially one that currently has little industry regulations. Enjoy the articles and, we hope, as you read them, you quickly will see the opportunity out there from stocking CBD products, just as you understand the importance of working with credible partners in a category that is just getting off the ground. dsn



Having a problem with your subscription? Send us full details with the mailing label of the last copy you received, along with your telephone number. Write to: Circulation Fulfillment Director, Drug Store News, P.O. Box 3200 Northbrook, IL 60065-3200; email drugstorenews@omeda.com; or call (847) 564-1468 CIRCULATION LIST MANAGER Elizabeth Jackson MeritDirect (847) 492-1350 x 318. REPRINTS PARS International, LF-Reprints@parsintl.com, (212) 221-9595 x435, tinyurl.com/LF-reprints. Single copy price is $15 for a regular issue and $100 for a statistical issue. PERMISSIONS For permission to reuse material from Drug Store News/DSN (ISSN 0191-7587) please access www.copyright.com or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, (978) 646-2600, (855) 239-3415. CCC is a not-for-profit organization that provides licenses and registration for a variety of uses.

CORPORATE OFFICERS Executive Chairman Alan Glass Chief Executive Officer David Shanker Chief Financial Officer Dan McCarthy Chief Operating Officer Joel Hughes Chief Innovation Officer Tanner Van Dusen Chief Human Resources Officer Ann Jadown Executive Vice President, Events & Conferences Ed Several

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Owen Mumford Inks Agreement with Bigfoot Biomedical

Harmony Hemp, Terraform Capture DSN/ECRM CBD Buyers’ Choice Award Harmony Hemp won the Drug Store News/ECRM Buyers’ Choice Award for its NeuroComfort Relief Gel during ECRM’s Hemp/CBD Health & Beauty Care EPPS held last month in Chicago. Terraform was the finalist for its SPF-

50 Moisturizer. The two companies were selected from dozens of entries in the award program, samples of which were displayed in the ECRM hospitality area during the EPPS meetings. Buyers cast their votes based on product innovation and packaging. “There is a great deal of interest in CBD products among retail buyers and category managers attending our sessions,” said Tony Giovanini, senior vice president of HBC for ECRM. “What’s amazing is the breadth of products now available with CBD, and the sheer number of established and emerging brands that are getting into the CBD arena. Harmony Hemp and Terraform are perfect examples of brands that are driving innovation in the category.” Harmony Hemp’s NeuroComfort Relief Gel with 500 mg of CBD introduces a natural solution to help soothe and comfort skin. In conjunction with the many benefits of CBD, it contains enhanced cooling menthol with deep penetrating and long-lasting heat of capsaicin for effective neuropathic relief. Terraform develops health, hair and skin care products using natural ingredients to develop a new paradigm in beauty, using intentionally curated ingredients and an advanced scientific approach to product formulation, according to the company. Its Terraform SPF-50 Moisturizer is a light-textured sun protection serum for the face that provides powerful SPF 50 protection. A CBD-rich — 150 mg of hemp-derived CBD — active complex of natural extracts, vitamin E and beta-glucan are meant to protect the skin and promote the regeneration of damaged cell structures.



Owen Mumford has inked a commercial supply agreement with Bigfoot Biomedical, a diabetes company developing data-driven solutions for optimizing the dosing and delivery of insulin. The agreement supports the inclusion of Owen Mumford’s line of Unifine Pen Needles into the connected injection system subscription supply bundles that Bigfoot currently is developing. The majority of people with diabetes that requires insulin — more than 5 million in the United States — use injection therapy, but insulin dosing requires a complex set of guidelines. The company said there aren’t many tools to track insulin injection administration and healthcare providers also lack solutions to support their efforts to implement prescribed insulin regimens. “We’re delighted to support Bigfoot’s innovative product and service vision for its injection systems with our Pentips line,” Owen Mumford USA executive vice president Travis Shaw said. “We look forward to a strong relationship built on shared commitments to providing quality products for insulin pen users.” Bigfoot Biomedical said its vision is to deliver injection systems as a monthly subscription and combine insulin dosing support and glucose management, with the goal of reducing the daily burden of diabetes management for people with insulinrequiring diabetes. “As a company comprised of people who live with diabetes, we know that one of the largest, non-therapy related burdens people face is the acquisition and management of diabetes supplies,” Bigfoot CEO Jeffrey Brewer said. “Our inclusion of Owen Mumford’s Pentips in our supply bundles will ensure our customers always have access to a high quality, comfortable pen needle for each insulin dose.”


Google Debuts New Medication Disposal Locator Tool In an effort to help make it easier for consumers to dispose of unwanted and unused medication, Google has begun piloting a new feature in Google Maps that helps identify locations that offer drug disposal. Among the drug disposal locations that include hospitals and government building are CVS Pharmacy and Walgreens locations with safe disposal kiosks. Users just search “drug drop off near me” or “medication disposal near me” to display disposal locations. The pilot was announced as part of efforts to promote National Prescription Drug Takeback Day during an event at the White House in the fall and was the result of a collaboration with Walgreens, CVS Health and local and state governments in Alabama, Arizona, Colorado, Iowa, Massachusetts and Maine, Google said. The Drug Enforcement Administration and Google Maps are working to expand the pilot through additional location data. For Walgreens, which has collected more than 400 tons of medication disposal units installed at CVS Pharmacy locations unwanted and unused medication since it began rolling out disnationwide, it has donated more than 900 additional units to posal kiosks, consumers have the option of more than 1,000 loca- community locations. It also said that it has collected more than tions. It also is working on offering a drug disposal option at all 375 metric tons of medications and plans to roll out 1,100 disof its pharmacies. posal units to its pharmacies and at police departments by the 20954_2019_Trade_Ads_Mar_DSN_Half_Page_Ad_FNL.pdf 1 2/12/19 10:37 AM CVS Health said that, in addition to more than 900 safe end of the year.









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ManukaGuard, Atlantic Access Group Win DSN/ECRM Buyers’ Choice Awards ManukaGuard won the Drug Store News/ECRM Buyers’ Choice Award for its Manuka Honey Gummies during ECRM’s Cough, Cold Preventative & Allergy EPPS held in January in Chicago. Atlantic Access Group was the finalist for its

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BalanX Anxiety & Stress Relief Spray. “As consumers focus more on natural remedies for preventive health, suppliers are stepping up to develop new products that address these needs,” said Tony Giovanini, senior vice president of HBC for ECRM. “Our two Buyers’ Choice Award winners are great examples of such innovation, one addressing physical well-being, the other addressing mental well-being.” ManukaGuard was founded to bring New Zealand’s unique medical grade manuka honey to the consumer via formulated products in functional delivery systems, according to company officials. Each of its Medical Grade Manuka Honey Gummies contains 1,000 mg of medical grade manuka honey. It contains no sugars of any kind, other than the honey, with the honey sugars converting to glycogen for stored energy. Taken daily, it serves to support and maintain the immune system, which helps prevent colds and flu, the company said. They are available in 60-count bottles and a three-count “Kids Well” lunch box sachet. Atlantic Access Group is a pharmaceutical company focusing on the development, production and commercialization of innovative multisymptom-related formulas, with the mission to create safer and more effective ways to find real, lasting relief. Its BalanX Anxiety Relief Oral Spray — part of its Emotional and Anxiety - Stress product line — is a fast-acting formula that acts directly on the different biochemicals commonly produced by the brain when symptoms of anxiety, stress, mood and emotional distress appear, the company said. The formula is nondrowsy and does not produce side effects.


Quaker Oat Dives into the Beverage Category Quaker Oat is expanding its line of offer-

Poland Spring Adds New Flavors to Sparkling Water Lineup Poland Spring is adding several new flavors to its line of sparkling water. The brand, which is part of Nestlé Waters North America, has added ruby

red grapefruit, lemon ginger, white peach ginger, blood orange hibiscus, orange mango and vanilla flavor twist varieties. Created from natural spring water sourced from Maine, the beverages contain real fruit flavors and refreshing bubbles, which reflect the brand’s mission to create refreshing beverages that use simple ingredients, the company said. “After the incredibly positive response to the 2018 relaunch of Poland Spring Sparkling, we are excited to maintain momentum with new flavor options,” Yumiko Clevenger-Lee, vice president and chief marketing officer of Nestlé Waters North America, said. “As we continue to expand our portfolio of unique and healthy sparkling offerings, our core focus remains unchanged and unmatched; simple ingredients starting with the 100% natural spring water Poland Spring has been known for since 1845.” Other offerings in the Poland Spring Sparkling Water line include lively lemon, lemon lime, zesty lime, orange, triple berry, summer strawberry, raspberry lime, black cherry, pomegranate lemonade and simply bubbles. The new Poland Spring varieties will be available in a mix of three bottles — 12 oz., 1 liter and 0.5 liters. Each of the flavored waters can be found in-store at supermarkets, club, convenience and chain drug stores in the northeast.

Camber Launches Generic Lovaza Capsules Camber Pharmaceuticals is introducing its generic Lovaza (omega-3 acid ethyl esters) capsules.

Camber’s generic of GlaxoSmithKline’s branded product is indicated to lower levels of triglycerides and may raise “good” cholesterol. Camber’s generic Lovaza is available in a 1-g dosage strength in a 120-count bottle.



ings with its latest introduction. The Chicago-based subsidiary of PepsiCo has launched of its new collection of Quaker Oat Beverage. Formulated with fiber from oat bran, each 8-oz. serving contains 0.75 g of the soluble fiber beta-glucan from oat bran, the company said. “As the leader in oats for more than 140 years, Quaker is uniquely positioned to deliver a breakthrough innovation within the dairy-alternative category,” said Robbert Rietbroek, senior vice president and general manager of Quaker Foods North America. “With more consumers gravitating toward plant-based lifestyles and seeking functional foods, we’re excited to offer a heart-healthy, plant-based beverage that addresses these wants and is accessible to a wide consumer base.” Quaker Oat Beverage can be enjoyed on its own, in smoothies or coffee, or swapped into other recipes, the company said. The products also offer consumers calcium, vitamin D, and fiber from oat bran and chicory root extract in each serving. The products are lactose-free and come in three flavors — original, original unsweetened and vanilla. Quaker Oat Beverage will be sold in 48-oz. bottles that retail for $4.29 each and can be found in the refrigerated dairyalternative section at retailers nationwide.

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Goddess Garden Introduces Reef-Safe Sunscreens Goddess Garden is intro-


ducing a line of reef-safe mineral sunscreen products with an SPF of 50. According to Nova Covington, CEO of the Boulder, Colo.-based company, the 12 new SKUs are available in sport, children’s and baby formulas, and will feature packaging that highlights user benefits. The lotions and sticks use ultra-sheer zinc and soothing plant-based ingredients that deliver a distinct user experience.

The SPF 50 oval-shaped sticks allow for an enhanced convenience with fewer swipes and easier application. All the new sunscreens, including the baby line, range in price from $14.99 to $17.99, while the sticks are priced at $8.99. “We are very proud to be offering a line of sunscreen products that are safe to use, reef-safe and meet the FDA recommendations,” Covington said. “This is a clear and clean line of products.”

Dexcom G6 App Lets Users Ask Siri to Read Blood Glucose Levels Dexcom’s G6 iOS app is making checking blood glucose levels as easy as asking Siri.

The app, which the company said was designed to simplify and change the way users manage their diabetes, allows Siri to share real-time glucose level readings. Dexcom G6 uses a small wearable that’s placed on the patient’s abdomen and wirelessly sends glucose levels to a smart phone, smart watch or receiver. Users then can monitor their numbers closely and discreetly without having to prick their fingers, the company said. “Based on feedback from our users, we are constantly evolving our technology to make living with diabetes more manageable,” said Jake Leach, chief technology officer at Dexcom. “We listened and are excited to launch this app update to improve the overall user experience with G6 and add even more functionality to the world’s most powerful diabetes management tool.” The system also features built-in alerts and alarms that can notify patients and family members before glucose levels reach potentially dangerous levels, the company said. By asking, “Hey Siri, what’s my glucose?” iOS device users will be able to have their readings said aloud, and have display graphs in their lock screens, which prevents users from manually having to open the app for their results. There also is an expanded share function that will allow users to share their readings directly with up to 10 people, as well as a 24-hour reminder before it’s time to replace the sensor, the ability to submit technical inquiries through a browser launched through the app, and an integration with Google Fit. Dexcom users can download the app via the iOS App Store and on Google Play in the coming months.



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Crystal Body Deodorants Creates Gender-Neutral Scents Crystal Body Deodorants has created two

Tom’s of Maine’s Activated Charcoal Toothpaste Shakes up Oral Care Tom’s of Maine is looking to shake

up the oral care category with its latest innovation — Activated Charcoal Toothpaste. Made with sustainably sourced, plant-based charcoal, the product aims to gently whiten teeth and freshen breath. Brand executives said the new toothpaste represented a logical next step given the popularity of charcoal in the past year across the beauty and personal care space — but development posed a challenge. “Charcoal in oral care is a relatively new frontier, so this meant extensive research because we weren’t going to release this until we were absolutely sure it delivered the promised benefits and was safe for

everyday use,” said Lindsey Seavey, Tom’s of Maine oral care brand manager. “It took years to formulate our new Activated Charcoal Toothpaste because, while there are many charcoal ingredients on the market, we needed to find ones that met the requirements of our stewardship model, the rigorous standards we set for natural, sustainable and responsible that drives all of our decisions. Tom’s of Maine Activated Charcoal Toothpaste is not tested on animals and is free of SLS, artificial flavors, sweeteners, colors or preservatives. The peppermint-flavored toothpaste is available in fluoride and fluoride-free options and has a suggested retail price of $5.99.

AAHP’s Industry Summit Set for June The American Association of Homeopathic Pharmacists will hold its inaugural summit, focusing on challenges and solutions in quality and safety of homeopathic drug products, in Baltimore on June 27 and 28.

According to Alissa Gould, AAHP communications chair, the event, to be held at the Hilton Baltimore, is designed to offer manufacturers, retailers and other industry officials a “small setting that promises interaction with experts and peers to address your business concerns at a fraction of the cost of multiple consultants.” She said that the AAHP comprises 33 manufacturers representing 90% of total homeopathic sales. The category generates more than $550 million in annual sales and is growing by nearly 13% annually over the last year in mass retail outlets. To register, attendees can visit jahc2019.org/aahp-summit.html.



new scents meant for everybody. The Louisville, Colo.-based brand, part of the French Transit portfolio, is adding two gender-neutral scents to its lineup — freshly minted and mountain fresh. Both scents are available in an invisible solid stick format that offers users odor protection for up to 24 hours. Crystal said freshly minted was inspired by the scent of freshly minted money and is blended with notes of cotton, linen and fresh mint. Mountain fresh has notes of jasmine, oakmoss, lemon and cedarwood, the company said. “We are excited to expand our existing line of invisible solid sticks, while offering more gender-neutral options,” Martin Floreani, president and CEO at French Transit, said. “They hold considerable appeal for consumers who gravitate towards fresh, clean, natural, unisex scents at a value price.” The new scents are free of aluminum, parabens and artificial fragrances, the company said. Crystal Body Deodorant’s products carry a retail price of $6.15.

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HRG’s February Finds HRG highlights five new product launches


ebruary may be the shortest month of the year, but Hamacher Resource Group’s new product team still managed to comb through 161 new product launches to find which ones stood out. HRG reviewed a product assortment that was 11% OTC products, 53% wellness products and 36% beauty products to find five that might stand out on the shelf. They were:


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This digestive health product from Avrio Health’s Senokot brand takes a natural tack to help relieve occasional upset stomach, nausea, indigestion and gas. The product, formulated from ginger root, is available in 30-count bottles. Church & Dwight’s Orajel brand has rolled out Toothache Strips, which are designed to dissolve slowly to provide longer-lasting, targeted pain relief. The company said they can last up to one hour longer than just a topical gel, and contain the maximum level of benzocaine. The product also includes menthol to soothe the gums. Orajel Toothache Strips are sold in packs of eight. Just For Men’s Control Gx from Combe is expanding its offerings with the new beard wash. It is formulated to reduce, but not entirely remove, gray hair for a subtle, natural-looking result. The product comes in a 4-oz. bottle. Johnson & Johnson Consumer has once again added a new feature to its Neosporin first aid product. Neosporin Burn Relief is meant to offer soothing pain relief for burns, while also offering 24-hour protection from infection. Avrio Health brought another standout product to market under its SlowMag dietary supplement brand. The Mg Brain offering combines magnesium citrate and vitamin B2 into a product that is aimed at reducing the frequency and severity of migraines through improved brain blood circulation, the company said. dsn




Marketing Your Diabetes Services Effective marketing strategies make a difference By John Motsko

H John Motsko, educator and program coordinator at Core Clinical Care, Apple Diabetes Center in Salisbury, Md.


aving established some sort of diabetes services in your pharmacy, how do you make the most of it while helping patients, improving your professional status, and adding to your bottom line? Most pharmacists receive little or no education on marketing, so it may be natural for us to think, “build it and they will come.” Unfortunately, in today’s complex markets, it’s not that simple. Patients constantly are exposed to TV, radio and written ads concerning health improvement, therefore effective marketing of diabetes services is critical to attract patients to your facility in an efficient way. At Apple Discount Drugs, we established our Diabetes Center approximately 11 years ago and have experienced quite a change in our marketing techniques. As you design your diabetes marketing programs, several items need to be taken into consideration. First and foremost, you must define your service capabilities. Will you be offering complete diabetes services? Do you want to achieve AADE or ADA recognition? Do you want to employ a registered dietitian or a Certified Diabetes Educator? Do you intend to do individual or group education, or both? Are you going to rely on walk-in traffic or referrals from providers in your community? What services already are available in your service area? How will you be different from the other services that are offered? What marketing budget, if any, will you have available? What media do you intend to use: Facebook, website, print advertising, TV advertising, signage at your facility, or even a marketing associate if you have one? What is your relationship with the providers and their staff that you expect to market to? Are you willing to speak about diabetes and your services at local organizations, such as the service groups and churches? Are you willing to go to events on weekends and in the evenings? Each factor will have an effect on your marketing plan and most likely you will include several, if not all, of these options. We do regular


TV advertising and print advertising in several local newspapers, along with our website and Facebook page. We have discovered that our website is more appropriate for the static services we offer, while our Facebook page allows us to be more dynamic in our announcements. We also use our Health Mart diabetes print ads to complete our media marketing, and a sign in our parking lot announces our diabetes services. The marketing plan accompanies robust offerings. Eventually, we started offering additional services, including a continuous glucose meter instruction and glucose meter data download and review at our center and through the cloud using One Touch Reveal, AccuChek Connect, Libre View and Dexcom Clarity. To complete our services, we combine diabetes education with medication therapy management and CPAP screening. Both the patients and physicians appreciate the breadth of services we offer. Obviously, we did not initially use all of these methods, but added other methods as our services grew.

It may be natural for us to think “build it and they will come.” Unfortunately, in today’s complex markets, it’s not that simple. Be sure to establish a diabetes product and education area in your store, and include print materials and OTC products appropriate for the patient with diabetes. Lastly, make it a habit of keeping some sort of record of the outcomes of your services, both for yourself and for possible marketing to prospective payers. Nothing sells better than positive outcomes. With them you are different, without them you are the same as other diabetes services. Post your outcomes and be proud of them. Work to the top of your license and you and your patients will be glad you do. dsn

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Building Chronic Care Through Partnership Collaboration and education are essential to achieving change, panelists said By David Orgel

The DSN Industry Issues Summit panel on chronic care patient management featured executives from retailers and solutions providers.


hronic care patient management is simultaneously one of the most challenging and opportunityfilled areas of pharmacy. The challenges, reflected in such conditions as diabetes, are highly complex and require collaboration among stakeholders across the healthcare system, according to participants in an executive panel at the Drug Store News Industry Issues Summit in New York in late November. At the same time, panelists from retailers to solutions providers emphasized opportunities for improvement centered on education, personalization and prevention. Technology can help play supportive roles in these areas, they said. “There are many preventable chronic conditions for which we must do a better job harnessing knowledge,” said Dave Wendland, the panel moderator and vice president of strategic relations at Hamacher



Resource Group. “We need to project that knowledge to consumers in a way that they will not only take advantage or take notice of it, but make lifestyle changes.”

Retailers Emphasize Customer Education, Information Access

Retailer panelists emphasized the crucial need to act decisively on chronic care issues, including focusing on education. “From a diabetes standpoint, there are huge needs in south Texas,” said panelist Leon Nevers, director of business development and procurement at H-E-B. “We have great food, but we also have quite a challenge with being able to work that food off and understand how to manage your disease state.” Nevers said leveraging solutions on both the pharmacy and food sides of the retail operation are crucial to success. “We started with our blood glucose testing by offering free health screenings in all

pharmacies, and helped patients understand how the numbers impact their lives,” he said. “I’m also very encouraged to see H-E-B as a grocery chain really embracing other opportunities to educate the consumer, such as with nutrition labels that are easy to understand.” Panelist Becky Dant, director of professional services at Costco, said pharmacists are uniquely positioned to educate patients on chronic conditions. “I think a pharmacist is a great person to carry that message and get buy in from their customers,” she said. “As we all know, patients with chronic conditions come into the pharmacy a lot, so there’s a lot of touchpoints there. And there are a lot of opportunities for us to ask them, ‘How are you doing with your food intake? How are you doing with your exercise?’ Pharmacists can hand out information on how patients can incorporate these into their lives more easily. I think they’re a


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DSN INDUSTRY ISSUES SUMMIT great touchpoint for that. And how do we make it fun for the patients?” Dant said Costco has helped support pharmacists through step-wise approaches to program rollouts that ease employees into new efforts. “We want the pharmacist to feel comfortable with the material, comfortable offering those services to the patients, and feel confident offering them,” she said. “So we’ve given them some time to absorb it.” Moreover, the ability to access information easily is a crucial component of providing care, Dant said. “I think accessibility to information is huge, both for the pharmacist and the patient,” she said. “It allows pharmacists to be more involved in the care of the patient, and for the patient to be more knowledgeable and ask questions of their pharmacist or their care provider.” Summer Williams Kerley, a retailer panelist and Rite Aid’s vice president of clinical services and business development, said pharmacist education of patients can extend to help with apps and connected health devices. “There are so many different wearables and apps available to every consumer,” she said. “It’s about encouraging the consumer to find the app or wearable or device that works for them. Our pharmacists are there to help the patients understand the importance of finding what works for them, and helping them stay engaged with that through conversations during patient visits.”

Summer Williams Kerley, vice president of clinical services and business development at Rite Aid; Leon Nevers, director of business development and procurement at H-E-B; and Crystal Lennartz, vice president of pharmacy performance at Health Mart Atlas

Pharmacists Need Tools for Success

Addressing chronic care challenges requires providing more tools to pharmacists to help them manage patients, said panelist Crystal Lennartz, vice president of pharmacy performance at Health Mart Atlas, which is part of McKesson. “One of the things we’ve focused on has been positioning the pharmacist as a coach,” she said. “We’ve been providing to our network of pharmacies motivational interview training, knowing that each patient is unique, and they’re going to have their own specific barriers to care, whether that’s adherence or a gap in care. And we’re also using artificial intelligence in the training to simulate for the pharmacist how the

patient may react to both the pharmacist and the technician. It’s a chance for them to get a do over, without a live patient in front of them.” Stacy Burch, vice president of marketing and commercial excellence at BD, said an important goal is to help drive pharmacist-patient conversations as early as possible in a condition like diabetes. “The onset of diabetes can start way before a patient gets diagnosed, in most instances,” she said. “So how can you start those conversations with the pharmacist early on? That would start the dialogue to change how people are eating, to change the things that they’re doing. We are working to help educate the pharmacist about

How H-E-B’s Pharmacists Boost Patient Engagement Is it possible to understand the impact of pharmacist-patient engagement through the lens of a single retail chain? The answer is yes, especially if that chain is the iconic H-E-B, the San Antonio-based, privately held retailer highly regarded for its connection to Texas customers. During the Drug Store News Industry Issues Summit Leon Nevers, the retailer’s director of business development and procurement, outlined how H-E-B has advanced patient engagement over the years. A key component, he said, has been implenting changed that ensure the pharmacist can engage with patients “The pharmacists get to know the patients’ personal healthcare needs, instead of just being a dispensing machine by counting pills,



stapling bags and sticking labels, and that type of thing,” he said. “Those days are really long gone.” “Our immunizations are an example of how we touch the patient, and they say ‘Thank you,’” he said, “Our health screenings are another opportunity through which we actually talk to our patients face-to-face about their personal health concerns, and then provide solutions found throughout our stores.” He said H-E-B has supported pharmacy’s advancement through technology and other investments, and through relationships with partners. “As you evolve and develop that patient relationship through the years, it’s just a great opportunity for us to have stickiness by building personal loyalty against some of the disruption that’s coming,” he said.



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DSN INDUSTRY ISSUES SUMMIT having those earlier conversations, so that patients come in and seek guidance earlier, and hopefully gain stronger control of their disease. This ultimately leads to better adherence and better outcomes for a healthier lifestyle.” Another panelist emphasizing consumercentric strategies was Shannon Huneke, senior director of strategic partnerships and alliances at United Healthcare National Accounts. “It’s really about putting the consumer at the heart of everything we do,” she said. “By virtue of the combination of the United Healthcare benefits business and the Optum Health Services business, we’re able to address every segment of the health ecosystem in every way. This includes the consumer, the provider, the government, the employer and the community — and the systems that support them. One way we live this mission is by taking technology, data and analytics, and predictive modeling, and [marry] them with the vast amounts of consumer insights and expertise of retailers and partners. We ultimately try to seamlessly bring that together to create a much more relevant, simple consumer experience.”

Progress Requires Personalized Solutions for Patients’ Needs

Several panelists said that achieving progress in chronic care requires the use of individual solutions to match the different needs of patients.

Becky Dant, director of professional services at Costco; Shannon Huneke, senior director of strategic partnerships and alliances at United Healthcare National Accounts; and Stacy Burch, vice president of marketing and commercial excellence at BD

“We’re really personalizing to what they want,” said Costco’s Dant. “We’re expanding our ability to reach patients in the ways that they want through expanded use of our mobile app. We have texting services that help us interface with those patients, whether it’s through refill reminders or educational pieces. We still have traditional telephone outreach. We are really looking at what does this patient need? Is it extra counseling? Is it just that they need refill reminders? They are able to opt in and opt out of those services as they see fit, to take some ownership of that care.” Rite Aid’s Kerley said her company builds

services around individual locations and patient needs. “As we build services and programs, they have to be very individualized and tailored to those patients’ needs.” United’s Huneke said technology can help support individual approaches for consumers. “It’s ultimately about driving a much more personalized experience,” she said. “How do we do that? Technology is important. It’s also about driving value and lowering costs, and certainly increasing quality. We have a program called Motion where we’re incentivizing our consumers to make better choices. Because at the end of the day, it’s ultimately about the level of engagement taking place.” dsn

Collaboration Drives Success in Improving Patient Health Outcomes Strategies targeted at addressing pharmacy’s biggest challenges exist, especially for chronic care patient management. During a panel on this topic at the Drug Store News Industry Issues Summit late last year, “collaboration” kept coming up over and over. Panelists said that stakeholder collaboration is a crucial strategy for making inroads that lead to sustainable improvements. Summer Williams Kerley, a panelist who is Rite Aid’s vice president of clinical services and business development, said collaboration is a crucial element of cost-effective patient care. “For us as a profession, as an industry, we need to focus on prevention,” she said. “And working together with all stakeholders within the ecosystem, we really need to start targeting ways to prevent certain diseases, so that we get to a point where we don’t have to talk about



chronic care anymore.” Shannon Huneke. senior director of strategic partnerships and alliances at United Healthcare National Accounts, emphasized the importance of strategic partnerships. “I take a lot of pride in our collaboration with CPGs and retailers,” she said, pointing to efforts related to the opioid epidemic — for which United Healthcare partners with such companies as Kroger and Johnson & Johnson — as a case in point. “We focus on how do we collectively work together to really abolish and eradicate this horrific epidemic through the help of pharmacy intervention,” she said. I would encourage us to be thinking about this more from a retail and health ecosystem standpoint, competitors included, because I think we’re all trying to fight the same mission.”


Ideas in Action Panelists discuss perfecting an omnichannel approach and retailer-supplier relationships By David Salazar


t’s no secret that retail has changed — and it’s even less of a secret in the industry that retailers and suppliers are constantly rethinking how they can capture share of the consumer’s mind and wallet. Though it can often feel like a moving target, a panel of retail executives in the OTC category convened at the 20th Drug Store News Industry Issues Summit in New York late last year to discuss some of



the “Ideas that Matter” when it comes to building retailer-supplier partnerships in an effort to win consumers over. “There’s more ambiguity and uncertainty than ever before — and that’s why we’re having this conversation,” said moderator Dan Mack, founder of Mack Elevation, a coaching and strategy consultancy in Chicago. “When you think about the big digital and cultural shifts that are

occurring, all of us are experiencing more change than ever before. We’re all living in a world where embracing agility and speed is the ultimate core competency.” That, combined with the rise of what Mack called the “reputation economy,” consumers’ gravitation toward purpose-driven companies and the still widespread importance of word of mouth — about 13% of OTC dollars comes from a personal

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DSN INDUSTRY ISSUES SUMMIT recommendation — creates an environment where knowing one’s customer, delivering on their needs and intimate relationships with brands are vital to business success. One area where communication between brands and retailers can be especially important is in marrying the digital with the physical to create a seamless omnichannel experience. Because of the way that consumers undertake product discovery and do their shopping, brands must rethink their approach, according to John Peine, Target’s senior divisional of health care and optical. “We’ve been saying for years now that the new front door to Target is through your mobile phone,” he said, highlighting the growth of digitally native brands, including Harry’s, with which Target partnered for a retail launch after it had established itself in the online men’s grooming space. “In this day and age, every brand should view themselves as digital natives because if someone has not yet purchased your products, the first exposure they’ll have is likely online or on their phone.”

Because of the way that consumers undertake product discovery and do their shopping, brands must rethink their approach.

(Above) Dan Mack, founder of Mack Elevation; (below) Robert Tompkins, group vice president and general merchandise manager of health and wellness at Walgreens; and Paul Gerner, vice president of drug store/baby/beauty/financial and nutrition services at H-E-B



Peine said that having detailed product information that includes ratings, reviews and multimedia should be part of that. The question for suppliers, he said, is “What does your digital footprint say about your products, and how does that come to life throughout the creation of the purchase process?” AmerisourceBergen’s Doug Trueman, vice president of consumer products and strategic global sourcing, echoed Peine in highlighting best practices to help reconcile digital and physical, particularly in the independent pharmacy space, where he said that the need for brands there is “to extend care.” To do so, he said that brands should focus on inventory, as out of stocks and customer service are a key friction point.

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DSN INDUSTRY ISSUES SUMMIT “In this technical age, there’s so much emphasis on innovation and the next disruption. While this is incredibly important, it’s also essential to remember the basics: standout customer service and in stocks,” Trueman said. “A sick patient that walks into a pharmacy wants to feel confident that the over-the-counter medication he or she needs is going to be right there in the cold and flu aisle. On top of that, they want their pharmacist to be knowledgeable, prepared with answers, and supportive in product selection. More simply, the patient is expecting quality care.” Trueman also said that images make it easier for independent pharmacists to order the products on Good Neighbor Pharmacy’s ABC Order platform, as well as insights that highlight what the product can provide. “To me, being a good distribution partner means being a champion of a brand’s story. A branded consumer product has a long journey from production to the shelf and to a shopper’s basket,” Trueman said.

“At AmerisourceBergen, we aim to make sure that a product’s value proposition and story is seamlessly pulled through the entire supply chain and ultimately through to the patient at checkout. This means we’re invested in making sure that the product is well represented in places like the aisle and on digital sites, such as the pharmacist’s ordering platform.” Success also can come from the logistical side, according to Annie Walker, Walmart vice president of OTC merchandising. She said that as Walmart builds out its omnichannel offerings — from pickup towers to online grocery and beyond — suppliers can help retailers ensure that it works in two ways: testing it out for themselves to identify potential hiccups, and by having a buttoned-up supply chain. “I believe that the vast majority of the problems that exist are where, down the road, there are some logistics gaps that occur within your supply chains,” she said. “I encourage you to really have a good

Customer focus also serves as a jumping-off point for building mutual profitability between retailers and suppliers. understanding of tracking and knowing where your goods are, how they’re flowing — and being confident you know the extent of your supply chain and how it flows.” Two components of the omnichannel experience that offer avenues for tandem navigation between manufacturers and merchants are around localization and personalization. Part of this is because the online arena has created the need for retailers to adapt their approach to localized assortments, according to Robert Tompkins, Walgreens group vice president and general merchandise manager of health and wellness.

Building Elite Partnerships Moderating the “Ideas that Matter” panel at the DSN Industry Issues Summit, Mack Elevation founder Dan Mack highlighted the fact that not all partnerships between retailers and suppliers are created equal. “Only 5%-to-10% of customer relationships with sales organizations are defined as elite,” he said. “The elite partners do things very differently — they act differently and they show up differently because they ask different questions, are more open and they think longer term.” Panelists shared what defines an elite partner for their businesses. For Walgreens’ Robert Tompkins, group vice president and general merchandise manager of health and wellness, elite companies are not only focused on the “what” — their next item launch or selling a product — but on the “how,” meaning how they will build brand equity and understand their shoppers. “The ‘how’ companies can explain to me not only what they’re trying to sell me, but how they want to do it, how they’re going to create brand equity and category equity, and how they’re going to build loyalty with my shopper,” he said. “If you can’t explain your how, you’re not going to be an elite partner with us.” H-E-B’s Paul Gerner, vice president of drug store/baby/beauty/financial and nutritional services, said that a focus on fundamentals — preventing out of stocks and other blocking and tackling elements — could form the basis of an elite partnership. Like Tompkins, Gerner said elite partnerships have long-term growth in mind — something that many lack. “I think there are too many CPG companies that are looking quarter



to quarter as opposed to actually having a vision and a strategy, and the ability to cogently articulate it,” Gerner said. When selling into independent pharmacies, AmerisourceBergen vice president of consumer products and strategic global sourcing Doug Trueman said that culture alignment can presage a good partner. “We’ve found that the best relationships start by having a common purpose, and for us, that purpose is always grounded in providing exceptional patient care. Once you’re locked in on that patient focus, you have a clear path forward,” Trueman said. “In addition, you can have productive conversations about the right channels and avenues for a product. We’ve found that starting with this alignment also allows you to think creatively and find unobvious opportunities.” Walmart’s vice president of OTC merchandising, Annie Walker, said that the basis for being an elite partner begins before a manufacturer even approaches a merchant, particularly for big brands looking to mimic growth that smaller brands are seeing. “If you want big to grow faster than small, you have to change your corporate thinking,” Walker said. “As much as we say ‘disrupt yourself before somebody else does,’ we don’t see the movement. I would challenge you to think about how you are going to change your internal organization to move faster and enable thinking differently to move forward. Being able to actually execute what you say you’re going to do is so critical and really important for the buyers.”





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John Peine, senior divisional of health care and optical at Target; Annie Walker, vice president of OTC merchandising at Walmart; and Ankit Patel, director of merchandising at Boxed.com

“Localization of course has been redefined now because of e-commerce,” Tompkins said. “You have to understand that localization now is a digital phenomenon, and you can create incredible efficiency by getting niche items online — and suppliers enabling that and being nimble enough to get even niche products online helps us a lot.” Tompkins said that Walgreens has implemented regional merchandise managers, who are able to get local products on the shelf. He also said that Walgreens no longer has a “one size fits all” mentality because each store’s customer base — and ROI — are different, and suppliers that understand this are particularly helpful. “We really look to suppliers to push us on this,” he said. “We need your intelligence in helping us understand what we can sell and where we can sell it. Help us make a good, efficient decision upfront in getting products into the right stores, where they can succeed and you can grow from there rather than pushing too far up front.” George Coleman, CVS Pharmacy’s senior vice president of merchandising, said that the human factor plays a key role in personalization, which is why he said the company has invested savings from the recent tax cut into front-line employees. “The people who



have the biggest impact on the impression of a local, personalized place is the pharmacist and pharmacy tech,” he said. “It can’t be really personal without human beings really feeling that at the retail level.” He said that while another part of personalization is reaching out through CVS Pharmacy’s Extra Care loyalty program at the right moments and proactively communicating with customers, the ultimate form of personalization could be having the correct store format in the right place. “It is also about the store format itself, and it’s about the assortment, so on the format side we’ve been trying to evolve,” he said, highlighting the Hispanic shopper-focused CVS Pharmacy y más format that got its start in Florida and has since expanded to certain Texas and California locations. Given the importance of assortment in creating an ideal customer experience, one of the topics Mack asked the panelists was balancing a portfolio that includes brands both from larger legacy companies and smaller and growing newcomers. Ankit Patel, Boxed.com’s director of merchandising, said that several big brands, despite continuing to drive large amount of volume and revenue, are seeing their share online differ from their share in brick-andmortar, with smaller brands growing their

online share. He attributed this largely to a shifting of consumer demands among a group gaining in influence. “As purchasing power transitions to this millennial population, new brands are winning with them,” he said. “And the true threat isn’t today. It’s in 15 or 20 years, when they own all the purchasing power, and if big brands can’t figure it out then, I think that’s when the real trouble is, and then declines will just be consistent year over year.” Patel said that one key to staying relevant is an old truism — focus on the customer. “Sam Walton said it right — the only boss is our customer.” Walmart’s Walker shared Patel’s outlook and said that the assortment would balance itself, if merchants pay attention to what customers want. “You always have to have a customer-centered, focused vision, and those delivering on that is how you balance the portfolio — figuring out what it is the customer wants or what they’re looking for,” Walker said. Customer focus also serves as a jumpingoff point for building mutual profitability between retailers and suppliers, according to CVS Pharmacy’s Coleman. “It’s always better to work with my supplier partners when we’re both going to win and we kind of know it’s fun and it’s

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DSN INDUSTRY ISSUES SUMMIT exciting, and that tends to happen with new products,” he said. If we’re trying to create a plan or around brand innovation, new products that are truly customer right, we can create these win-win solutions because we’re aligned, because we think it hits the right customer need. A win-win is where you really put some thought around the customer need, and given some great innovation, and worked with us in advance to do that.” H-E-B’s Paul Gerner, vice president of drug store/baby/beauty/financial and nutritional services, said that working with suppliers who are knowledgeable about how their product will perform and the needs it serves can be a boon to merchants. “If you’re presenting new items, the more you can help our buyers understand what demographics, what ethnicities, what income segments products will be most attractive to, then you truly create that collaboration in partnership.” Whether it’s customer needs or having a mutual purpose, alignment is key to creating a business relationship that benefits both retailers and suppliers. Boxed.com’s Patel said that aligning early could build the

Doug Trueman, AmerisourceBergen vice president of consumer products and strategic global sourcing, and George Coleman, CVS Pharmacy senior vice president of merchandising

foundation of a stronger and more profitable relationship. “In the very beginning, it’s very important that we’re aligned and we’re essentially

speaking the same language,” he said. “Two is greater than one, and I think if we really build the business together, we can achieve greater results.” dsn

Breaking Down Barriers to New Products As the larger retail game changes, companies have had to adapt how they go about bringing innovative products to market — and the stakes have gotten higher. Dan Mack, founder of Mack Elevation and moderator of the “Ideas that Matter” panel at the 20th DSN Industry Issues Summit, said that almost half of all resources allocated to new item launches go to items that underachieve or are discontinued, and asked panelists to share what can help a new product succeed in a crowded marketplace. CVS Pharmacy senior vice president of merchandising George Coleman said that products that set themselves apart are not simply line extensions or launches that are looking to mimic a competitor. “If it’s truly innovative new technology, is a new form of solving a real customer problem, that can help ensure its success,” Coleman said, adding that companies should come to the table not just with a plan for the product’s launch, but its longevity over time. He also said that for a holistic launch, merchants need plenty of lead time. “We’d love to put together the circular plan, the off-shelf plan, the on-shelf plan and our personalization plans, but we can’t get all those things coordinated and robust if we don’t get enough advance warning and start planning early, because when we do they’re generally successful.



Target’s senior divisional of health care and optical John Peine shared Coleman’s emphasis on the imperative for new products to meet consumer needs. One pathway to success, he said, is having a comprehensive marketing plan, and he said that Target Media Network offers brands support in the marketing space. “We get the right products that fit our demographics, and we can put it together in the right way,” he said. “Target Media Network is a great way to unlock and propel that growth to new heights.” Coming from the e-commerce space, Boxed.com’s director of merchandising, Ankit Patel, also echoed Coleman by emphasizing the importance for brands to have a long-term outlook on a new product, as well as the importance of early collaboration with retailers. He said that bringing a retailer into the launch planning process could help highlight potential avenues. “I think that there are specific insights that retailers can bring that aren’t always available to the CPG companies,” Patel said, noting that Boxed.com has a sampling program that can help with product trials. “You have to be strategic in terms of where you want to deploy these launches.”

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CBD: On the Cusp of Success The state of the CBD category is one of both exuberance and caution as retailers and manufacturers wait for FDA guidance BY NORA CALEY


hile there is no doubt that this is an exciting time to be in the cannabidiol, or CBD, industry, it also is a time of great uncertainty for manufacturers in the fledgling space. With the passage in December of the Agriculture Improvement Act of 2018 — better known as the Farm Bill — hemp, including hemp extracts, derivatives and cannabinoids, is no longer a federally controlled



substance. The bill does state that the hemp has to have a tetrahydrocannabinol, or THC, concentration of not more than 0.3%. While the deregulation appears to open up opportunities for retailers to start selling CBD products that offer everything from pain relief to better sleep, so far, many merchants are not exactly rushing into the CBD business. The Food and Drug Administration announced that introducing food with CBD into interstate commerce still is unlawful, and that the agency is working on pathways for the lawful marketing of these products. That has not stopped manufacturers from eagerly developing products and coming up with ways to merchandise CBD capsules, oils, creams and even pet products. The thought process, it appears, is that once the FDA gives complete and final approval to hemp products, retailers will rush to get in line to carry them. “The retailers are waiting for the FDA regulatory platform to be written,” said Paul Carpenter, partner and founding member of New Leaf Pharmaceuticals, based in Newtown, Conn. “They don’t want to put products into a planogram and then have it yanked off the shelf. That’s a difficult position for them.” The Farm Bill allows farmers to plant hemp seeds, said Jason Mitchell, president of MetaCan, which makes Roswell, Ga.-based HempFusion products. That means there will be more farms

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SPECIAL REPORT: CBD pain relief. “It seems like a lot of those therapeutic effects from medical marijuana are due to CBD,” said Murdoc Khaleghi, a physician and senior medical advisor for Telford, Pa.-based Elevate Hemp. “What makes pain really interesting is it is definitely one of the more common problems we see in medicine. We’ve never had good therapy for pain, and that is part of the reason for the opioid crisis.” Many topics are going to be researched now, said Laura Fuentes, co-founder, CEO and compounding pharmacist at Deerfield Beach, Fla.-based Green Roads. “Now that hemp is not a Schedule 1 narcotic, universities are going to be able to do research,” she said. In fact, Green Roads, which manufactures CBD oil, edibles, pain cream and other products, is working with the University of Florida to research growing patterns of hemp in the states. Fuentes said that there is much contradictory information available, new CBD companies popping up daily and a slow-moving regulation process that hasn’t fully matured, which makes consumer confusion a challenge. As a result, Green Roads is working to make CBD facts more transparent. Green Roads products are pharmacist-formulated with custom proprietary product formulas, using an advanced clean extraction process. Green Roads also utilizes multistage third-party lab testing to ensure product potency, quality and safety, and includes QR codes on all packaging, linking products back directly to the third-party test results. There has been much research, and more to come, on how CBD affects specific areas of the brain. The science will help retailers, especially drug stores, to become more interested in participating in the space. “All of the big chains are now looking at this,” said Brad Halpern, chief marketing officer at Los Angeles-based Be Trū Organics. “The industry is waiting to explode.” growing hemp plants, but it does not necessarily mean retailers are going to get into the hemp or CBD business right away. Still, some smaller merchants are carrying CBD products. “They may be independent compounding pharmacies or family-owned chains,” he said. “They are starting to expand their offerings.” Other retailers, including health food stores, regional chains, spas and salons, and online sellers have entered the category, too. Some retailers are hinting that they will soon offer such topical products as salves and creams, but not such ingestibles as capsules and gummy bears. That is a prudent approach, according to Tony Tomassini, chief marketing officer of Functional Remedies, based in Superior, Colo. “Retailers see the opportunity, and they want to capitalize,” he said. “We applaud anybody who is more concerned with being right than being first. That’s our conservative way forward — go to market right versus right now.” Functional Remedies, which manufactures hemp oil products, is partnering with retailers to educate consumers about the category. “Educating the buyer and the consumer is of utmost importance to us, especially in this stage of the game,” Tomassini said. “We want them to make informed decisions about buying any product in this category.”

THE RESEARCH Consumers and retailers make informed decisions by reading the research, and much of the research points to benefits of CBD for



WHAT RETAILERS SHOULD DO When the industry does explode, retailers can position themselves as the ideal place to buy CBD products. “Many consumers don’t feel comfortable purchasing these products from the smoke shops that have traditionally carried them,” said Jason Roth, CEO of Boulder, Colo.-based Mile High Labs. “They would much rather buy it like they do any other medicine or supplement — from a trustworthy pharmacy or drug store.” He cautioned that hemp makes many stops along the way to becoming CBD. “Data can become misconstrued, and packaging mislabeled,” Roth said. Retailers should ask such questions as where the hemp is grown, whether it has been tested for contaminants, how it is processed, and whether the manufacturer extracts the CBD on its own or purchases it from another company. Consumers assume that retailers have done this due diligence, according to Courtney Roundy, founder of Salt Lake City-based Harmony Hemp. Manufacturers can help by offering such information as farm-to-lab traceability, certificates of analysis and other information. “Know your supplier is legitimate,” he said. Some retailers, especially the drug store chains, already have wellness initiatives, so it makes sense to partner with suppliers that have similar missions. “We genuinely care about the customer,” Roundy said. “This is all about wellness. Treat your system not your symptoms.”

SPECIAL REPORT: CBD IN-STORE DETAILS The top segments in CBD are sleep, anxiety and musculoskeletal pain, said Scott Raybuck, president of Cleveland-based ZuRI CBD Supply. Baby boomers, with their ailments, knee and back pain, and sleep issues, are the prime purchasers of CBD. “The 50-plus age group is by far the biggest,” he said. Pet products, such as for separation anxiety, also are gaining popularity. What is driving the CBD boom, Raybuck said, is that it is an ingredient that the body has been missing. Humans and animals have endocannabinoid systems, and if they are not consuming cannabinoids, the systems are deprived. He likened it to taking supplements to make up for an iron deficiency. This essential nutrient explanation is one that many manufacturers use. “Hemp is a very edible plant and a huge source of nutrients,” said Ryan Lewis, founder of Las Vegas-based Global Cannabinoids. “People didn’t realize we need hemp in the diet. As people get more educated, hemp becomes more accessible.” The analogy he used: a lack of vitamin C can result in scurvy. CBD has neuro-protecting capabilities, which suggests that a lack of it plays a role in the rise of Alzheimer’s and other degenerative brain diseases, he said.

MERCHANDISING Even though manufacturers can explain many benefits related to CBD, the products do not fit neatly into one category the way vitamins or analgesics do. Retailers might wonder where to merchandise the products. A dedicated hemp section is the best way to merchandise the products, said Blake Patterson, president of Denver-based MarketHub, a company that works with manufacturers and retailers to set up Hemp Health Zones for any class of trade. “We are seeing more and more retailers gravitate to compartmentalization theory, where my pet lives next to my pain, which lives next to my anxiety,” he said. “It sounds completely chaotic, but it’s the best way to introduce a new category for now until there’s brand loyalty.” He also said that packaging plays a role, and labels that have such callouts as “calm” or “serenity” are effective because consumers shop according to need states. Drug stores should merchandise CBD products differently from mass retailers, said Perry Antelman, CEO of Abacus Health Products, based in Woonsocket, R.I. “You go to drug stores



because you have one or two things you want to pick up,” he said. “If you are looking for something for pain, you make a beeline for the pain section. If you have a product that was CBD-based and it’s on an endcap, you walk right past it.” Mass retailers, where shoppers spend more time and there is more opportunity for stocking up purchases and impulse buys, are better places to put CBD products on an endcap. “People are waiting in line for a cash register, and they look around,” Antelman said.

GREEN RUSH While merchandising is one key element for success in this new category, Antelman said education is the most important matter. Retailers need to be able to differentiate which companies are offering safe and legal products, and which companies simply are jumping into a newly lucrative category. The latter, he said “are running to the green rush.” While the term “green rush” once referred to entrepreneurs moving to states where medical and recreational marijuana have been legalized, the term also refers to new businesses cashing in on the hemp industry. “The cannabis/CBD/hemp green rush is unlike anything experienced in retail,” said TJ Stouder, co-founder and CEO of Denver-based Holistik Wellness. “Consumers across all demographics are rushing to stores looking for any buzzword in the category, ready to buy.” Matt Wolf, CEO of Denver-based Uleva, described the state of the CBD category at mass retail with this scenario: “It’s almost like a herd of wildebeest in a river bank, dipping their toe into the water, trying to decide if they want to jump in or if there are crocodiles,” he said. “Uleva believes it’s croc-free and the water’s fine.” There will be much growth in the near future. “We are excited with the growth potential in the next 12-to-24 months,” said Todd Davis, CEO of Cave Creek, Ariz.-based CBD Unlimited. “We project the CBD industry to exceed $2 billion in sales by late 2020. Education and the customer’s positive therapeutic experience have been the foundation of our products in the early development of this nascent industry.” CBD has the potential to be a multibillion-dollar category, MarketHub’s Patterson said. “It covers so many things — anxiety, pain, sleep, inflammation, beauty,” he said. “You look at all these different pieces, and you look at demographics, it’s for every age group, male, female and the family pet. It’s phenomenal.” dsn

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Who’s Who in CBD Here’s a close look at many major CBD suppliers BY NORA CALEY


ou can’t tell the players without a scorecard.” That famous phrase, usually reserved for the baseball diamond, holds a lot of weight in the emerging CBD category, where dozens of companies are lining up to supply retailers with a wide range of products as soon as they get final Food and Drug Administration approval. Drug Store News is offering a close look at some of the key players in the category, who they are and what makes them unique from the competition. In alphabetical order, here is what they had to say.

101 CBD All CBD is not created equal, said Justin Benton, president of Ventura, Calif,-based 101 CBD. Retailers should look for products that contain full-spectrum CBD instead of isolate, because the latter refers to burning down the CBD into a powder, which makes it lose valuable nutrients. “We firmly believe in raw CBD,” he said. The company makes CBD oils in varieties called Alleviate, Chill, Boost, CBD, and Decarboxylated CBD Oil, which is heated at lower temperatures that result in a higher potency. Also available are CBD Topicals, including a Raw Relief Roll-On and Raw Relief



CBD Topical for soothing localized pain of arthritis, neck and back spasms, and migraines. Topicals are widely used by massage therapists, and are a healthy way to deliver CBD, Benton said. “We don’t do vaping or edibles,” he said. “A brownie might be fun, but you don’t want to eat that every day.”

ABACUS HEALTH PRODUCTS The OTC health company Abacus Health Products recently announced the launch of an advanced skin care line within its CBDMedic family of products. This new line is for the treatment of acne, eczema, and itch and rash, and will include four topical products, including ointments, creams and facial cleansers. The products will utilize FDA-monograph active pharmaceutical ingredients and cannabinoids, and will be formulated with natural and organic ingredients. The Woonsocket, R.I.-based company has several new products in its pipeline, and in the next two years plans to launch CBD products for foot pain, dermatology, acne, anti-inflammatory, and eczema itch and rash.

SPECIAL REPORT: CBD “One hundred million Americans suffer from acute or chronic pain,” said CEO Perry Antelman. “The major retail pharmacies are hungry for these products.”

BE TRŪ ORGANICS Be Trū Organics is a Los Angeles-based company that makes Be Trū Wellness products. The hemp comes from 100% certified organic farms in Switzerland, and the hemp extract is organic, all natural, pure, non-GMO, gluten-free, kosher, and is processed in an ISO 9000 GMP-certified lab. The company also uses nanotechnology that splits one particle into 14 million particles for better absorption and longer-lasting effects. These are important attributes in an already crowded industry. “There are over 150 companies making products that are unregulated,” said chief marketing officer Brad Halpern. “A lot of products look like they are made in someone’s garage.” Be Trū Wellness products include body pain relief cream, body pain relief patch, dream beverage drops for sleep, mind daily gummy chews, energy beverage drops and focus beverage drops. For pets, there are Catchies Feline Hemp Oil with coconut oil and catnip oil extract, and Dogchies All-Natural Hemp Complex.

CANNABLISS ORGANIC The wife and husband team of Melissa and Nick Christensen, who founded Cannabliss Organic, have family roots in the beauty industry and past experience in hemp wellness and cultivation. The Aurora, Colo.-based company makes skin care products with a high concentration of full-spectrum hemp oil that is specially blended with ancient Korean herbs to work in synergy with the body and to nurture and heal. The products include Bliss Body Oil, Bliss Kiss Balm, Foaming Cleanser, Hemp Salve, Moisturizing Lotion and other products available in prestige stores and resorts.

CBD CARE GARDEN The focus for CBD Care Garden is hemp-based wellness and beauty. The Denver-based company sells such products as antiaging face products, body butter and body washes in high-end resorts and spas. “We are in pretty much every state now,” said CEO and co-founder Vanessa Marquez. “I think retailers have been chomping at the bit to get involved.”

CBD UNLIMITED CBD Unlimited, headquartered in Cave Creek, Ariz., has been a leader in the hemp-based CBD industry since 2014. Products come to market under the CBD Unlimited brand, as well as the PhytoBites line of products for pets. Early in 2015, the company realized the need for education and information within the CBD product segment. This led to multiple doctor-led case studies to help determine the most effective forms of delivery and to define dosing guidelines. This research helped lay the foundation for product



*These statements have not been evaluated byy the Food and Drugg Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

SPECIAL REPORT: CBD CHARLOTTE’S WEB Charlotte’s Web said its purpose is “To better the planet and the people living upon it.” The company is doing this with high-quality hemp extract, in such products as CBD Oils in Full-Strength, Extra Strength and Original Strength. Hemp Capsules with CBD, plus naturally occurring phytocannabinoids, terpenes and flavonoids help provide support for normal, everyday stresses and recovery from exercise. Charlotte’s Web is based in Denver and manufactures in Boulder, Colo. “It’s obviously working for enough people, they are shouting from their social media rooftops,” said co-founder and chairman Joel Stanley.

CURALEAF Curaleaf has several brands, including Curaleaf Hemp, which makes natural, nonintoxicating products for a better quality of life. The Wakefield, Mass.-based company said the effective hempbased CBD products meet the strictest quality standards in the industry. Products are available in such categories as Pure, Relieve and Revive, and include lotions, drops, patches, softgels and vape pens. All Curaleaf Hemp products are made with the highest quality ingredients from the full-spectrum CBD oil to the premium essential oils, company officials said. All CBD is tested before formulation and all products are batch tested before distribution, company officials said.

ELEVATE HEMP The official partner of Spartan Race, Elevate Hemp Extract delivers a wide spectrum of mind-body health benefits and works naturally to lessen pain-causing inflammation as it targets the body’s cannabinoid receptors to actively suppress pain, according to company officials. Available in soft gel caps, mint chewing gum, dissolvable strips, liquid drops, oral spray and topical cream, Elevate’s full-spectrum hemp extract is manufactured to pharma standards in a current Good Manufacturing Practices FDA-registered facility. Telford, Pa.-based Elevate Hemp tests the products to ensure hemp extract potency and for the absence of foreign ingredients and microbial contamination. forms, formulations and dosing guidelines within the current product assortment. CBD Unlimited offers specific delivery methods: topical mist and balm, as well as tinctures and adaptogen herbal capsules, which include a nighttime formulation. The Phyto-Bites brand features dual-delivery pet chews infused with CBD to promote pet health and support mobility, and may reduce separation anxiety and pain for both dogs and cats. The targeted SKU assortment is designed to help retailers and customers understand how to use the products, while providing solutions within select, top-selling product categories. Additionally, this targeted product assortment ensures the ability to deliver a consistent supply of high-quality products. This focus will help CBD Unlimited and their retail partners drive positive customer experiences as they enter this new category.



FUNCTIONAL REMEDIES Functional Remedies offers full-spectrum hemp oil produced with a proprietary, whole-plant lipid infusion process to get phytonutrients out of the plant in a way that preserves nature’s intended balance of phyto cannabinoids and other compounds. “Everyone seems to know the one term, CBD, which is one molecule among many,” said Tony Tomassini, chief marketing officer at the Superior, Colo.-based company. “Through lipid infusion, what you end up with is a true full-spectrum hemp oil that contains the natural balance of phytocannabinoids, terpenes, polyphenols, flavonoids and other beneficial phytonutrients capable of delivering the entourage effect.” The entourage effect refers to the magnified effect of the

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SPECIAL REPORT: CBD individual ingredients because they are all present, a variation of the idea that the whole is greater than the sum of its parts. Another factor that differentiates Functional Remedies is that it is a vertically integrated hemp oil company. The company does not contract with third parties, so it maintains the custody of raw materials, which helps maintain consistency and quality control. Functional Remedies even owns its own hemp farm in Colorado. “Colorado is still the only state that has all of its regulatory requirements in place for hemp,” Tomassini said.

GLOBAL CANNABINOIDS Global Cannabinoids said it is the largest manufacturer of privatelabel CBD products. “We manufacture for some of the biggest brands in the country,” said Ryan Lewis, founder of the Las Vegasbased company. The company makes topicals, balms, creams and other products. The largest segment is pain, followed by sleep. “Cannabinoids really help people with their sleep,” he said. “They really bring your body into balance.” One of the things that sets Global Cannabinoids apart, Lewis said, is the company does not own the hemp farms. The company gets its supply from farms in Oregon and Colorado, and sends products for third-party analysis, which guarantees potencies and confirms the absence of heavy metals and pesticides.

GREEN ROADS Green Roads is a veteran in the CBD field and leads with education first, a key differentiator in the CBD industry. Its experience is widely recognized throughout the industry, and the company recently won the 2018 CBD Product of the Year award from the Cannabis Business Awards. The Deerfield Beach, Fla.-based company has a licensed pharmacist who compounds creams, salves, oils and edible products that are specially formulated with soothing botanicals and natural plant-based ingredients, including precise combinations of the cannabinoid. The products are multistage third-party lab tested, and the packaging has QR codes linked to lab results. Green Roads said its in-demand future products include the new Green Roads Muscle & Joint Heat Relief, launching this month. Green Roads Muscle & Joint Heat Relief is specially formulated to penetrate sore muscles and work quickly. An easy-to-use roll-on, this proprietary blend combines the Green Roads patented CBD formulation with menthol, capsicum, vitamin E and natural botanicals to deliver targeted relief when users need it most.

HARMONY HEMP The slogan for Harmony Hemp is: “Treat your system, not your symptom.” The Salt Lake City-based company offers several products, including the NeuroComfort line. NeuroComfort Neuropathy Support Water Miscible Hemp Extract is designed to help regulate and aid the endocannabinoid system to help treat the source



SPECIAL REPORT: CBD of nerve pain. NeuroComfort Nerve Health with Hemp Seed Oil is specially formulated based on extensive research focused on rebuilding nerves and relieving pain associated with neuropathy. Harmony Hemp also makes such supplements as Brilliant Mind Brain Support capsules designed to enhance cognitive function with water miscible hemp extract. Its Flexible Joint Support is meant to enhance the body’s natural lubrication and prevent joint deterioration, while aiding in everyday aches and pains. In personal care, Harmony Hemp Hydration with Essential Oils uses essential oils and organic moisturizers to naturally relieve itchy, dry skin, and HempBath Bombs are packed with premium hemp seed oil and other natural essential oils combined with organic shea butter and organic cocoa butter.

HOLISTIK WELLNESS To make it easier to deliver a dose of CBD, Holistik Wellness makes beverage stir sticks containing water-soluble full-spectrum hemp extract. The stirrers also contain other natural active ingredients. The products include Holistik pain with white turmeric, Holistik sleep with melatonin and chamomile, Holistik beauty with collagen, and HOLISTIK recover with white turmeric and ginger. “Holistik Wellness is a brand committed to simplifying the cannabis landscape, delivering products that are easy to understand and can fit into the day of new and experienced users alike,” said co-founder and CEO TJ Stouder, who is moving the company to Denver.

LEADING EDGE PHARMS Leading Edge Pharms is a biotechnology company focused on the research, development and commercialization of novel cannabinoid therapies and innovative delivery platforms. The company’s Cannavera product line features its first commercial product, Silvidiol, a proprietary compound formulated with THC-free broad spectrum organic CO2 hemp extract and Emerald Aloe Vera. Cannavera topical oil, crème, ointment and liquid products are natural, nonsystemic, free of THC and marketed as a step-wise approach to pain management therapy in the opioid-alternative category. What differentiates Henderson, Nev.-based Leading Edge Pharms from other companies is the years of research, according to CEO David Chadwick. “If you’re going to reference pain relief and make specific medical type claims, you have to have research to back it up,” he said. “You have a company like ours that spends four years of formulating and doing studies, and then you have folks who get into the business almost overnight.”

MARKETHUB Manufacturers that need help getting hemp-based products in retail look to MarketHub, which calls itself the hemp retail category leader. The Denver-based company offers legal, category management, distribution and merchandising expertise. “Brands have to get to a position where they are ready for primetime, ready for retail and everything it takes to do that,” said Blake Patterson, president




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and CEO. “A lot of these guys were selling the products at fairs.” MarketHub’s Hemp Health Zones, custom merchandising displays that showcase vetted products, helps businesses make the move from fairs to drug stores. The vetting process means the brands meet certain standards related to corporate structure, sourcing, manufacturing, labeling and other factors.

NEW LEAF PHARMACEUTICALS New Leaf Pharmaceuticals has been manufacturing nasal sprays for 20 years. The Newtown, Conn.-based company recently announced the launch of Rhinodol nasal spray, delivering the CBD using a transmucosal technique to ensure the highest bioavailability possible. Bioavailability refers to the amount of a drug that is absorbed and available for use in the body compared with the amount of drug delivered or administered. Bioavailability varies depending on the route of administration. CBD is a fat-soluble substance and has poor bioavailability when administered orally through the stomach and gut. The company said the most optimal route of CBD administration has proven to be transmucosal or



intranasal, with between 48% and 62% being absorbed and available for use in the body. “We have products that are very effective and have good bioavailability at a price point the consumer feels they can reach,” said Paul Carpenter, partner and founding member of New Leaf Pharmaceuticals. “If they are trying a $10 or $15 product that you swallow and the absorption rate is 8% to 12%, it’s not going to be effective, and you lose them forever.”

METACAN While CBD is a hero ingredient, other ingredients also contribute to a healthy endocannabinoid system. For example, black pepper fruit and clove oil contain terpenes, so the oil is an important ingredient in HempFusion Digestive, HempFusion Hemp Extract, HempFusion Sleep and HempFusion Stress. New from HempFusion is hemp extract liquid with black seed oil. “It’s a very effective oil, loaded full of omega acids,” said Jason Mitchell, president of MetaCan, the Roswell, Ga.-based company that makes HempFusion products. “Even for the oils used as a contributing carrier oil, we want

so consumers want to try CBD products. Retailers can succeed in this booming category by merchandising the products in the store. “Detailed packaging, educational endcaps and engaging shelf talkers help to close a sale by building consumer trust and brand loyalty,” he said.

PRANA PRINCIPLE Castle Rock, Colo.-based Prana Principle has been in the supplement industry for 24 years, and has a dedicated legal team that can answer questions regarding the legality of CBD. Prana Principle, a brand of APAX Brands, packages and presents products in a way that allows it to be shipped to all 50 states. Prana’s Full Spectrum Phytocannabinoid-Rich Hemp Oil Extract Soft Gels and Full Spectrum Phytocannabinoid-Rich Hemp Oil Extract Tinctures contain nonpsychoactive phytocannabinoids and such compounds as CBD, cannabigerol, cannabinol and cannabichromene with a range of naturally preserved terpenes. The products are monitored through third-party labs regularly to ensure they remain at 0% THCcontent. “The last thing retailers need is you send hot product that is high in THC, and a consumer tests positive,” said CEO Sebastien Hebbelinck. New from Prana Principle are products for pain with CBD and curcumin, which has inflammatory effects, and CBD and melatonin for sleep.


to make sure we don’t add chemicals. We try to make things as natural as possible. Every ingredient we use plays a role.” Mitchell said the research suggests that if the body is deficient in omega-3 oils, the endocannabinoid system may not be functioning. New products include Twist, which is available in peach mango and key lime and orange sherbet and orange citrus flavors. The user simply mixes a spoonful in water. It’s completely soluble, so it makes taking these products a pleasure, Mitchell said.

MILE HIGH LABS Mile High Labs is an industrial-scale cannabinoid extractor that produces a considerable amount of the CBD full spectrum, distillate and isolate available on the market today. The company operates the only end-to-end Good Manufacturing Practice-certified extraction facility in North America, and said the industry’s most recognizable and successful brands rely on Mile High Labs’ CBD as their main active ingredient. Based in Boulder, Colo., the flagship extraction facility is in Loveland, Colo. The category is getting much attention, CEO Jason Roth said,

Uleva Products offers full-spectrum hemp extract herbal supplements rich in phytocannabinoids to help support the body’s endocannabinoid system. Each of Uleva’s six formulas has been combined with specific herbal ingredients to provide hemp-based support for a healthier lifestyle. The six formulas are Digest with ginger, Flex with glucosamine and chondroitin, Fuel with green tea, Relax with Ashwagandha, Relieve with turmeric, and Sleep with melatonin. Contract Pharmacal manufactures Uleva in Hauppauge, N.Y.

ZURI CBD SUPPLY ZuRI offers more than 70 SKUs of CBD products, including wellness drops, topicals and pet items. The CBD Isolate is double tested to ensure zero THC content, and the company uses organic, nonGMO ingredients in its formulas. Retailers in all channels, from drug chains to shoe stores, are asking for the products, said president Scott Raybuck,. “Everyone that was sitting on sidelines with the legality issue is getting into the CBD market,” he said. “We have a rep that brought on 22 drug stores in one month.” The Cleveland-based company offers training for retailers so they can answer consumer questions about the products and about the CBD category overall. ZuRI CBD is planning several product launches, including cosmetics, supplements and sports recovery. “Sports organizations are taking CBD off the banned substance list,” Raybuck said. “People are living longer, their bodies are wearing, and they don’t want to live with that pain or anxiety.” dsn




Catching the Customer’s Eye Respario’s offerings look to build an interactive in-store experience


elping independent retailers level the playing field is a big part of Respario’s core strategy. The Dallas-based digital media and technology company focuses on telling its client stories through digital signage, interactive devices, mobile solutions and static media. Company president and CEO Ian Stone sat down with Drug Store News to talk about how his company can help solve its clients’ challenges.

and media. While we have several legacy solutions for independent pharmacies, our strategy team is continually looking at innovative ways to help tell an expanded story in the pharmacy. Our view of the pharmacy of the future includes dynamic interactive product coaches, mobile integration, digital shelf talkers, and other technologies that we may not even know about yet. We continually ask pharmacy owners what their challenges are, and work to help solve them.

Drug Store News: What makes Respario unique, and how do you offer solutions? Ian Stone: We have been crafting our clients’ stories and activating integrated technologies since 2005, and our team has all of the components required for these solutions under one roof, including technology resources, application development, video production and deployment. It’s our solutions and how we work to solve our clients’ challenges through a well-defined, strategic approach, a deep dive discovery process, creation and production of solutions, and a seamless delivery that are unique. At our core, we offer one of the industry’s only end-to-end technology and media solutions, and we have a strong focus on health care and retail pharmacies.

DSN: Tell us about how the Pharmacy Health Network works. IS: Pharmacy Health Network is a digital signage platform that is designed for independent pharmacies and regional chains, where we install consumer flat screen monitors and a digital media player in the pharmacy, and provide health-and-wellness media and sponsored advertising from national prescription and OTC brands. In addition, we give the pharmacy or chain tools to create their own messaging and media about specific pharmacy programs, such as clinics, medication synchronization, pharmacy specials and community events. We also provide a collateral rack to each pharmacy and supplement the on-screen experience with print materials. Pharmacy Health Network is currently in over 1,000 pharmacies nationwide, and the network is in growth mode with both independents and regional chains that see the benefit of the solution and how it can help their customers.

“We continually ask pharmacy owners what their challenges are, and work to help solve them.” DSN: You have a strong base with independent pharmacies. How do you play in the pharmacy of the future, and how do you add value? IS: Independent pharmacies have traditionally been a strong category for Respario, and we look for ways to help independents compete in the marketplace with our technology



DSN: How do retailers benefit from the services you offer? IS: There are many benefits of Pharmacy Health Network, and since 2009 the network has been providing key advantages to retail pharmacies. Our pharmacy partners tell us that perceived wait time goes down, that they sell more product, but most importantly, Pharmacy Health Network helps to drive meaningful conversations

Ian Stone, president and CEO, Respario

between the customer and the pharmacy staff. Pharmacies also benefit from our turnkey solutions, our technology and media expertise, and our experience in the retail pharmacy space. For each Pharmacy Health Network customer, we provide a full package of technology and services, white glove site survey and installation, and custom media design for the pharmacy or chain. And because we work with sponsors and advertisers, Pharmacy Health Network is offered at no cost to the pharmacy. DSN: Working with retailers, where can you take this in the future? IS: While our road map has several stops on it in regard to new innovations, our team is continually looking at how technology will be focused on customer engagement and the in-store experience to drive the retail experience. We’re always reviewing and fine-tuning how technology in retail works, how customers experience it, and how to balance the technology with human interaction in the pharmacy space. dsn


A Piece of the Pie: Independents Build New Business Models Independent pharmacies broaden their scope to stay competitive BY MARK HAMSTRA




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NCPA estimated that the number of independent pharmacies totaled 21,909 in 2017.


ndependent community pharmacies face unprecedented pressures in the form of national chain competitors and a drugpricing system that’s stacked against them. More than a third of the pharmacies in the country — about 35% — are independent pharmacies, according to data released last fall from the National Community Pharmacists Association. NCPA estimated that the number of independent pharmacies totaled 21,909 in 2017, down slightly from 22,041 in 2016. Those independent operators that remain have found ways to survive and even thrive, however, often with revenue models that stretch beyond the dwindling margins they can expect to recoup for dispensing prescriptions. They are leveraging their strong community ties and high service levels, expanding their product assortments, and seeking to gain compensation for the value they add to overall patient care. “Generally speaking, it’s a very difficult time for independent pharmacy,” said Tim Hamrick, president and CEO of Bessemer, Ala.-based American Pharmacy Cooperative Inc., a network owned by independent pharmacies that provides buying power and other benefits for its 1,800-plus members. The main challenges these operators face are the prescription reimbursement structure and the difficulty in retaining customers in an environment that often encourages patients to go elsewhere for their prescriptions, he said.



On their own, small operators have little negotiating power with the large pharmacy benefit managers, and have often been forced into contracts that reimburse them below their costs for buying prescription drugs, Hamrick said. “Our industry is a unique one, where your chain competitor next door is affiliated with the company that sets the reimbursement you receive for a prescription,” he said. “Even if the PBM isn’t affiliated with a retail pharmacy competitor, they all have their own mail-order pharmacies, and will design employer benefits programs to steer patients to their mail order pharmacies, especially for more expensive and profitable specialty medications.” Kurt Proctor, senior vice president of strategic initiatives and president of the Innovation Center at the NCPA, said that the PBMs drive more profitable patients to their own networks, while shifting more complex cases where prescription adherence is low to other pharmacies. “They are anxious to push those patients to a different pharmacy,” he said. Many independent pharmacies have found revenue-driving niches in such areas as weight loss programs or partnerships with local medical facilities that focus on specific illnesses, for example, Proctor said. Others might offer expanded front-end departments, and some might find their niche is their location itself, underserved by competitors. Hamrick of APCI said successful independent operators are pursuing several strategies to remain competitive, including working

to buy better from their wholesalers and leveraging technology to improve efficiencies and streamline inventories. “Most of all, they are increasing their focus on what has made this industry valuable in the first place — patient care,” he said. Independent pharmacies “have personal connections to their patients that span decades,” Hamrick said. “So, we see that despite [the challenges], the independent pharmacist today doesn’t turn his or her back on patients.”

HEALTH CARE BEYOND PRESCRIPTIONS Independent pharmacies need to deploy creative strategies that distance them from being reliant on filling prescriptions, while at the same time leveraging their capabilities to play an important role in the overall healthcare system, said Patrick Devereux, pharmacist at FMS Pharmacy in Bessemer, Ala. “The more we can improve outcomes for patients and improve outcomes for health care as a whole, then we have a little bit of insulation, so we’re not depending on the revenue coming in from the PBMs,” he said. “We need to utilize opportunities to practice at the top of our license, and there are services that we can provide that have higher margins and are higher-impact services than simply dispensing prescriptions.” FMS Pharmacy provides health screenings for some large selfinsured employer groups in the area, for example. By administering finger-stick tests for cholesterol and glucose, and consulting with employees about ways to reduce the risk of diabetes and cardiovascular disease, the pharmacy can help employers reduce their own insurance costs, he said. “It is something we can be paid for that delivers value to both patients and employers,” Devereux said. “These are models that are already working in both chain pharmacies and independent pharmacies, and these do not depend on PBMs.” In addition, he said that PBMs cannot charge direct and indirect remuneration, or DIR, fees for these services. DIR fees, which are assessed after a prescription has been dispensed, can often wipe out any margins pharmacies might have generated on the sale, operators said.

Data from the 2018 NCPA Digest found that 79% of community pharmacies offer medication therapy management, or MTM; 70% provide immunizations; 57% perform blood pressure monitoring; and 53% furnish durable medical goods. “We are performing every clinical service that we can that is presented to us,” Devereux said. “We make sure none of those dollars are being left on the table, and none of those patients are being unserved or underserved.” FMS currently is talking with a hospital system about providing chronic care management for its outpatient clinics, for example, and also is offering a diabetes education class for which it can bill Medicare without going through a PBM. The pharmacy maintains a strong diabetes program in part through the relationships it has with local physicians, who refer many of their patients to the program, Devereux said. By providing outcome data to the physicians that showcases the impact its programs are having, FMS attracts additional referrals, he said.

BUILDING RELATIONSHIPS Jim Spoon, owner of Spoon Drug in Tulsa, Okla., and the winner of the NCPA 2018 Willard B. Simmons Independent Pharmacist of the Year Award, said that having strong relationships with local physicians is key to the success of independent pharmacies. “We work well with the doctors,” he said. “It’s important to look for those little niche areas where you can make a little extra money and support your business, so you can take care of people.” Spoon Drug, which operates three locations in the Tulsa area — one under the T. Roy Barnes Drugry name — does “a little bit of everything,” including offering drug compounding services and support hose, as well as gift merchandise. “We’ll special order just about anything anybody needs,” Spoon said. “We take just about every insurance and try to encourage people to trade with us instead of doing mail order.” One potential area for growth is around cannabidiol, or CBD, products. Spoon said his pharmacists are able to offer value-added counseling around CBD items, for example, because of their pharmacology expertise, compared with other stores

The Neighborhood Pharmacy Lives up to its Name One of the strengths of independent pharmacies is their ability to tailor their offerings to the needs of the individual communities where they operate. At appropriately named Neighborhood Pharmacy of Del Ray in Alexandria, Va., for example, founder Stacey Swartz and co-owner Barbara Hayward have created a drug store designed to meet the needs of that individual neighborhood. The store has expanded its offerings to meet the needs of Del Ray, an area

of Alexandria nicknamed “Well Ray” because of its abundance of yoga studios, massage clinics and other health-oriented businesses. Neighborhood Pharmacy has responded with an expanded offering of homeopathic remedies and other products that are ideally suited for the location. “We have homeopathic physicians here who recommend homeopathic vitamin supplements,” Swartz said. “It is great for us in some ways because it’s being recommended by another practitioner, and the

practitioners tend to like it because they don’t have to keep it in stock in their location. It’s really a very mutual beneficial relationship.” The store’s location next door to a yoga and Pilates studio also has impacted the product offering. “We get people who are stopping in on the way to their classes, and they come in and say, ‘Hey, I really wish you carried this essential oil. If you did I would buy it from you,’” she said. “ And that helped us to build up our inventory.”



COVER STORY selling CBD products where the staff might not have that same knowledge and insight. Marketing can be a challenge for independent pharmacists, who are competing against the big marketing budgets of larger chains, but Spoon said he tries to leverage social media and also seeks to ensure that the company comes up at or near the top of local Internet search results.

LISTENING TO CUSTOMERS Stacey Swartz, co-owner and pharmacist in charge at the Neighborhood Pharmacy of Del Ray in Alexandria, Va., said her company also has been expanding its offerings to shift away from being too reliant on revenues from filling prescriptions. “We put in a full line of compression stockings, we have highend vitamins, and we have high-end skin care,” she said. “These are things that can bring us more revenue, and we don’t have to worry about if insurance companies come back six months later and take that money back in their audit.” She attends a lot of NCPA meetings to network with other pharmacists and to look for “the best ideas that are out there” to grow the business. The pharmacy also relies on its local customers for merchandising ideas. “They’ll come in and say, ‘I really wish you carried this’ or ‘I really wish you did this,’ and if it’s feasible and reasonable for us to do, we will bring it in,” she said, adding that she and her staff try to do whatever it takes to make the pharmacy experience “as stress-free as possible” for its customers. “Having that reputation helps us to stay competitive, and I think that goes a long way,” she said.

VALUING OUTCOMES Hamrick of APCI said independent pharmacists are “uniquely positioned” to succeed in an environment that values outcomes. “Independent pharmacy has relationships and trust with its patients that have taken decades to build,” he said. “And due to

these relationships, it’s independent pharmacy that is best positioned to help employers and government payers lower their overall healthcare costs. We just need to make it to the transition where pharmacy is getting paid to produce results for its patients and their payers.” That is the rationale behind the formation of the Community Pharmacy Enhanced Services Network, a joint venture of the National Community Pharmacists Association and Community Care of North Carolina.

The Community Pharmacy Enhanced Services Network brings together dozens of local networks from around the country that focus on optimizing health outcomes. CPESN (see sidebar below) brings together dozens of local networks from around the country that focus on optimizing health outcomes. “There’s a tremendous opportunity for the medical side to save money by working with pharmacies, and there’s value that’s created there that can be recognized and paid for to those pharmacies,” Proctor said. Community pharmacists need to make sure they are providing value to their customers, so that their patient relationships become so important to the healthcare community that the PBMs stand to lose by not including community pharmacies in their networks, he said. “Doctors, care managers and others need to say, ‘What do you mean Joe’s Pharmacy’s not in the network? I rely on Joe’s Pharmacy to take care of my diabetic patients,’ for example,” Proctor said. “I think those who do those things have a potential for a very bright future,” he said. dsn

CPESN Seeks to Integrate Pharmacy’s Value One of the vehicles that has helped independent pharmacies generate added revenues is the Community Pharmacy Enhanced Services Network, a joint venture of the National Community Pharmacists Association and Community Care of North Carolina. CPESN is a clinically integrated network that seeks to better integrate the services that community pharmacies provide into the broader healthcare system, thus helping pharmacies earn a reward for their role in the cost savings that accrue from helping patients achieve desired outcomes. It currently includes 47 different networks



operating in 42 states across the country. “A lot of this comes down to pharmacies doing things the way the rest of health care does, rather than in our own proprietary way over and over,” said Kurt Proctor, senior vice president of strategic initiatives and president of the Innovation Center at the NCPA. CPESN works directly with payers who understand the value that community pharmacists can provide in helping patients optimize their overall healthcare. Payers, which include insurance companies and such government programs as Medicare, have a strong interest in controlling the costs

that arise from complications and emergency room visits that pharmacists are often in a position to prevent. The medical community also has a strong interest in controlling these costs. Unlike the large national PBM contracts, CPESN operates on a highly localized basis that is well suited to community pharmacies, Proctor said. “It’s extremely important that these local networks are interacting with the local employers, the state-based Medicaid departments, etc., to bring them a local solution that’s addressing the real issues, the real cost drivers on the medical side of the ledger,” he said.


First Line of Care Drug Store News honors the innovators helping shape the OTC space By Carol Radice


onsumers make it pretty clear what they expect from OTC products. It all comes down to four factors: accessibility, affordability, trust and empowerment. Offer them, and back it up with some strong marketing, and there is a good chance that they will at least experiment with your brand. According to the Consumer Healthcare Products Association, consumers are relying on OTCs more than ever. The Washington, D.C.-based trade group’s research shows more than three-quarters of adults look to OTC products as their first choice to deal with minor ailments. Parents are among the most likely to turn to OTC medicines to treat their children’s minor ailments before seeking professional care. The most common healthcare concerns consumers seek out OTCs for include issues related to cough/cold/sinus, digestion, allergies, and minor aches and pains. This month, Drug Store News recognizes the movers and shakers of the OTC world with our Retail Excellence, or REX, Awards. The winning companies were selected for their dedication to protecting and supporting consumer health. These are companies that have raised the bar higher each year in regard to innovation. The REX Awards 2019 OTC award recipients are:

ADM PROTEXIN For more than 20 years, ADM Protexin has been producing probiotic products under its Bio-Kult label. Alexa Wood, brand manager, said ADM Protexin’s innovation and leadership in the market comes from developing its own research-based probiotic strains. To date, the company has developed 14 probiotic strains, all of which are proven to survive the acidity of stomach acid. Compared with similar items on the market, the Miami-based company’s products contain no artificial colors, flavors or preservatives; are non-GMO; free of gluten, egg and nuts; and have a guaranteed two-year shelf life. ADM Protexin’s products also do not need to be refrigerated. “We are focused on ensuring we are always at the forefront of the latest science, which includes in-vitro, early-stage development, concept exploration and human clinical trials,” Wood said. “Our Bio-Kult probiotics are manufactured at our state-of-the-art facility in Somerset, South West United Kingdom, designed specifically for probiotic research, development and production.” This year, the company will be introducing its Bio-Kult Migréa, an advanced combination product that targets both the digestive tract and the head. According to Wood, this new product combines 14 probiotic strains, plus magnesium and vitamin B-6, both of which contribute to the normal functioning of the nervous system.



AUBIO LIFE SCIENCES Rachel Wagner, CEO and managing director of Aubio Life Sciences, said when it came to developing the company’s skin care line, the focus was on developing products that featured quality ingredients. It also was important to the company that its formulations would make a difference in people’s lives. From this mission, Aubio Life Sciences has created its Cold Sore Treatment Gel. Offered in a 3-gram tube, it features lidocaine, allantoin and botanicals. Aubio also offers a Hydrating Lip Balm with sunscreen. The Scottsdale, Ariz.-based company has partnered with U.S. Ski & Snowboard as their official cold sore treatment provider, as well as the Association of Volleyball Professionals. “We believe harsh weather conditions go hand in hand with the triggers of cold sores,” Wagner said. “Our products are ideal for those leading active and healthy lifestyles.”

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REX AWARDS 2019: OTC teaching institutional partners have had tremendous impact on our brands and enable us to publish results.” The company is working on topical products to address symptoms associated with diabetic neuropathy, chemotherapy induced peripheral neuropathy and ionizing radiation induced skin damage for the millions of patients undergoing chemo and radiation therapy.


Aubio has commissioned a study to review its products’ benefits. The results will be published later this year. Wagner said the study’s preliminary findings support what Aubio officials knew all along — its cold sore products contain antiviral and repair properties.

AVADIM HEALTH Avadim Health is a life sciences company committed to identifying therapeutic gaps in care and filling them with evidence-based, clinically proven solutions. The company’s first innovation, Theraworx Relief, was created to topically address muscle cramps and spasms associated with restless leg syndrome, and officials said approximately 50,000 new patients are started on the product each week. Ralph Lombardo, senior vice president of sales and marketing at the Asheville, N.C.-based company, said Avadim Health is focused on delivering clinically proven, published and peer-reviewed topical solutions so that consumers, especially seniors, have something they could use affordably without worrying about it interacting with the drugs they take or causing the typical side effects often seen with oral systemic medications. Avadim Health will launch two new topical innovations in 2019 — one that addresses joint discomfort and inflammation and another for post-menopausal chronic urinary tract infections.“Our highest priority is to bring our retail partners proven and researchbased solutions that work,” Lombardo said. “Our academic



Founded in 1853 by J.J. Bausch and Henry Lomb, Bausch + Lomb is the largest global provider of eye health products. After more than 165 years, the company’s mission of “helping people see better to live better” continues as it links the innovation, quality and craftsmanship with the passion and collaborative spirit of its employees. This focus and drive allowed the Bridgewater, N.J.-based company to earn the status of the fastest growing consumer healthcare business for six consecutive years and be the top driver of growth within the OTC eye care category. In 2018, Bausch + Lomb brought to market several products designed to help care for patients’ eyes in today’s digital age and support their evolving eye health needs as they age. These products include Lumify redness reliever eye drops, the first and only OTC eye drops containing low-dose brimonidine tartrate developed for the reduction of eye redness, and Soothe Xtra Protection Preservative Free lubricant eye drops, a preservative-free formula to help with dry eye symptoms. Bausch + Lomb also introduced Ocuvite Blue Light eye vitamins and PreserVision AREDS 2 Formula Chewable eye vitamins. “As a fully integrated U.S. eye care business, Bausch + Lomb is solely dedicated to protecting and supporting the eye health of millions of people around the world,” said Joe Gordon, the company’s president. “We remain relentlessly focused on inventing new materials and engineering new technologies that meet the changing needs of patients.”

BOIRON Founded in France in 1932 by twin brothers and pharmacists Jean and Henri Boiron, Boiron’s founders saw an opportunity to answer a growing demand for reliable homeopathic products. Headquartered in Lyon, the company continues as an independent pharmaceutical laboratory operated by the Boiron family. The company is best known for its top-selling flu medicine Oscillococcinum and Arnicare line of pain relievers. Some of its newest products include Arnicare Bruise, Arnicare FootCare and Arnicare Roll-on in the external analgesic category. Boiron’s Camilia line has emerged as a top-selling teething medicine in the baby and children categories. Boiron recently introduced ThroatCalm, an alternative to benzocaine-based medicines, for relief of minor sore throat symptoms. “Our products are unique because we play in white-space areas where there may not be homeopathic options,” said Gary Wittenberg, vice president of national accounts. “We have also brought innovations to the market with easier-to-take medicines, including

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REX AWARDS 2019: OTC Understanding consumers’ everyday healthcare needs, views and product preferences is an integral part of GSK Consumer Healthcare’s new product development process. “Our brands are backed by science and inspired by the real wants and needs of the millions of people who walk into pharmacies, supermarkets and go online all over the world every day,” said Colin Mackenzie, region head, Americas, at GSK Consumer Healthcare. To drive growth, the company has partnered with leading research and strategy companies to develop insight-led category platforms and innovation solutions. GSK Consumer Healthcare’s Innovation Labs, located at its headquarters in Warren, N.J., enable the company to deliver real-time insights into shoppers’ purchase decisions; unlock healthcare opportunities through science, technology and innovation; and drive deeper collaboration with retail partners. This state-of-the-art lab suite includes a shopper science lab, a consumer sensory lab, and a research and development lab. According to Mackenzie, the labs were developed with a product’s life cycle in mind, spanning science and research, product development, testing, in-store layout and e-commerce design.


quick-dissolving pellets, tablets and sterile single-use liquid doses.” Boiron offers the medical community a variety of educational resources on the benefits of homeopathy, including sponsorship of training courses conducted by the Center for Education and Development of Clinical Homeopathy.

DOCTOR EASY MEDICAL PRODUCTS Family-owned Doctor Easy was founded in 1997, when physician Teddy Garcia and his wife Marsha saw the need for a safer, more efficient method of earwax removal. “When all the doctors in our office wanted us to make an ear washer for their practice, I knew we had developed something primary care physicians really needed,” said Marsha Garcia, president of the Orange Park, Fla.-based company. Since then, the Elephant Ear Washer has been used more than 40 million times and Doctor Easy products have become synonymous with ear cleaning. In the last few years, with increased emphasis on self-care, the company has expanded into the consumer arena, introducing WaxRx, a professional-grade home ear wash system and Earvana for dry ear itch. “We’re excited by the expanded interest in the ear care category from retailers and grateful for the opportunity to bring our experience in professional ear care to the consumer,” Marsha Garcia said.

GSK CONSUMER HEALTHCARE GSK Consumer Healthcare, one of three divisions at GlaxoSmithKline, is known for its Sensodyne, Theraflu, Excedrin, Nicorette, Flonase Allergy Relief and TUMS brands, among others.



With roots dating back to the early 1900s, Hyland’s has worked hard to earn the status of being the oldest and largest U.S. homeopathic company. Throughout the years, the Los Angeles-based company has stayed true to its mission of offering consumers of all ages safe, convenient and effective remedies for their health needs. Parents, in particular, have come to rely on the company’s homeopathic products to relieve their children’s oral pain issues or cough-cold symptoms. Adults often turn to Hyland’s for its leg pain products. This past year, Hyland’s has introduced several new line extensions, including its Baby Oral Pain Relief Tablets, which are now available in day and night formulas. The company also debuted Hyland’s 4 Kids Leg Pain Relief. Next, Hyland’s rolled out Restful Legs PM for those experiencing leg cramps that keep them up at night. Recognizing the need for a homeopathic menopause formula, Hyland’s introduced Doctor Wise Homeopathy, a five-SKU line created to relieve symptoms many older women experience as they age. “People come to our brand because they are looking for a gentle, safe choice made with natural ingredients,” said Thao Le, vice president of marketing and innovation. “In many cases, they are searching for an option that does not contain NSAIDs and will not interfere with other medicines they may be taking. Alternative medicines such as homeopathy, which date back to the late 1700s, fit that description well.”

IM HEALTH SCIENCE Officials at Boca Raton, Fla.-based IM Health Science proudly said their products are “powered by nature, perfected by science.” It is a combination they think will play nicely with consumers, especially those with irritable bowel syndrome or functional dyspepsia. IM Health Science offers IBgard, a product that uses peppermint oil and a delivery system that ensures it is delivered to the

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REX AWARDS 2019: OTC Kelli Rodriguez, director of U.S. sales and marketing, said Kamedis’ products were created to help skin differently than other products on the market. “Our extraction process and patented botanical combinations result in products that don’t just work on your skin, they work with your skin, triggering your immune system to fight dermatologic disorders and help restore the skin’s natural balance rapidly and effectively,” Rodriguez said. The company recently introduced a therapeutic line of shampoos, lotions, creams and gels that combine traditional Chinese medicinal botanicals with Western ingredients. Among them is the new Eczema Therapy Cream and Eczema Therapy Wash is a twostep eczema regimen that officials said has been clinically proven to reduce flare-ups by 50% in two weeks. “Our products work, contain no steroids and are safe. It took a 3,000-year-old system to deliver results in days or hours,” Rodriguez said.


small intestine, the primary site of IBS. In clinical, multicentered, double-blind and placebo-controlled trials, the company said the product has been shown to start working as early as 24 hours and continues to work for as long as four weeks. IBgard is available in two SKUs, a 12-capsule package and a 48-capsule package. FDgard is designed to treat functional dyspepsia in the upper belly using a combination of caraway oil and peppermint oil. The product is available in two SKUs, a 12-count and 36-count package. “Our products meet an unmet need,” said Dave Swenson, president of the company. There is a large population of people out there looking for items likes these that are natural and backed by science.”

Coconut Creek, Fla.-based Lifelab Health’s singular mission is providing consumers with U.S.-made healthcare products, featuring natural and organic ingredients. The company’s NuSyllium product, for example, is made with 100% USDA-certified organic psyllium fiber. NuSyllium is GMOand gluten-free, has no artificial flavorings or food dyes, and comes in original and natural orange flavors. According to managing director Louis Machin, the organic psyllium fiber in NuSyllium is clinically proven to promote digestive health, lower cholesterol levels and help with weight management. Extending its natural product offerings, Lifelab Health has introduced NuAloe Organic Aloe Vera, an aloe drink supplement offered in individual, freeze-dried granulated powder packets. With an emphasis on convenience, NuAloe powder packets require no refrigeration and are ideal for on-the-go healthy lifestyles. Looking to tap into the interest in organic products, Lifelab introduced its HoneyWorks line of cough-cold products for children and adults. Made with 100% USDA-certified organic dark honey, HoneyWorks products offer fast, drug-free and effective relief from sore throats and coughs. HoneyWorks is free from such artificial additives as dyes, preservatives, flavorings and colorings. It also is free of GMOs, gluten, dairy, tree nuts and peanuts, and has no trans fats. “Within our HoneyWorks line, we included certified organic options for the increasing number of parents looking for drug-free cough-cold alternatives to give their kids,” Machin said.



Oakland, Calif.-based Kamedis is best known for its clinically proven, botanical-based skin care products that treat acne, eczema, dandruff, psoriasis, itching, irritation and redness without known side effects or additives, such as parabens, steroids, dyes and SLS. Kamedis’ products go beyond treating symptoms to help restore the body’s natural balance. The company’s skin care collections contain clinically proven products that are the first to merge Eastern with Western approaches, applying traditional Chinese medicinal principles and proven botanicals in pharmacy-available products.

When officials at Medina, Ohio-based NasoNeb set out to create its Sinus Therapy System, they wanted the product to be effective, as well as easy and comfortable to use. The company introduced the third generation NasoNeb Sinus Therapy System in 2018, which incorporates changes inspired by consumer feedback. It also introduced the NasoNeb Moisturizing Nasal Solution last year. Kathleen Leigh, vice president of marketing, said the solution’s dual-salt formulation includes multiple moisturizers and is specifically pH-balanced for the nose.





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REX AWARDS 2019: OTC Leigh pointed out that peer-reviewed clinical studies from leading institutions have demonstrated that the NasoNeb system offers comprehensive relief because it delivers product to the whole sinus cavity. “It is designed to be less drying than saline alone. For retailers, it represents a strong repeat sales opportunity,” Leigh said. NasoNeb also has invested in additional equipment for its warehouse and production areas to increase capacity. The company supports its retailers with coordinated marketing that includes in-store promotions, temporary price reductions, shelf tags, circulars, social media, print, direct mail, electronic advertising and geotargeting.

PANTHERYX PanTheryx is a biotechnology company focused on realizing the potential of novel interventions to address a wide range of serious GI microbiome-related health conditions. Founded in 2007, the Boulder, Colo.-based company uses its proprietary technology platform to develop offerings that range from supplements to biologics that address unmet needs in the care continuum. The company is best known for its flagship product DiaResQ, which launched nationally in 2016. As Brian Budeselich, the company’s vice president of sales, said, what makes DiaResQ different is that it addresses the source, not just the symptoms, associated with diarrhea.

“It is a food for special dietary use that contains immune factors, micronutrients and macronutrients that are beneficial for children and adults with diarrhea,” Budeselich said. DiaResQ has been selected by healthcare equity organization PATH as one of the top 30 leading healthcare innovations with great promise to transform global health by 2030. As a company, PanTheryx is gaining recognition for the innovation in its pipeline — medical food and biologics candidates — being developed for C. difficile infections, chemotherapy-induced diarrhea and inflammatory bowel disease.

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REX AWARDS 2019: OTC Pak was designed to target antibiotic overuse for colds and flu. Sarath Malepati, CEO and creator of the EZC Pak, said her company’s product is one of the few utilizing premium ingredients. It also is one of the only ones to not have added sugar. The company recently launched EZC Pak-D, which has all the benefits of its premium EZC Pak, plus vitamin D. Due to growing interest, the company’s products now are available in more than 8,000 retail locations. “EZC Pak is the only OTC physician-directed solution for colds and flu in the category,” Malepati said. “Our brand identity blends the best of natural with the knowledge of modern medicine and pharmacy for the mass market audience.”


PFIZER CONSUMER HEALTHCARE Pfizer Consumer Healthcare develops, manufactures and markets nonprescription medicines, vitamins and nutritional products, including such brands as Advil, Centrum, ChapStick, Emergen-C, Robitussin and Preparation H, among others. “Our deep understanding of what consumers need and want, combined with rigorous science that is the foundation of our research and development program, has helped us develop innovative healthcare solutions throughout the years,” said Kevin Macero, chief customer officer at the New York-based company. Putting these insights to work, the company introduced several new products in 2018, including Robitussin Honey Maximum Strength Cough + Chest Congestion DM — the first of its kind among leading cough brands. Emergen-C introduced Probiotics+, containing two strains of probiotics for immune health support, plus vitamin C. Pfizer Consumer Healthcare also expanded ChapStick’s Total Hydration line with a Vitamin Enriched Lip Oil. “We pride ourselves on the trust we have been able to build with our retail partners through mutually beneficial strategic relationships — going beyond tactical and transactional — to bring solutions that benefit both retailers and consumers,” Macero said.

PPC GROUP Los Angeles-based PPC Group is best known for its EZC Pak, a physician-formulated immune support pack composed of organic echinacea, zinc and vitamin C. According to company officials, EZC



For Prestige Consumer Healthcare in Tarrytown, N.Y., its drive to innovate comes from the desire to improve consumers’ lives within the OTC healthcare category, company officials said. Some of the brands the company is most known for include Summer’s Eve, Monistat, Clear Eyes, Dentek, Dramamine, Compound W and Nix. The company recently introduced a number of products within its existing brands. It launched Dramamine-N Multi-Purpose formula for relief of nausea and Dramamine-N Long-Lasting formula, which offers up to 24 hours of nausea relief and prevention. Within its Compound W line, the company introduced NitroFreeze, the first OTC wart remedy to contain nitrous oxide. The company’s Summer’s Eve brand launched FreshCycle, a line of feminine cleansers. “For generations, our trusted brands have helped consumers care for themselves and their loved ones,” said Joseph Juliano, vice president of innovation and consumer insights. “We are constantly improving, creating products that match the ever-changing lifestyles and needs of people and families everywhere.” Juliano referred to Prestige Consumer Healthcare as a different kind of company. “We are the largest independent provider of over-the-counter products in North America, yet nimble enough to give detailed attention to every one of our product offerings.”

RHINOMED Since its founding in 2013, Rhinomed has been focused on helping people overcome breathing issues stemming from nasal congestion and obstruction. CEO Michael Johnson said Rhinomed’s strategy is to ensure its products are not only on retail shelves, but that they carry the endorsement of leading clinicians. The company, which has offices in Melbourne, Australia, and Cincinatti, is best known for Turbine, a breathing aid favored by many top level athletes, and Mute, an adjustable nasal dilator created to help people breathe more, snore less and sleep better. More recently, the company has been working on better understanding the relationship between nasal congestion, sleep and aromatherapy. After extensive consumer research, listening to leading sleep dentists and sleep specialists, and getting feedback from the U.S. Army, Rhinomed will be introducing a line of pure essential oil vapor, delivering products this spring.

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“Medical research is increasingly telling us that how well one sleeps can impact many aspects of your life — from heart health and cognition to your mental state,” Johnson said. “Rhinomed is committed to driving innovation and creating new, noninvasive solutions that radically improve the way people breathe, sleep, maintain their health and take medication.”

XLEAR American Fork, Utah-based Xlear was founded in 2000 and is best known for its patented sinus care products and Spry Dental


Defense System, both of which are xylitol-based. The products first debuted in the natural products industry, but as word spread, Xlear easily has been able to expand into food, drug and mass retail outlets. The company recently introduced Xlear 12 Hour decongestant nasal spray. “There really hasn’t been much innovation in the nasal spray/sinus care category for decades,” said Nathan Jones, the company’s president. Jones said that xylitol was chosen for Xlear's products because of its effectiveness binding to bacteria. “What’s more, by utilizing xylitol in our sinus formulas, we are able to mitigate most of the negative side effects traditional sinus products cause, including the really bad taste, dryness, increased upper respiratory tract infections, and it can substantially reduce the rebound effect,” Jones said. “And, unlike other products used to treat sinus issues, ours can be used preventively as well.” Given xylitol’s long-standing reputation in preventing tooth decay, Jones’ company recently developed its Spry Dental Defense System, which includes gum, mints, toothpaste and mouthwash, as well as several products designed for children. As is the case with the company’s nasal products, xylitol acts to prevent bacteria from colonizing in the mouth. “Because bacteria can’t thrive, it also can’t produce its by-product, acid, which can lead to tooth decay and cavities,” Jones said. dsn



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Instaflex Rolls Out Pain Relief Cream Healthy Directions and Adaptive Health

announced a new addition to its Instaflex line of nutritional supplements, which can be found on GNC shelves. The Charlotte, N.C.based company unveiled its new pain relief cream, the first topical addition to the brand’s portfolio that gives users a layer of support to help them move around more comfortably. “Instaflex pain cream is a safe, effective option for people who are trying to reduce their pain while staying active, without the risks associated with over the counter pain pills,” Ben Teicher, president of Healthy Directions, said. “I am thrilled to be associated with the well-respected

Instaflex brand to get this highly effective solution into the hands of more people who need it.” Developed with the assistance of doctors, the cream also is clinically studied and formulated with an exclusive patented oxygenated oil that works to relieve pain from such conditions as arthritis, back pain, strains, joint and muscle pain, the company said. “We are very happy to be adding this effective pain relief cream to the Instaflex product line,” Brandon Adcock, CEO and co-founder of Adaptive Health, said. “Instaflex Pain Relief cream is a good fit for the high standards of the brand. It is doctor developed and provides an additional level of support for our customers.”

Fortera Nutra Solutions Introduces Diamond Fortera The maker of male enhancement supplement Red Fortera is bringing a new offering to market — this time focused on women. The Morganville, N.J.-based company has introduced Diamond Fortera, a supplement meant to enhance women’s libido and pleasure on demand. Diamond Fortera is offered in a single-serve size, as well as a four-serving box. The product is meant to be taken 30 minutes before intimacy. Diamond Fortera has hit 500 drug and convenience stores, the company said. “We are extremely excited about strengthening the Fortera Brand with this new opportunity to engage female customers,” said Seth Horowitz, Fortera Nutra Solutions’ director of business development. “She will ask for this diamond by name.”



Arm & Hammer Launches Heel, Foot Moisturizer Arm & Hammer brand is expanding its

footprint in the foot care category with its latest launch. The brand has introduced Arm & Hammer Foot Care Moisturizer + Gentle Exfoliators.

The product, developed and marketed by Premier Brands, which licenses the Arm & Hammer brand name from Church and Dwight, includes a patent-pending formula meant to moisturize and restore skin with AHA exfoliators and hydrating coconut oil. It also features a no-touch sanitary massaging brush to make application to heels and feet fast. The product also is non-greasy and won’t leave a residue on feet or shoes, the company said. The product has launched in CVS Pharmacy stores and on CVS.com.


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Two Legs Good, Three Legs Better How pharmacist prescribing works in the U.K. and how it can inform American efforts By Ed Rowland and Trevor Gore


nlike several other markets, the U.S. consumer healthcare system generally does not allow for the “third leg” of health care: pharmacists prescribing prescription medicines. The reasons are many and the debate continues as some states are allowing some level of pharmacist prescribing, but in general, it’s a key way the U.S. market differs. Is the grass greener and/or is the water bill higher with this model? In the U.K., there are basic levels of pharmacy classification, defined services, training and supervision required, as well as some significant price controls and limits to the overall system. Overall, the numbers



and results are impressive and have certainly contributed to a healthier U.K. population. The story is bigger than Superdrug providing Botox treatments or the myriad vaccinations available at Boots, including cholera, hepatitis A, hepatitis B, Japanese encephalitis, meningitis, rabies, tick-borne encephalitis, typhoid and yellow fever. The top U.K. drug chains can ensure that you can travel safely anywhere and look your best at the same time. On a more serious note, 12,500 high-risk asthma sufferers were identified at U.K. pharmacies last year. The “third leg” of health care in the U.K. includes three basic classifications: drugs that can only be prescribed by a doctor,

drugs that can only come from a pharmacist and drugs that are widely available to the public — OTC products. The number of prescriptions that come from pharmacists are impressive, with more than 1 million prescriptions written each year for the last two years. The “P” law is quite well defined: “Pharmacy medicines may not be sold, offered or exposed for sale by retail, or supplied in circumstances corresponding to retail sale in the course of a business carried on by any person, unless that person is, in respect of that business, a person lawfully conducting a retail pharmacy business, the product is sold, offered or exposed for sale, or supplied on premises that are



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a registered pharmacy … ” It’s far more expansive/inclusive than the saying “What happens in Vegas stays in Vegas.” A U.K. pharmacy can be qualified as one of three general types in terms of the services it provides. The baseline or essential services are not surprising: dispensing, repeat dispensing, signposting, self-care, clinical governance, public health and medication waste disposal all make the initial cut. The next level, enhanced pharmacy services, include more active participation in a consumer’s wellness, including sexual health, care homes, intermediate care, domiciliary assessments, smoking cessation, needle exchange, supervised consumption, diabetes screening, weight management, healthy diet, health checks, alcohol interventions, palliative care, full clinical medication review, out of hours, shingles, and pneumococcal and meningitis. The highest level, unsurprisingly, is called advanced. This level has several components, the most complex and comprehensive of which include medicine use reviews and new medicine services. The U.K. model centers on medicine use reviews and new medicine services. Both have broad usage, include fee caps and focus on specific conditions and/or patients.



The medicine use reviews involve reviewing patients’ use of medication, ensuring they understand how their medicines should be used, making sure they understand why they have been prescribed, and identifying and addressing any problems. New medicine services are meant to support patients with newly prescribed medication for longterm conditions. The U.K.’s experience with medicine use reviews is instructional on several levels. First, the scale is impressive. In the last year, about 3.4 million medicine use reviews were completed by more than 11,000 pharmacies. Second, there is a fee of 28 pounds — roughly $36. Third, there is a cap of 400 on how many MURs any pharmacy can handle. Fourth, there is a high degree of focus as 70% of medicine use reviews must address specific target groups and high-risk medicines: anticoagulants, antiplatelets, NSAIDs and diuretics. A focus on unintended side effects also exists with cardiovascular patients on four or more medicines, and those with respiratory conditions who are on two or more medicines. The U.K.’s experience with new medicine services also is instructional. The scale is broad: almost 1 million new medicine

services were carried out by over 10,000 pharmacies in the last year. As with medicine use reviews, a fee cap ranging from between 20 and 28 pounds exists. New medicine services also have a fairly narrow scope — pharmacist support for patients starting new therapies for asthma/ COPD, Type 2 diabetes, antiplatelet/ anticoagulant therapy and hypertension. In 2016, the U.K. rolled out Healthy Living Pharmacies, an organizational development framework underpinned by three enablers: workforce development, dedicated consultation areas and community engagement. The engagement area has thus far been the most ambitious with measured progress. Healthy Living Pharmacies provide a framework for commissioning public health services through three levels of increasing complexity, with pharmacies aspiring to get to the next level. Level 1 pharmacies promote health, well-being and self-care, and more than 8,300 pharmacies (over 70%) have progressed through the profession-led self-assessment process and registered with the Royal Society for Public Health to attain Level 1 status. It then proceeds to Level 2: prevention, in which pharmacies provide such services as medicine use reviews and new medicine services. Level 3: protection, with pharmacies in this group providing treatment. The U.K. also has created two basic routes for allowing pharmacist prescribing — independent and supplementary. The more advanced level is the independent prescriber who is responsible for the assessment of patients with undiagnosed or diagnosed conditions, who makes decisions about the clinical management required, and who ultimately draws up a treatment plan. The independent prescriber also has the authority to prescribe the medicines required as part of the treatment plan. An independent prescriber may prescribe autonomously for any condition within his or her clinical competence. Supplementary prescribers are authorized to prescribe for patients whose condition had been diagnosed or assessed by an independent prescriber, within the parameters of an agreed treatment plan. Supplementary

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PHARMACY | U.K. PHARMACY PRESCRIBING prescribers can prescribe any medicine, including controlled drugs, within the parameters of an agreed treatment plan. By 2016, almost 4,000 pharmacist prescribers — roughly 8% of the total number of U.K. pharmacists — were active. About 2,500 were independent prescribers, more than 400 were supplementary prescribers and almost 100 were both. Almost three-quarters of qualified prescribers said they had prescribed at some point since qualifying, and over 60% had prescribed in the past 12 months. So, who can apply to be a prescriber? There are the obvious requirements: current pharmacist registration with at least two years of U.K.-based post-registration experience. It’s the next level of requirements that are more challenging: support from the sponsoring organization with proven identified service need for this role extension and a named recognized medical practitioner who has agreed to supervise, support and assess the student during his or her clinical placement. Applicants must show basic clinical competence in the area they wish to prescribe, and, more importantly, have a training framework agreed upon with a doctor or dentist. The system has built-in checks and balances. An accredited training course will typically cost between 2,000 pounds and 3,000 pounds ($2,600 and $3,900), usually run for six months and be delivered part-time through a combination of face-to-face and self-directed studies. After the course work, a pharmacist must complete at least 12 days of learning in a practice environment with designated medical practitioner mentoring. The designated medical practitioner, who directs and supervises the pharmacist during mentoring, also is responsible for assessing whether the materials have been learned and if the pharmacist has acquired certain competencies. So, how do U.K. pharmacists decide which areas of prescribing they will pursue? Interestingly, the onus is on the pharmacist to be already clinically competent in the areas of interest, including up-todate clinical, pharmacological and pharmaceutical knowledge. The course does not teach clinical competence, but rather allows



pharmacists to demonstrate it. Ultimately, a pharmacist is restricted to prescribing in areas of clinical competency. The choices for the pharmacist are broad: working as a GP practice pharmacist; providing travel/ flu vaccinations; focusing on such men’s health issues as erectile dysfunction, premature ejaculation and hair loss; managing such minor ailments as UTIs, sore throats or ear infections; or managing such longterm conditions as asthma, COPD, diabetes, hypertension or anticoagulation services, while linking with a local GP practice. The U.K. system also goes one step further in identifying general areas of treatment, bypassing the traditional prescription from a medical practitioner or a pharmacist. A Patient Group Direction is a written instruction for the sale, supply and/or administration of medicines to groups of patients who may not be individually identified before presentation for treatment. They allow specified healthcare professionals to supply and/or administer a medicine directly to a patient with an identified clinical condition. There is no need to wait for a prescription or an instruction from a prescriber for such conditions as chlamydia, smoking cessation, asthma and erectile dysfunction, as long as the healthcare

professional working within the patient group direction assumes responsibility for assessing that patients fit necessary criteria. As with any new paradigm, there are challenges. Among the most significant are a general lack of awareness about what pharmacist prescribers can do, funding for pharmacist prescribers, a lack of financial incentive in taking on an enhanced role with the price caps, pharmacists not always confident in diagnosing as opportunities to develop physical assessment skills are limited, and finally, some competition between different prescriber roles, especially pharmacist and nurse prescribers. The United States is dipping its toe in the waters of pharmacy prescribing in such rural states as Idaho, and even California and Washington, but it is not a national structure. Filling gaps in care through pharmacist prescribing would strengthen community pharmacy’s value proposition within the healthcare system. The U.K. has learned a lot about pharmacist prescribing, some through trial and error, some through not. The vast majority of these efforts work and work well. At some point, the United States will determine if the grass is indeed greener on the other side of the Atlantic. dsn


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Amplicare Expands Tech Offerings Pharmacy technology company Amplicare is expanding its offerings with the addition of two new benefits to its suite of solutions. Amplicare’s platform now includes a capability that identifies pharmacy patients at high risk of experiencing an opioid overdose in their household. The platform provides tools to help pharmacists educate patients about Naloxone and its availability over the counter without a prescription. Amplicare concurrently rolled out a similar capability to help pharmacists increase the rate of vaccinations, coinciding with the current flu season. These updates provide pharmacists the opportunity to act on health interventions within their workflows, easily monitor progress, and manage the life cycle of these interventions, the company said. “Community pharmacies are uniquely positioned in our healthcare system as the most accessible healthcare providers for patients, and they stand at the front lines of the fight against health crises,” Amplicare CEO Matt Johnson said. “As the role of pharmacists moves beyond dispensing prescriptions, our focus is to help them tap into the growing number of opportunities that exist in the clinical and business side of health care.”

Ruling Brings Suboxone Sublingual Film Generics to Market A recent ruling by the United States Court of Appeals for the Federal Circuit regarding Indivior’s patents for its Suboxone sublingual film (buprenorphine and naloxone) is opening the doors for manufacturers making a generic of the treatment for opioid addiction. The court concluded that Indivior had not shown that it is likely to succeed on its claim that Dr. Reddy’s generic, which was introduced last year before an injunction blocked its sale, infringes on its patent for the product. As a result, Dr. Reddy’s relaunched its generic Suboxone sublingual film in four dosage strengths. Also hitting the market is Indivior’s authorized generic of its own product. “We expect this launch will create the opportunity to maximize



the value of our Suboxone film franchise,” said CEO Shaun Thaxter. In addition, Mylan launched two dosage strengths of the generic drug and Alvogen launched four dosage strengths. The rush from generics makers to get their products to market is not without reason — IQVIA data estimates the market size of the product at $1.87 billion for the year ended Dec. 31, 2018.

PerceptiMed’s WillCall Tech Deployed at Nebraska Pharmacy PerceptiMed’s ScripClip pick-to-light

will-call bin system has been deployed at Nebraska Medicine’s flagship outpatient pharmacy, which has just completed a major expansion and remodeling that supports the new technology. PerceptiMed’s proprietary software interfaces with the pharmacy’s dispensing system to know which bag holds each patient’s prescriptions. Then, via radio waves, it activates an LED light on the correct bag for each patient, causing the bag handle to light up so the cashier can see and retrieve the bag quickly. Barcode scanning at the cash register ensures the right bag is given to the right patient, according to PerceptiMed. Nebraska Medicine’s director of community-based pharmacy services Vince Jorn said, “Because the new willcall bin looks so impressive, the pharmacy chose to use the will-call bin rack and hanging bags to separate the dispensing area from the patient pickup area. This eliminates the need for pharmacy personnel to hand-transfer filled prescriptions from behind a solid shelving area to the patient pickup area, saving a few seconds on every transaction. “We are honored to be part of Nebraska Medicine’s expansion,” said Bob Curry, PerceptiMed’s CEO. “It is especially rewarding to be a technology partner with Nebraska Medicine’s newly remodeled outpatient pharmacy.”

Sanofi, Regeneron Lower Praluent Prices Regeneron Pharmaceuticals and Sanofi announced that Praluent would be available at

a new reduced price of $5,850 annually. This is a 60% reduction from the original price for both the 75-mg and 150-mg doses. Praluent is a PCSK9 inhibitor, a class of injectable drugs approved in 2015. It is approved for use as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults, with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease, who require additional lowering of LDL-C. The new lower-priced Praluent is expected to result in lower patient out-ofpocket costs. This follows an earlier announcement in March 2018, when Regeneron and Sanofi committed to lower the a U.S. net price for payers in return for helping to reduce burdensome access barriers for appropriate patients. With the new lower-priced Praluent, most Medicare Part D patients are expected to pay $25 to $150 per month, a potential savings of up to $345, depending on their insurance plan. Eligible commercial patients will continue to have access to co-pay assistance through MyPraluent. The company said that, for illustrative purposes, this calculation of monthly savings, e.g., two Praluent doses, assumes a scenario where Praluent is on a specialty tier with 33% coinsurance, and Praluent then moves to preferred brand tier co-pay of $25. The new, lower-priced Praluent is expected to be available for pharmacies to order in early March, and the doses with the original list price will remain on the market at least through 2019. Sanofi and Regeneron aren’t the only PCSK9 inhibitor makers looking to make their drug more affordable. Amgen announced in January that all Repatha device options are available at a 60% reduced list price of $5,850 per year.

FDA OKs Mylan’s Wixela Inhub, the First Generic Advair Diskus The Food and Drug Administration gave Mylan the green light for Wixela Inhub, its generic Advair Diskus (fluticasone propionate and salmeterol inhalation powder), marking the first approved generic of the GlaxoSmithKline inhaler. It is indicated for the twice-daily treatment of asthma in patients age four years old and older, maintenance treatment of airflow obstruction, and reducing exacerbations in patients with COPD. Mylan’s generic inhaler will be available in three strengths: fluticasone propionate 100 mcg/salmeterol 50 mcg, fluticasone propionate 250 mcg/salmeterol 50 mcg and fluticasone propionate 500 mcg/salmeterol 50 mcg. The dosage strengths are priced at $93.71, $116.44 and $153.14, respectively. In the United States, more than 26 million people — 7 million of whom are children — are known to have asthma. COPD is a progressive lung disease that makes it hard to breathe and may become worse over time. It can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. “Mylan remains steadfast in its

efforts to expand patient access to medicines, and the FDA approval of Wixela Inhub reinforces our commitment to provide patients greater choice and lower-cost alternatives,” Mylan CEO Heather Bresch said. “This milestone represents the culmination of an extensive research and development program, and Mylan’s more than $700 million of investment.” “We are committed to advancing new guidance for sponsors to make the development of generic versions of complex products more efficient, and we’re prioritizing review of many applications covering proposed generic complex products for which a generic has not yet been approved,” said Anna Abram, FDA deputy commissioner of policy, planning, legislation and analysis.

FDA Approves Lupin’s Generic Adcirca Lupin has received the Food and Drug

Administration’s blessing for its generic Adcirca (tadalafil) tablets in 20-mg dosage strength. The product, the generic of Eli Lilly’s branded product, is indicated for the treatment of pulmonary arterial hypertension to improve exercise ability. The product had a market value of roughly $474.3 million, according to December 2018 IQVIA data.



Weathering a Pending Storm Five ways beauty brands and retailers can survive a possible industry downturn By Seth Mendelson


ecession? What recession? That is the tone being taken by a number of cosmetics officials in the face of fears that an economic slowdown is on the verge of overtaking the category and threatening to halt its long track record of growing sales and profits. Talk of the slowdown comes from TABS Analytics, a tech-enabled analytics firm that delved into the beauty purchasing habits of 1,000 women between the ages of 18-to-75 years old for its fifth annual Color Cosmetics Study. The results: Sales are slowing in the $86 billion category, though it appears that some will weather the storm better than others. “[It is] a state that retailers and product manufacturers can expect to last for several years,” said Kurt Jetta, president and founder of TABS Analytics. TABS developed a road map of future trends based on consumer response about what they buy, where they buy and purchasing plans in the eye, nail, face and gift set categories. The company’s survey drilled down into three classifications of users — heavy, medium and light — based on number of items purchased in beauty segments. The red flag in this year’s research comes from the “heavy” users becoming less engaged in the category. “While the overall health of the cosmetics industry may not be as bad as the research suggests, this sector is clearly in decline and will soon be in



CVS Pharmacy signage indicates whether or not beauty marketing materials have been digitally altered.




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FIVE STRATEGY TRENDS recession,” Jetta said. The only exception in a downturn comes from non-Hispanic black consumers, according to the study. He also said that those polled are spending less time shopping beauty. What triggers interest, however, is natural products. In the middle of the worrisome news, Jetta pointed out that shopping experiences at Sephora and Ulta Beauty were slowing. Yet, he said, the only brick-andmortar growth spots were CVS Pharmacy and Walgreens — perhaps promising news for the struggling mass market. So, does that suggest that even as beauty regresses, mass chains can maintain a healthy business? Several of the nation’s mass market experts and retailers think so and are rushing to react to consumer demand for natural, niche and notable beauty brands. Here are five tips industry executives offer for weathering the pending downturn.

Exclusive, Limited Distribution and Private Beauty Brands

CVS Pharmacy is rolling out 60 brands as it strives to keep momentum going fueled by an array of efforts to grow beauty, including a new store format called BeautyIRL and its Beauty Mark campaign to eliminate the use of digitally retouched images in beauty and identify when images have been altered. Many of the new lines, such as Bliss and Urban Skin Rx, are not found in other mass doors. Bliss already is off to a blistering start, according to Maly Bernstein, vice president of beauty and personal care at CVS Pharmacy. The brand has undergone a refresh and is going into 3,000 CVS Pharmacy doors. Also new at the retailer are other “masstige” offers, including Hello Kitty Skin Care, Sun Bum and Essence — the latter of which is a top performer in Germany. Rite Aid recently added a line called Cake Beauty, an in-store exclusive that is allnatural hair and body products. The chain also made a foray into K-beauty with a line called Kokie Cosmetics. Getting brands not typically sold at mass is not limited to the big chains. Bartell Drugs, for example, under David Bradley, formerly of Walgreens Boots Alliance, has built out an entire upscale area stocked with



Rite Aid in-store exclusive brand Cake Beauty is an all-natural hair and body line.

Alchimie Forever, Hey Honey and Institut Arnaud. Bartell also has introduced a CBD products, including from CV Science. To build loyalty, retailers are tapping lines only found in their doors. CVS Pharmacy has several exclusive lines, including MUA and the newly added, Korean-inspired collection called JOAH. Bernstein said JOAH performed well during the holiday season. JOAH also is one of the brands at CVS Pharmacy bearing the Beauty Mark, signifying that images have not been altered. Target expanded its private-label nail collection, Defy & Inspire, into an endcap called Match Makers that is coordinated lips and tips made just for the retail giant. Not to be left out, Walmart teed up with several brands for exclusives. Neutrogena cocreated a new line called N by Neutrogena, which features new makeup and skin care products exclusively available at Walmart. Also, Walmart and e.l.f. Cosmetics joined forces to create elf+, a new collaboration that hit shelves in early January.

Partner Up

Both CVS Pharmacy and Walgreens have hammered out unique investments to lure consumers, especially younger shoppers, into their doors. CVS Pharmacy invested in Glam Squad to offer in-store services, and Walgreens did the same with Birchbox to bring in prestige logos. Recently, both chains also piloted dental-related services. With wellness taking center stage, experts expect more bundling of services. Kohl’s is a prime example of a retailer looking for ways to drive customer count that could have a rub-off on beauty. The retailer is accepting Amazon returns in about 100 stores, and most recently announced that it was teaming up with WW, previously known as Weight Watchers, to make a foray into wellness offerings. In addition to selling the company’s The Healthy Kitchen kitchenware, cookware and tools, Kohl’s will pilot a WW studio in a Chicago store later this year that will host workshops for WW members. In 500 of its 1,158 stores, Kohl’s is reducing

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FIVE STRATEGY TRENDS its square footage in order to rent space to other businesses, including grocer Aldi. Down the road, according to industry consultant Allan Mottus, there could be opportunities for in-store Botox injections and other fillers. Superdrug already is experimenting with the practice in London, which could serve as a template. Collaborations are not limited to retailers. Maybelline’s latest partnership goes beyond the celebrity-endorsed deal. Instead, Maybelline teamed up with sneaker brand Puma for an exclusive with Ulta Beauty.

Limit M&A Activity

Manufacturers, retailers and investors need to think twice about making short-tem big bets in the cosmetics sector, according to TABS. “You should limit beauty investments unless getting a great deal,” Jetta said. The study suggests brands reduce mergers and acquisitions for now and rationalize color and line extensions. “Right now, it is about blocking and tackling,” Jetta said. While M&A activity has subsided somewhat in the mass beauty world, the most recent examples show such well-thought-out deals as Combe’s purchase of Sustain Natural, a company that complements its portfolio. Also, Procter & Gamble’s buy of Walker & Co. helps deepen the behemoth’s reach with multicultural consumers. Walker & Co. has two brands — Bevel, a men’s shaving brand tailored for men with coarse hair, and Form, a women’s hair care business centered on coily hair.

Have a Purpose

Purpose-driven brands and retailers have an edge in this market, according to CVS Pharmacy’s Bernstein, who said purpose-led companies have higher stock performance. The intent of many moves at CVS Pharmacy — including its exit from tobacco sales, its removal of potentially dangerous chemicals from personal care items and its Beauty Mark initiative — all are designed to help customers live better lives, she said. Many mass brands also have altruistic sides. Pacifica, for example, which is sold at Target, Ulta Beauty and Whole Foods, launched an upcycling program on its website in collaboration with Preserve.



The beauty industry, according to Pacifica’s founder Brook Harvey-Taylor, is a major producer of excess packaging that yields mounds of waste. “You can see it in big plastic palettes. There’s so much garbage for the number of products you are putting into those pieces,” she said. The efforts are getting noticed by retailers. “Sustainability always seems to be a high priority for our customers, and we know that it is important in their buying decisions,” said Mary Catherine Horgan, beauty buyer at Pharmaca. “We prioritize sustainability and don’t love to see extra packaging, even if the intention is to reduce theft on smaller items.” Most recently, Unilever unveiled reusable packaging innovations across nine of its brands. Products bearing the new packaging will be tested on Loop, a wastefree global shopping system. The brands include Ren Clean Skincare, Love Beauty and Planet, Love Home and Planet, Seventh Generation, Dove, Rexona (known as Sure in the United Kingdom and Degree in the United States), Axe and Hellmann’s. According to Lauren Goodsitt, global beauty analyst with the Mintel Group, zero waste will be pushed to the forefront this year. “This is a movement and something you must be thinking of now in terms of every aspect of product concept,” she said. “If you are not, it will be difficult to exist in the future. There is a shift in lifestyles and people are looking to live a sustainable life.” She said that changing habits is tricky, but companies are investing in education, among them Garnier, which rolled out a campaign to teach consumers about how to recycle personal care products.

Inclusivity and Natural

If there are two areas to zero in on, retailers and brand executives said they are expanding natural offerings and broadening their product assortments to be more inclusive. Natural may be the new normal, but according to Karen Wolfe, vice president of client consulting at Nielsen, labeling a product natural is not enough for today’s discerning customers. “They are more informed, and they are reading about the ingredients in products.”

Retailers and brand executives said they are expanding natural offerings and broadening their product assortments to be more inclusive. Wolfe noted that consumers now know the difference between real and artificial lavender, and as a result, artificial lavender products show declining sales while natural offerings show a 13% sales. The cautionary words: if you are touting vegan or sustainable ingredients, you better be able to support it. Target is getting attention for its efforts to provide truly natural options. The most recent move is adding chic New York-based nail salon Tenoverten’s line of nontoxic nail care to about 800 stores. Tenoverten’s products are free of eight caustic ingredients, vegan and cruelty-free. The brand is just the latest in a string of better for your lines debuting at Target. The chain also just added beauty supplements from Pacifica. The other buzzy category that can help mass marketers court shoppers away from specialty is inclusive ranges. Fenty woke the industry up with its foundation shades for all skin tones. Mass has jumped onboard with retailers adding extending shade ranges from leading brands such as Maybelline. Cosmetics companies now debut foundations with at least 40 shades. If they don’t, they face shaming from influencers who can make or break launches. The trend is moving beyond cosmetics. Urban Skin Rx, a professionally-inspired line created for darker skin tones, debuted in Target last year and is rolling out to 1,750 CVS Pharmacy and 460 Ulta Beauty stores. As quickly as the industry is moving, these are efforts that executives are betting can help them thrive. Though Jetta acknowledged the study’s conclusions are troubling, he said beauty can emerge even stronger on the other side. “Solid revenue management practices become more important in a recessionary environment,” Jetta said. dsn

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Into the Fold Greeting card companies innovate around multicultural and younger consumers By David Salazar


hat doesn’t kill you makes you stronger” might as well be the mantra of the greeting card industry. Despite long-held concerns that the e-card or Facebook wall post would wipe out the nearly $8 billion industry, it continues to hold strong. With the category headed into the No. 3 and No. 5 biggest card-giving holidays — Mother’s Day and Easter, respectively — it still occupies an important place in people’s lives despite the growth of social media. In fact, as Carlos Llanso, CEO of Clinton, Mass.-based Legacy Publishing Group and acting president of the industry’s trade group, the Greeting Card Association, tells it, the Internet has even helped build up the category’s appeal among consumers. “Social media and online components help us strengthen and maintain relationships that then lead to a card-sending event or opportunity,” Llanso said. “Because there’s less letter writing and physical communication, it makes getting a greeting card even more profound.” Which is to say that, between holidays and such year-round festivities as birthdays — which maintain the pole position as the top reason people give cards — there is no shortage of opportunities for greeting card manufacturers to reach a consumer. What has changed, though, is the type of consumers the greeting card companies are targeting, what those consumers are looking for and how these manufacturers create value. Besides helping build relationships, many greeting card company officials chalk the category’s staying power up to continued innovation, increased multicultural and multigenerational offerings, creating products that convey value, and leveraging social media and e-commerce to build sales.



Multicultural/Multigenerational Focus

Though greeting cards have not gone the way of video rentals, neither is the category immune to the macro trends that have roiled every other category, in particular the need to expand the scope of products to further include multicultural, LGBT and other communities. “There are still greeting card companies that almost exclusively cater to a particular community or demographic, but it’s also now normal for bigger companies or those that haven’t traditionally focused on certain demographics just have that as part of their offerings,” Llanso said, noting that one of the top selling cards in Legacy’s Seedlings line, which features envelopes made of seed paper that can be planted and composted, is a same-sex wedding card, something that he said likely wouldn’t have played 10 years ago. As in such categories as cosmetics and skin care, where reaching consumers often considered niche despite having substantial buying power are increasingly in focus,

card makers are zeroing in on such consumers by creating products tailored to them. For example, Kansas City, Mo.-based Hallmark earlier this year launched Eight Bamboo and Golden Thread, two lines aimed at Asian consumers and holidays that are specific to Chinese and Indian culture. “Honoring each distinct heritage and blending it with inspirations of modern culture, Eight Bamboo and Golden Thread will help Chinese and Indian consumers meaningfully connect with their loved ones during key holidays, such as Lunar New Year and Diwali, and culturally significant moments, such as a baby’s 100th day and first birthday,” said Amy McAnarney, Hallmark’s vice president and general manager of key accounts and development. McAnarney said that in the coming months, Hallmark is set to roll out new lines aimed at black and Latino consumers. Uplifted, within its Mahogany card line, will feature new designs and uplifting editorial meant to speak to black shoppers. Within its Hallmark Vida line, it will launch











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GENERAL MERCHANDISE | GREETING CARDS Love Ya Mucho, which features a mix of English and Spanish editorial, focused on bilingual shoppers. As card makers focus on offering products for culturally significant occasions, they also are looking to innovate around shifting age demographics. Legacy’s Llanso said that generally, people are getting married and having children later, which requires editorial tailored to them. Younger consumers are buying more cards as well, which he said requires relatable products. “As we see the millennial generation buying more cards — they’ve actually been leading the way in greeting card purchases the last few years — the editorial is geared toward that younger generation looking for authenticity and cards that speak the way they speak,” he said. American Greetings, based in Cleveland, has built out its offerings, targeting younger card buyers. From birthday cards to alloccasion options, peppered in among more traditional heartfelt offerings are cards that prominently feature creative typography and such millennial-specific mottos as “Treat Yo Self!” and “Cray-Cray.” Edison, N.J.-based Designer Greetings also is delivering on relatability. Dawn Garvey, Designer Greetings’ CFO, said the company is introducing A Little Salty, a humor line. “This collection features edgy, topical, political and trendy humor, some of which is hilariously mean,” she said. “Some cards include social media references that will amuse people of all ages. Each card comes with a matching signature envelope that adds a playful finishing touch.”

Worth the Money

Llanso said that when the recession hit in 2008, Legacy, which also sells stationery and gift products, noted a decline in sales among every category except greeting cards. This, he said, highlights the fact that consumers — then and now — see the value in cards. “You may not be able to afford to buy someone a gift, but you can get them a card, and if that card is going to cost a little bit more, but I see the value in it, I’m OK paying $4.99 for a card,” he said. The key is providing value for a consumer’s buck



— something he noted manufacturers have been taking to heart. “A few of the trends taking shape in the industry are cards with interactive elements, such as the use of 3-D imagery and other interesting technical features. In addition, high end designer cards that provide a personalized sentiment are in demand,” Designer Greetings’ Garvey said. She also said that the company is introducing a lasercut card line to appeal to these trends, and building on the success of its 3-D lenticular line that was introduced in 2018, refreshing its existing everyday line with designs for various occasions. Hallmark’s McAnarney highlighted the success of the brand’s Paper Wonder line, which features folds, pop-outs and artistic detail that reveals an intricate scene, and said that it would be brought to bear on Mother’s Day and promoted with a national marketing campaign. Value also can be created through highlighting a brand’s purpose — Legacy buys a meal for a child for every card purchase, and the company’s Seedling line appeals to eco-conscious consumers, Llanso said. It also helps appeal to younger shoppers. “They’re looking for product that’s responsibly sourced, that what they’re buying is good for the environment and any other cause-related marketing,” he said. “They want to make sure the companies they’re spending their money on stand for something and believe what they believe.

That’s an important part that GCA members are aware of and try to do something about.”

Not Only Analog

Just because they make a physical product doesn’t mean greeting card companies are averse to taking an omnichannel approach. One method is to use it as a driver of foot traffic. “Social media is a great way to highlight product being sold in stores,” Garvey said. “Designer Greetings finds that Instagram is the most beneficial platform to show off the many different designs and embellishments our cards offer.” While one way to meet consumers where they are online is social media, it also can include burgeoning shopping habits. With the Food Marketing Institute and Nielsen projecting U.S. online grocery spending will grow to 20% by 2025, Hallmark sees partnering with retailers offering click-andcollect or delivery options as a prime opportunity. The company last April kicked off an e-commerce offering, and McAnarney said it is continuing to build the service out. “Just as we do with our best-in-class localization within rooftops, Hallmark works with the retailer to curate the assortment for their specific shopper’s online shopping needs,” she said, adding that Hallmark works with retailers to offer flexible fulfillment options, and that “adding a greeting card to a purchase doesn’t add much weight to the overall basket, but it does add significant sales.” dsn

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Melding Automation with the Human Touch The robot era requires new in-store approaches By David Orgel

R David Orgel is an awardwinning business journalist, industry expert and speaker. He is currently the principal of David Orgel Consulting, delivering strategic content and counsel to the food, retail and CPG industries.


obots have long captured the imagination of science fiction enthusiasts. They even have played high-profile roles in movies, from Gort in “The Day the Earth Stood Still” to Hal 9000 in “2001: A Space Odyssey.” In the real world, robots are playing increasingly important roles in businesses including retail. For example, they are crucial to some warehouse efficiency functions for physical and online retailers. Now, however, bots are starting to advance from behind the scenes to the front of the store. Giant Food Stores, a Carlisle, Pa., unit of Ahold Delhaize, just moved from piloting to starting the full-scale deployment of its in-store robot, the 6-foot-3-inch “Marty.” This bot will be rolled out across the 172 Giant and Martin’s Food Markets stores. Other retailers that have put robots in customer-facing areas include Walmart, Target and Schnuck Markets. All this leads to a host of new questions. What are the benefits of this in-store automation? Will they be realized? How will customers react? What will be the impact on associates? This topic was spotlighted at the NRF Big Show in January at a session aptly-named, “Why is there a Robot in My Store?” Giant president Nicholas Bertram and his fellow panelists showcased new in-store robot developments. There’s no question that the potential benefits of customer-facing robots are significant. Giant’s early focus is on leveraging bots to help avoid such safety hazards as spills that can cause slips. The robot can put out alerts for quick corrective actions. Other likely near-term uses for retailers are supporting shelf auditing, demand forecasting and planograms, and battling out-of-stocks and food waste. A range of technologies are likely to play a role in these efforts, including artificial intelligence. The robot strategy lends itself to helping retail executive teams gain more visibility into store locations to improve operations. The panel pointed to the “elephant in the room,” which is the impact on retail workforces.


Does it replace people? On the contrary, Bertram said, “Every retailer is focusing on servicing the customer, so freeing up associates for high-touch service is good. Customers want experts in stores.” My feeling is that in-store robots can be a winning strategy, as long as retailers get the automation-human balance right. This requires rethinking in-store approaches. Customers likely would be pleased if knowledgeable humans were more available for service. This would support the growing experiential goal of physical retail today. Yet, it requires investments, including for associate training and ensuring employees are willing to engage with shoppers.

The robot strategy lends itself to helping retail executive teams gain more visibility into store locations to improve operations. If science fiction has merged with reality, how are customers adapting to robots in the aisles? Pretty well, based on early evidence. Giant even found that some customers are posting selfies with Marty on social media. This isn’t completely surprising, given that consumers increasingly are accustomed to living with technology in their homes. Retailers understand the benefits of giving somewhat human looks to the bots. Giant worked with its technology partners to make sure Marty has appeal. The robot is billed as the “one with the googly eyes.” Of course, it’s possible to imagine thorny scenarios in the future, such as for a retailer that uses the store as a fulfillment center. One industry executive recently said to me, “What happens when a customer and a robot are both fighting it out for the last item on the shelf in a certain category?” If that does happen, hopefully both human and robot will realize the humor and irony in that situation, and maybe even bond a little. dsn








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