Adult Incontinence: Not Your Grandmother’s Market

While the term adult incontinence once conjured up images of an old lady on her deathbed or a paraplegic confined to a wheelchair, today that is no longer the case. In fact, today’s incontinence sufferer is more active and younger seeming than ever before. Even as many sufferers approach their 70s and beyond, they consider themselves as vibrant as ever and don’t want a problem like incontinence—or the product they choose to handle it—to stand in their way.

With an estimated 200 million people affected globally, adult incontinence is becoming more widespread as older populations continue to represent a larger demographic segment around the world. While an overwhelming majority of sufferers are women—approximately 75-80%—more men are being affected by the condition than ever before and while it is usually considered a concern of the elderly, more younger people are afflicted.

In fact, a recent survey conducted by Cotton Incorporated of 115 million known sufferers in the U.S., found that the fastest growing population in this market is obese African-American women between the ages of 20 and 30.

Therefore, companies doing business in the adult incontinence space have to juggle a number of different needs. There are light incontinence sufferers who usually get away with using feminine hygiene products to mask their condition; stress incontinence sufferers, who use a combination of products depending on the day and heavier incontinence sufferers who want products they can use discretely while maintaining the active lifestyles they crave. Then, of course, there is the institutional market catering to the extremely old or sick and bedridden.

Add to this the stigma surrounding the market, with many sufferers buying alternative products to avoid the shame associated with incontinence, and these manufacturers have their hands full. However, the rewards are worth the aggravation as this is one market within hygiene that is predicted to grow worldwide. Unlike the disposable baby diaper market—which is characterized by low birth rates and high penetration rates in developed markets and manufacturers have to look at emerging areas for growth—adult incontinence has plenty of room to grow in places like the U.S. and Western Europe where active seniors and even younger sufferers will pay top dollar for products that are effective.

“The baby boomers are entering their golden years and they carry high expectations from their products for good quality of life,” says Mimmi Lagergren, vice president communications of incontinence care Europe for SCA. “At the same time, the financial crisis combined with the growing elderly demographics has put pressure on the healthcare systems globally, which directly affects healthcare products. We must focus not only on developing high functioning products but also on economical solutions for the players.”

In recent months, SCA has made acquisitions in Taiwan, Turkey and Brazil and has worked hard to promote its Tena brand of adult incontinence items in North America, where it has a new investment in Bowling Green, KY through a partnership with Japan’s Unicharm.

Getting into the business

Domtar Corporation has been focusing on adult incontinence to diversify its business, which has traditionally been steeped in the pulp and paper market. In August, the Montreal-based company bought the North American arm of Attends adult incontinence items and in January took the European arm of this business into its folds.

At the time of the North American acquisition, Domtar executives called the deal a good step forward in the company’s movement into consumer products.

“This is a good transaction that allows us to take measured steps into the consumer products market in a product area where high single-digit global growth is expected,” says John Williams, president and CEO of Domtar. “We believe there is the potential to double Attends’ earnings within five years and we are committed to unleashing the great organic growth potential. With this acquisition, we will consume internally some of our high quality Lighthouse fluff pulp produced in our nearby Plymouth, NC, mill. Domtar will continue to look for innovative ways to build growing businesses based on sustainable wood fiber.”

Attends’ North American arm produces a complete line of incontinence care products and washcloths marketed primarily under the Attends brand name. The company offers more than 170 SKUs and serves a wide range of customers throughout the U.S. and Canada. In the U.S., the company operates a 775,000-square-foot facility with nine production lines and a distribution center in Greenville, NC. Attends has approximately 330 employees, annual sales of approximately $200 million, and an estimated run-rate EBITDA of $39 million.

Michael Fagan, currently president and CEO of Attends Healthcare, Inc., will continue in this role. Commenting on the transaction, Fagan says, “I am delighted to join Domtar and to take the business to the next level of success. With strong commitment and support, the new ownership structure will allow us to realize the full potential of Attends.”

Meanwhile, Attends Europe sells and markets a complete line of branded and private label adult incontinence products. It distributes its products in several channels with its own sales organizations in nine countries. Attends Europe operates a 374,000 square foot manufacturing facility with eight production lines, a research and development center and a distribution center in Aneby, Sweden.

“The acquisition of Attends Europe moves us further along the path we started down last summer and it consolidates our ownership of the Attends brand on both sides of the Atlantic. With this acquisition, we are adding another platform for growth with a well established business that has the critical mass to drive product development and brand growth with our current North American business,” says Williams. “Demand for incontinence care products in Europe is strong and our intent is to double earnings within the next five years.”

Depend on us

Recognizing how difficult it can be a for a first-time buyer of incontinence products, Kimberly-Clark’s Depend customer service team has made it a personal goal to make life easier by providing a human touch in guiding customers to the best solutions.

According to K-C company research, 80% of first-time users of incontinence products are not sure which product to buy and women can usually spend around $135 trying

to find the right product. To help them, the Depend brand team created no- and low-cost sample kits for men and women that include various products, an information booklet and coupons to alleviate the frustration and expense with purchasing incontinence products.

Additionally, Depend took these efforts a step further by creating a program whereby these consumers could reach out to a live person for guidance during this sensitive process.

“The first thing we did was dedicate a team of representatives to the Depend brand,” says

LouAnn Doolittle, consumer services sector lead for the Depend program. “Each advisor received in-depth training on the brand objective strategy and tools available to assist the new category entrants.”

Other efforts included extending the hours of availability to speak with a live persona from 40 to 84 hours spanning seven days a week. Live Chat was added to the Depend website to increase accessibility. Unique, toll-free phone numbers were provided for key retailers to offer differentiated support and allow customized conversations. Toll free phone numbers, which connected consumers to a caring, supportive advisor, also were included on the free-standing inserts and national ads promoting the sample kits.

Another key element that consumer services provided the Depend brand was the ability to reconnect with consumers once they received the samples. More than 90% agreed to be contacted after receiving the sample and when surveyed, 95% confirmed that personal interaction is influential and even necessary to make the right choice when it comes to purchasing incontinence products.

“Partnering with the Depend brand team and having direct involvement in this commercial program provided our team with the tools to engage with those new to the category in a meaningful way,” Doolittle says. “Our Depend advisors have found it very rewarding to help guide individuals who are searching for the right products to maintain their active lifestyles while coping with incontinence.”

According to K-C, connecting with consumers on an emotional level is paying off. Conversations have increased 107% versus 2010 and the top two conversations center on sample requests and product usage. So far, More than 25,000 sample requests have been processed. When surveyed, 71% of consumers said they will purchase Depend brand products after trying the sample and 87% said that having multiple sizes to try from was useful.

“The consumer Services team has been invaluable at establishing the Depend brand as a trusted ally and has helped us remove obstacles by providing information, support and guidance, which is critical in a brand that consumers have such an emotional connection with,” says Jaime Hirsch, Depend associate brand manager. “By eliminating these barriers and personalizing the experience, we are achieving record new user numbers and share numbers.”

In addition to making its customers feel comfortable, K-C has worked hard to develop products that cater to their needs. Whether it’s gender specific disposable underwear or disposable underwear designed and packaged like regular underwear, new products cater to a new type of adult incontinence user, one that looks at the years beyond 65 and retirement differently than previous generations. And, with this demographic expected to grow from 40 million to 55 million between now and 2020, category growth in incontinence is crucial.

In fact, adult incontinence is becoming so important that K-C specifically cited innovations within its Poise brand as a sales growth driver company-wide. Last summer, K-C last summer introduced hourglass-shaped pads under the Poise brand. These pads are especially designed to meet the needs of women with light bladder leakage who experience difficulty with the fit and performance of traditional protective pads. The pads have “stand-up” leak shields that help eliminate gaps, an absorbent core that offers the excellent protection the Poise brand is known for, all in a narrower product. In addition, Poise Hourglass Shape Pads have first-of-a-kind “pink lace” graphics and are packed in an attractive pouch, for a feminine look and feel.

“Poise Hourglass Shape Pads bring breakthrough technology to the world of light bladder leakage,” says Jay Gottlieb, vice president, North American adult & feminine Care for Kimberly-Clark. “This first-of-a-kind product is designed especially to meet the needs of women who are experiencing LBL and have difficulty with the fit of traditional protective pads. Poise Hourglass Shape Pads provide the performance women expect from the brand and now offers a more feminine design these consumers will love.”

The unique contoured shape of the new Poise innovation curves around the legs, enhancing the fit around the natural curves of a woman’s body. According to Gottlieb, the new product line fits so well that women only have to try it once to believe it. In K-C consumer research and testing, 83% of women who tried the product said they would buy it.

SCA has also been introducing more choices for its customers in the adult incontinence market. In March 2011, the company launched gender-specific protective underwear through its Tena line. Calling it a new approach to the category, SCA was the first European company to introduce this concept to the market. More like a piece of clothing than a diaper, the diaper has a design print and is less bulky thanks to a new soft material. The shape of the product varies depending on whether it is intended for a woman or a man.

According to SCA research, products like this can help change product conception in the adult incontinence market and women who were previously using feminine hygiene products to mask their conditions are more likely to use this product than other types of adult incontinence products.

“The protective underwear product that we have launched provides mobile users to have complete discretion and security and still have a regular underwear feel,” says SCA’s Lagergren. “Incontinence solutions must target not only functional absorption requirements but also address emotional needs as well in providing dignity, self confidence and improved quality of life.”

Meanwhile, in China SCA has developed the Tena Belt adult incontinence product, which features less material, increased airiness and breathability, providing more dignity for the patient and less burden for the caregivers.

“This innovative product is based on Chinese consumer insights and leveraging our global processes and expertise, has been developed in China within seven months fromm idea to launch,” says Stephan Dyckerhoff, president of SCA’s North Asia hygiene operations. “

The Tena Belt includes breathable materials both in the pad and in the belt. The separate belt and also be washed few times, meaning the pad is attached with hook fixation onto the belt, which makes the application very easy, saving time and energy for caregivers.

Cotton Incorporated Conducts Survey

At Vision 2012, Janet O’Regan, supply chain manager for Cotton Incorporated, reported the results of a recent survey gauging attitudes within the North American adult incontinence market. The survey polled 116 million women in the U.S. who have a history of adult incontinence problems. Of the respondents, two-thirds of the women said they buy the products frequently and many of them often combine products.

Of these women, 80% say they have stress incontinence while 53% said they have urge incontinence. Just 50% buy incontinence pads, meaning half of sufferers managed the problem with feminine hygiene items. This is particularly true among younger sufferers who tend to be more embarrassed to shop the adult incontinence aisles. Customers older than 50 tend not to be as embarrassed about buying AI products. These same customers spend $50-100 per month to address the problem.

Many respondents said they buy feminine hygiene products because they say their issue is not severe enough to warrant purchasing a second product type. At least half of these responders say that their needs are met completely by the product they are currently using; others say they only use the more effective AI products when they are going to be away from home for a long time and don’t want to risk an accident.

What these responses indicate are that incontinence is not just the problem of the old and frail, O’Regan explained. In fact, there are tremendous opportunities for companies eager to target the younger incontinence sufferer or even older sufferers who hope to continue an active lifestyle.