Episode 02 | Brand Differentiation in the Consumer Healthcare Landscape: Standing Out in a Crowded Market

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UK Managing Director at Ceuta Group, , an IQVIA business, Annette D’Abreo, is joined by Ceuta Group’s Head of Healthcare Brand Strategy, David Gray, and Healthcare Marketing Director at Ceuta Group, an IQVIA business,  Jon Connolly, to discuss how brands can adapt their strategies to stand out in the increasingly competitive Health & Wellness market.

As the UK, and most countries around the world, place more focus on Health & Wellness and specifically, self-care, there is a huge opportunity for brands to capitalise on consumers’ growing awareness and desire to optimise their health. The question is how…

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“It’s about more focus, and putting the right kind of investment behind the right kind of messaging in the right context.”

Jon Connolly


Annette D’Abreo  00:12

Hi, I’m Annette D’Abreo, UK Managing Director at Ceuta Group and this is the original Ceuta Group Podcast.

Today I’m joined by Ceuta Group’s, Head of Healthcare Brand Strategy, David Gray, and Marketing Director at Ceuta Healthcare, Jon Connolly. We’ll be talking about the key changes the consumer healthcare market has gone through in the past five years and how brands can adapt their strategies to stand out in this increasingly competitive landscape.

So, it’s great to have you both here. Lots to talk about today, but what do you think have been the major changes in healthcare that we’ve seen in the last five years?

David Gray  00:47

Well, I mean, COVID, has probably been the biggest single impact on consumer healthcare in the last few years. It’s changed the zeitgeist to a certain extent.

I think in terms of healthcare, it’s probably changed people’s attitudes to a degree in the way they look at their own health. Obviously, access to doctors and General Practitioners (GPs) has been increasingly difficult. And so I think the main change has been really a bit of a shift from looking solely at problem resolution, which is the typical health care category norm, towards slightly more preventative health. And if you look at the boom in, you know, Vitamin D3, the whole growth in Vitamin C, etc., those elements have really, really changed. We’ve seen that happen a lot.  

Annette D’Abreo 01:35

So that whole healthcare landscape, Jon, has really changed, I guess, because of these bigger things that have happened, I mean, COVID being absolutely critical. But how do you think it’s just affected healthcare and over-the-counter (OTC) healthcare in general? 

Jon Connolly  01:49

Well, I think some areas have changed, some will be more short-lived, and then there’ll be a lasting legacy in other areas as well. So David mentioned Vitamin D3, so the area of immunity was obviously very topical at one stage and that will wane as COVID increasingly becomes more of a past than a future. But there are other areas as well. So pharmacy took a real kind of boost during COVID with limited access to other sources of advice and sales. There’s evidence to show that people are increasingly heading into the pharmacy looking for advice and so on from a qualified healthcare professional, so it does feel as though that will be a lasting aspect of the COVID phenomenon.

Annette D’Abreo  02:29

Yeah, yeah. David, anything to add to that?

David Gray  02:31

Yeah. I mean, I’m personally delighted to see that pharmacy is coming to the fore. You know, if you look at Europe, if you look at France, and Spain and Italy, particularly pharmacy has always been the first port of call. I think unfortunately, in the UK, that wasn’t the case for a while. Pharmacists are very, very well-qualified professionals. They’re more than capable of actually diagnosing. I mean, I know they’re not allowed to, but they are more than capable of, in many cases, prescribing. So it’s good to see that the government is recognising that, and we’re starting to see the role of pharmacy and a bit more of a joined-up health care service. I think it’s the simplest way to have, and that’s great news, I think, for consumers, for retailers, and for anybody involved in selling and marketing in this category.

Annette D’Abreo  03:16

I think pharmacists’ standing has really risen dramatically since COVID. As you say, because they are fantastic healthcare professionals. They provide a great service, and more and more are becoming prescribing pharmacists as well. 

Jon Connolly  03:28

And just to say around a consumer perspective, you know, increasingly turbulent times, so whether it’s COVID, or whether it’s conflict or financial crises, there’s a lot more uncertainty and in the past, that’s when brands have come to the fore, because in this uncertain world when someone opens the medicine cabinet, they see the reassurance there of brands that are stable and bringing that much-desired bit of stability back to their lifestyles. There have been many cases where those kinds of traditional mainstay brands have performed quite well in those difficult times.

Annette D’Abreo  04:02

As the landscape changes, as consumers have different pressures, as even seasonality changes to a certain extent, you know, we sometimes have a stronger winter than other winters, where there’s more prevalence of cold and flu, etc, how do brand owners in all these changing times manage to stand out? 

David Gray  04:22

I mean, as Jon said, there have been changes, but the fundamentals of brand marketing haven’t changed at all. The three really important parts of brand marketing were around, you know, awareness. So you have to have heard of a brand, know a brand, it has to have fame, and that’s about the communication strategy, but it’s also about visibility at the point of sale, be that online or in bricks and mortar. So brand awareness is still very important. Attractiveness of the brand, so we talk about meaningful difference when we talk about attractiveness, which is fundamentally saying, is that brand relevant to the need of the consumer on the occasion? How distinctive is it from the competition? And importantly, in healthcare particularly, how credible is it? Can you believe that this is from a credible provider? 

Obviously, retailers provide a degree of security in the mind of the consumer. If a product is on the shelf in Boots, for example, generally speaking, the consumer says, yes, that must be okay, because Boots wouldn’t stock it if it wasn’t, so the credibility side is complicated in that it has a number of different aspects. It’s not just about claims and distribution. It’s a whole range of elements that build trust in the brand. And as John said, we saw it in food. It actually happened, you know. A lot of the legacy traditional brands saw sales increase during these times of uncertainty because it gives you a degree of confidence in elements. 

So, I think building out a strategy, particularly on the brand side of things and making sure your brand is distinctive, credible, and relevant, is really, really important. And that’s about understanding consumer changing needs, where they have indeed changed, or where they haven’t changed, where they’re still the same as they ever were. So it’s about making sure that you understand the consumer and don’t jump to conclusions about “Things have changed” because there might not be a permanent sense of change. So insights are very, very important lately.

Jon Connolly 06:12

So when we use the phrase “the consumer”, of course, the consumer is anything but uniform, so, as David says, it’s kind of the age-old disciplines of robust marketing and understanding the niches within that audience. Very seldom is a brand successful because it appeals to everybody all of the time. So if you can find a sizable niche, even if you’re a brand in a category that’s being redefined by innovation, there will still be many people who appreciate the traditional values and a brand that they recognise from their grandparents’ or even their parents’ medicine cabinets, and so on. 

And so it’s, as a brand owner, recognising what your strengths are and then staying loyal to them. So, how can I compete? Yes, somebody is coming along and creating a lot of noise and speaking about the category in different ways, but that doesn’t necessarily make you redundant — that can make you stronger because there’ll be a sizable proportion of people out there who are very much attuned to where you have always been. It’s having the antenna that enables you to figure that out. And so when it comes to change, I mean, we could all make many mistakes by jumping on every single change. It’s only with the benefit of hindsight that you know that that’s a trend versus a fad. If you back too many fads, it becomes a very expensive exercise.

Annette D’Abreo 07:31

But if we go back to COVID and we see how so many people went online, we saw online sales dramatically grow and we also see that it’s clearly social media. And so the way that the brands are communicating has changed a lot, hasn’t it, in the last couple of years, even? 

David Gray 07:48

Yeah, I think, you know, in the healthcare space, I mean, there are various phrases that can be coined, “webucation” is one of the ones that gets bandied around, where people have increasingly (pre-COVID – it’s been going on for a while), the first thing you do now is go to Dr Google. And if you speak to healthcare professionals, they get quite frustrated sometimes, GPs particularly, because people come in and they’ve self-diagnosed before they even go and see the healthcare professional. 

But I think what that has done very definitely is it’s raised understanding of conditions. The challenge, of course, is where are the credible sources of information? Because as we all know, you can go online and find information about absolutely anything, so I think one of the really interesting dynamics is brand trust and loyalty and authority are really, really important. And again, it comes back to that you have to establish what you actually stand for and your relevance to the consumer. 

But you’re absolutely right, the communication channels are manyfold. And I think that’s also started in certain areas. I’ve seen some really interesting changes. I mean, we’ve just completed some work across Europe for a client, and traditionally, Italy, Spain, and France would have been pharmacy-first for purchase. With an older demographic, that’s absolutely the case. Younger consumers are a little bit more prepared to self-diagnose and to self-medicate, where possible. 

Annette D’Abreo  09:15

Yeah, and I think that’s a huge point, isn’t it, David, just about the different age profiles and how different age groups behave, how they get their information. Jon, I mean, you have it across some of the brands that you manage, where it’s a completely different type of conversation, isn’t it?

Jon Connolly  10:01

We’re talking about communication. Communication is a two-way thing. So there is, there’s probably never been more content put out there by brand owners. Now, how much of that is communication that needs to be listened to? And if it’s not being listened to because it’s in the right forum or it’s using the wrong set of words and so on, then there’s going to be sort of effectiveness issues with that. So yes, it goes back to those age-old things: know your audience and know what engages them, which media… At the end of the day, we’re here to influence. And yes, the claims, the appearance, and the storytelling are all part of that as well. But then there’s also the environment and the extent to which people can believe what they see and hear more readily.

Annette D’Abreo  10:16

If we look back five years, and where we are today, it’s changed out of all recognition. So it’s just a bit of crystal ball gazing, I guess? And what do you keep an eye on moving forward?

David Gray  10:26

I mean, insight is critical, and understanding the consumer has always been the basis of marketing, if you don’t understand your consumer and who’s buying your products, then you’re starting off on the wrong foot, so…

Annette D’Abreo  10:38

Sorry, David, just to interrupt. Before you even launch, I think one of the things that we’ve seen is that that work isn’t done before you get there. There’s a pressure to launch your brand without having found that out first.

David Gray  10:51

Yeah, I mean, I’ve been in marketing a long time. And I think one of the things that I’ve seen happen is there was a big shift towards measurable media, if you like, performance marketing because you can measure it, without that necessarily being exactly what people are consuming. 

So you have to start with a strategy. You have to start with a communication strategy. And then your various communication channels fit into your overall strategy, which is about the path to purchase, about consumer consumption, and media consumption habits, so consumer understanding is at the heart of it. I agree with you that there are many, many times when I think particularly new brands will go to market without really understanding the consumer. And, you know, let’s be honest, 95% of all new product launches fail. I mean, that is huge. So understanding your consumer, to John’s point, your proposition, so what is it about your brand and your proposition that appeals to that consumer, and then bringing that alive and activating that in a way that is compelling and engaging is really critical. 

I think we’re both violently agreeing with one another that the fundamentals of marketing have never changed. It’s still about awareness. It’s about attractiveness. It’s about availability. The mental physical availability split, which is talked about a great deal is correct because mental availability is the right product at the right price in the right place, with the right proposition. So if you’re a premium brand, you need to be associated with premium brands, if you’re a value brand, you need to be associated with value brands. So all of the marketing levers come together in a way to drive a single-minded proposition that people can understand.

Jon Connolly  12:33

Unfortunately, this is a complex world, right? And so a moment ago, we were talking about the consumer — there is no uniform consumer — and even within something as narrow as OTC, there are major differences between categories as well. So you really do need to understand in granular detail… It makes it more challenging, but then also much more rewarding, of course, when you then succeed, you know. 

There are categories in which typically, the consumer has perhaps got their fingers in their ears to an extent. And then there are others. Well, let’s say if you’re doing core research groups and so on, they might be fighting each other out of the way to make their views known because they’re so passionate about their experiences and frustrations in some cases. And I say the challenge for the marketer as well is that penetrating one is rather more difficult than the other because in one case, say, they’ve got their fingers in the ears. And on the other side of things, they are receptive to anything new coming along, because they’re already convinced that something better should be out there and they’re just waiting to hear what that might be. 

Annette D’Abreo  13:30

And I think just again, just with a view to the future, clearly, the industry is promoting self-care, and people are now used to maybe because they’ve got waiting times with their GP, they’re now used to going to see the pharmacist or looking online for advice. That has moved the way people treat themselves as well, I think, and more and more products are switching. There’s a drive to work with the Medicines and Healthcare products Regulatory Agency (MHRA) and with the government to switch the right categories that are appropriate to switch that will bring more people in as well into OTC. With that comes the need to educate from a trade perspective with pharmacists assistants, etc, etc. So I think it’s a fantastic industry to be in, isn’t it, because it really does help people get well and stay well? 

Jon Connolly  14:19

I think there are breakthroughs in science as well around how self-care through things like nutrition can kind of help stave off some of the chronic illnesses. I mean, if you look at the impact of obesity and so on, then you realise that the UK, several years ago anyway, was number two in the global league table of obesity. I mean, when you link that to things like type two diabetes and so on, just that early stage recognition of how you can help yourself, it won’t happen overnight, but over the course of 5/10 years, you’ll see gradual improvements and shifts in the way that people manage their long term health.

David Gray  14:55

Yeah, absolutely. I mean, I am very proud to have been involved in the Change For Life campaign that was developed nearly 20 years ago, that was the beginning of a recognition that lifestyle changes are important and that health isn’t binary. It’s not just about problem resolution, it’s about prevention. It’s about lifestyle choices. It’s about looking after yourself. And I think the healthcare industry as a whole, not just the OTC and the manufacturing side of things, having more of a joined-up approach, as I was saying earlier, you know, joining the GPs, the pharmacist, the aftercare, having proper care pathways when you leave the hospital. 

Also, very importantly, we clearly don’t have unlimited budgets in the country, so the more we can direct people to self-care, the less burden that is on the tax payer. And very often for the user, it’s a much more convenient way of treating lots and lots of conditions, you know, cold and flu is a classic example where you don’t need to go to see a doctor. You can just go and buy a brand over the counter. And there are many, you know, there are two or three very well-known brands in that space that people will go and buy and you know, they will treat the condition for you. 

Annette D’Abreo  16:07

There are brand owners who are outside the UK market who’d like to enter here. They could be from other English-speaking markets like North America, but equally, they can be from Europe and predominantly, German-based, and you’ve had quite a lot of brands over your career that you’ve brought in and successfully recommended the right course of action. Can you just explain a bit how you approach that?

David Gray  16:33

Yeah, I mean, I think one of the challenges, you know, is that the UK market is quite a specific market, so market understanding is very important. Routes to market distribution, pricing, and competitive environment, all of those elements are important. 

But I think when you are starting with a brand, you start with really understanding what made it successful in its own country. So if it has a loyal following, if it has a high user base, who are those people and why do they buy it? Where does the brand equity sit? But of course, regulatory environments differ enormously. The transferability of claims, for example, is something where we’ve seen many times that you can’t just simply pick up a product from one regulatory domain and move it into another. So understanding the regulatory framework and what you can and can’t say, which claims travel, which trade claims don’t travel, and is what makes that brand appealing in one market appealing in another market, is really, really important. So the business intelligence function that we have within the business is important, because what we’re looking at really is understanding the brand in its own environment, but also the environment into which it’s trying to move.

And sometimes it’s not transferable. There have been classic examples of brands that have grown very successfully in one market and they’ve extended their franchise in their own market almost opportunistically and are sometimes occupying multiple therapeutic categories. Well, you can’t just transplant that into another market, because actually, most brands start in a therapeutic category, particularly, in healthcare, certainly in licenced medicines, with a particular indication that they become famous for. Then, of course, you can extend once you’ve established trust and credibility in one therapeutic category, but if you try to move into multiple therapeutic categories simply because you have those products, it becomes product marketing, rather than brand marketing. So again, you have to start with the brand, you have to start with the consumer, you have to start with the regulatory environment, and you have to understand the competitive environment. 

And of course, in the UK, there is a very different distribution and retail landscape to, say, Europe. Boots, being an example, dominates here in the UK, but it’s independent pharmacy elsewhere. So again, it’s really understanding the similarities and the differences, and then picking on those areas of meaningful difference that you can really exploit in the market. 

Annette D’Abreo  19:01

And I think likewise, Jon, for you, so that’s a brand new brand coming into a market — it might not be the UK, it might be France, it might be Africa, it could be anywhere, really, David, because you work around the world. But we know there are brands that are sitting in the market that have a lot of heritage. Some of them have really just been left to, to just tick by and some of those we’ve managed, and I think that’s a different approach again, isn’t it? 

Jon Connolly  19:31

Oh, absolutely. So if you call them tail brands, then you know, some tail brands in appearance…

Annette D’Abreo 19:38

Heritage brands.

Jon Connolly 19:39

Well, tail brands, heritage brands, yeah, so some tail brands will have heritage and others, I guess, won’t. But yes, if we call them heritage brands, then it’s quite easy within the bigger organisations in particular, just to kind of consign them to an open-ended period of decline, so they get less and less attractive from one year to the next because reversing these things takes effort. 

But it also takes skill, so the combination of autofocus, and then rightly applied focus. We’ve had many examples over the years where we’ve taken brands that have been in decline for the past 10 years, let’s say, and within a year or perhaps two, well, first of all, you get stability, and then you start climbing because you recognise why people bought them in the first place and you play to your strengths. So yes, there’s a huge amount of value, untapped value in some of the bigger organisations’ heritage brands. 

Annette D’Abreo  20:30

And I think sometimes, we don’t realise that when you’re trying to bring in something new, there’s quite a big, steep, uphill climb to do that. Whereas, there’s a latent awareness and just this knowledge of how a brand fits into your life, and there’s a trust.

Jon Connolly  20:46

There is, and we’ve had brands coming on board with 20-30% declines year on year for a number of years. They are falling off the edge of a cliff and so it takes an awful lot of effort to first of all slow that decline, and then stabilise and then… So it’s very much an evolutionary path. And of course, the art is in how you collapse that and make it as quickly as possible, because, like in many things, confidence is absolutely key. 

If retailers see your 20 and 30% declines, they start cutting distribution, to David’s earlier point about accessibility, and so on, then that becomes self-fulfilling. It’s very difficult to kind of reverse that once that trend has set in. But if you can develop a message that demonstrates to buyers that we know what we’re talking about, we’ve got the pulse on a significant number of your shoppers here, and give us a little bit of time and we’re going to come back with plans that go through that exercise, then I say we’ve got several case studies where we’ve managed to turn that around in the grand scale of things in a very short period of time. And without massive investment. It’s about more focus, and putting the right kind of investment behind the right kind of messaging in the right context, rather than just kind of blasting away and keeping your fingers crossed, hoping for the best.  

Annette D’Abreo 21:58

Yeah. So John, finally, just, you know, thoughts about I guess, one thing that we haven’t mentioned is about investment and the importance of how long it might take you to establish your brand. 

Jon Connolly  22:10

Well, certainly if we’re looking at new product launches, new brand launches and so on. I think a key success factor is, is brand owners recognising that this doesn’t happen overnight. You don’t build a brand in a short period, like six months or so. And it requires consistency. 

There’ll be consistency in messaging so that consumers aren’t confused about what you stand for, but also consistency in investment, so brand activation over a number of years, let’s say, and also a level of determination. 

Very seldom does success just follow a very easy kind of linear path. There will be bumps in the road, whether it’s competitive challenges, whether it’s retailer or consumer developments, and so on. And one of the keys to success, if you have absolute belief in your ability to develop this brand and to accrue all of the benefits that come from that, then having the ability to grit the teeth and continue investing through difficult times is proven to be an essential success factor.

Annette D’Abreo  23:08

Great. Thank you, Jon.

David Gray  25:26

Yeah, I think really important. I mean, you can’t just promote your way to the top either. I mean, this is the other mistake that’s made, you know, promotions, there’s a lot of money put into promotions. I mean, there is. 

Annette D’Abreo 23:20

Not promotions on their own. 

David Gray 23:22

No, exactly. So brand building is really, really important in the field and the network, which I think most people are familiar with, has proven beyond any doubt that investment in brand together with promotions, of course when there are promotion cycles. I’m not saying don’t promote, but solely to promote your way to build a brand isn’t the way to go forward. You have to invest in brand building. And as Jon said, the route to building a brand is a long path. That’s why successful brands are successful. They’ve been built up over a period of time, and they have real meaning in the mind of the consumer and therefore they drive preference and loyalty and preference and loyalty drive cash flow, which is what we’re all ultimately interested in. Repeat purchase drives cash flow, cash flow allows you to reinvest, and that reinvestment in the brand, over a period of time will reap rewards, but it’s a long game.

Annette D’Abreo  24:10


Jon Connolly  24:10

But even then with promotions, I think there’s a sense of understanding the dynamics, understanding what you bring, because I, as a marketer, would much rather have success where everybody’s paying full price quite happily because they understand the benefits that my brand will bring and the edge it has over rivals. I mean, selling because it’s 30% cheaper than it was yesterday, that’s not my goal. The goal is to kind of get that understanding and to provide compelling value at full price. 

Annette D’Abreo  24:39

Thank you both. Well, on that very important note, thank you for your time today, John and David, and thank you for listening.

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