Category Beat: Upper Respiratory

A new “higher baseline” of illness Is redefining category demand

Illness incidence remains elevated vs. pre-pandemic norms, with steady rates year-over-year and flu prevalence rising as vaccination rates decline. This has created a higher baseline of category demand, even as total UR sales soften. Consumers continue to rely heavily on OTC solutions vs RX to manage common illnesses, but younger adults show a usage gap despite reporting more frequent illness.

Implication:

Retailers and brands must treat UR as an year-round category, not just seasonal. Build year-round activation plans and educate younger demographics to close the OTC usage gap through targeted messaging, simplified navigation, and trust-building around ingredients.

Channel shift Is creating competitive openings

Brick & mortar is still the dominant purchasing outlet due to immediacy of need. Club, online, and dollar channels are gaining share, while Drug is losing penetration and share of wallet. Online penetration for UR, though smaller than other HBC categories, is growing faster than in-store. Outlets with increasing sales and share reflect value-seeking behavior amid inflation and rising healthcare costs.

Implication:

Traditional leaders must reassess channel strategies. Growth will favor retailers offering value and convenience. Brands need e-commerce-ready assortments and value-tier architecture; Drug must invest in regaining trips through urgency-based messaging and by utilizing the pharmacy as a differentiator.

Private label strength is reshaping competitive dynamics

Private Label is the #1 “brand” in UR, holding 26% of total dollar share. PL is even stronger in key segments such as Allergy, Cough, and Cold/Flu. Consumers rank Health & Beauty as the #1 category for private-label trust, driven by value perceptions and strong loyalty.

Implication:

Branded manufacturers must defend against PL through clear differentiation touting: efficacy, speed, multi-symptom relief, and clean formulations.

FDA disruption around phenylephrine is altering decongestant behavior

Oral phenylephrine (PE) is the largest decongestant ingredient by share, but questions around efficacy have driven sharp sales declines and may result in the ingredient’s removal from shelves. Alternative ingredients, such as Saline and Pseudoephedrine (PSE) have not filled the gap, with PSE’s behind-the-counter status acting as a barrier to migration.

Implication:

This is a category-defining moment. Manufacturers must accelerate reformulation, innovation, and clear communication around ingredient efficacy.

Natural, convenient, and “better-for-you” solutions are winning online

Amazon data shows rapid growth driven by SKUs featuring convenience (sprays, strips, lozenges), natural ingredients (honey, propolis, elderberry), and strong-efficacy claims (“12HR,” “Maximum Strength,” “Multi-symptom”). Propolis throat spray remains the #1 bestseller for two years, and sugar-free and natural cough drops dominate top ranks. Nasal-based solutions lead in Allergy/Sinus online.

Implication:

Brands must integrate natural cues, clean-label ingredients, and format-based convenience into innovation pipelines. Online strategy should emphasize claim-forward, benefit-driven content and superior ratings.