June 1, 2005

producers take heed of success in baby diaper market and now offer bells and whistles for improved performance in AI products

Cloth-like backsheets. Stretchable, breathable side panels. Thinner, more absorbent cores. Elasticized leg cuffs. Sound familiar? While this list of value-added features may sound like those touted in the baby diaper market, these often technical innovations have made their way into the adult incontinence market at last. Driven by improved performance requirements, AI manufacturers are doing all that they can to keep up with the constantly rising standards set by baby diaper producers in terms of innovation and downright ingenuity.

What�s in it for them, you may ask? According to INDA, Association of the Nonwoven Fabrics Industry, Cary, NC, 2004 sales to end users in the North American market amounted to about $1.1 billion in the retail channel and $900 million in the institutional channel (hospitals, retirement homes, long-term care facilities, etc.). That brings the total North American adult incontinence market to approximately $2 billion. �Combined North American consumption volume for both channels was about 5.3 billion units in 2004, although this figure is not finalized,� said Ian Butler, INDA�s director of market research and statistics.

While these figures may pale in comparison to the baby diaper market�which stands at $4.4 billion at the retail level according to INDA�AI is a market that is certainly worthy of producers� attention now and is expected to grow. �The retail market�s unit growth has averaged in the 5-6% per year range and I expect it will continue for some years,� offered Mr. Butler.

Market tracker Euromonitor International, Chicago, IL, found AI to be one of the fastest growing market sectors of all between 1998 and 2003 due to the increasing number of older consumers with whom this category is mainly associated (see Table 1).

Meanwhile, Euromonitor named AI the second fastest growing disposable product sector in the world in value terms between 1998 and 2003, and the fastest in 2003. The sector reached $827 million in 2003, an increase of 6% compared to the previous year, and an increase of a whopping 34.2% from 1998, Euromonitor reported.

Going forward, the outlook for incontinence products is good, with a forecast CAGR of 3.4% between 2003 and 2008. As illustrated in Table 2, the incontinence sector is expected to reach a value of $977.8 million at constant 2003 prices in 2008, a gain of 18.2% in real terms compared to 2003.

A look at the recent past clarifies growth levels. An estimated 1.69 billion adult diapers were expected to be sold in the U.S. in 2002, according to an article published in USA Today. Ten years earlier this number was just 700 million and 20 years earlier it was 392 million. Approximately half of all people over the age of 70 experience transient or chronic incontinence, with diapers mostly being worn during lengthy meetings, excursions or long trips. Generally they are not worn at home, although some wear them overnight, according to USA Today.

Just as in its sister market, the baby diaper sector, geographical growth in adult incontinence products appears in the industrialized regions of the world (as shown in Table 3). Central Europe, North America, Japan and Australia are among the most important markets, with Eastern Europe strongly growing as well but from a smaller base.

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What�s It Like Out There?
Producers of all sizes agree that it�s tough going in the hygiene market in general and AI is no exception. �The market seems to get increasingly competitive, with new companies entering and existing companies adding production capacity,� commented Chris Gegelys, president of Humanicare, East Brunswick, NJ. �That, along with swings in the raw material market and consolidation at the wholesale and retail customer levels, creates a challenging environment that requires a sharp focus on efficiency and establishing the best possible network of business relationships,� he said.

In addition to raw material price hikes and heightened levels of competition, AI suppliers are also facing constant pressure to keep costs low. Whether products are headed for retail shelves or institutional use, the bottom line is clear: there is simply no room for additional costs.

According to Dieter Feustel of German producer Paul Hartmann AG, two trends dominate the development of AI products. �The market splits into low cost products that are sold at low prices and professional incontinence care systems, where absorbent incontinence products are offered in combination with other health care solutions to institutional or home care customers.�

Despite such concerns, suppliers are enjoying growth in certain areas of the market, most notably the at-home sector. In the past, incontinence was one of the key considerations for admittance to a nursing home. Today, with new options for assistance and care, individuals are able to stay in their homes or a family member�s home for a much longer period of time. As a result, this product category has charted impressive growth in the traditional and non-traditional retail markets.

�The real growth in the marketplace is coming from the at-home sector,� confirmed Rick Finlayson, vice president of marketing for PaperPak. �Although aging is not a cause of incontinence, as our population continues to gray, the size of the adult incontinence market is growing with it,� he said.

Paul Hartmann AG also described the at-home sector as a key area of growth along with light incontinence products. �The fact that light incontinence products today are offered in supermarkets has increased the importance of this segment,� explained the company�s Dr. Feustel. He added that, in Germany, increased demand for AI products in home care is also related to cost saving efforts in the health system. �More people will be taken care of in their homes with the support of mobile caregivers instead of staying in hospitals or nursing homes,� he said.

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Let�s Talk Trends
Through improved product design and technology, producers are currently underway with efforts to address issues specific to the AI market. �There has been an increased understanding and focus on the odor control and skin care capability of adult incontinence products,� explained Raymond Carter, SCA�s North American product director. �AI products are more than �just absorbent containers� for holding urine. Careful design and selection of materials allows modern absorbent products to help reduce skin issues, incontinence-related odors and provide improved dignity and confidence to both the individual user and the caregiver,� he said.

AI marketers and suppliers are also doing everything in their power to comply with demand for updated product designs as briefs and disposable underwear gain popularity among consumers. One company on the forefront of this trend is Humanicare, which has seen tremendous growth in the category of disposable protective underwear. �Overall market supply in this category has increased during the past couple of years, making it more accessible for many customers and enabling strong volume growth,� explained the company�s Mr. Gegelys.

In addition to disposable protective underwear, Humanicare offers washable protective underwear, the most popular versions of which consists of a moisture-proof pouch that holds disposable pads in place. The pouch forms front, back and side walls to prevent leakage and, when it is used with a pad that does not have a moisture-proof backing, it allows both the top and bottom of the pad to absorb fluid during periods of heavy loss, thereby making much more effective use of the pad.

�In fact, the product allows people to use a relatively small pad but still have effective protection against complete loss of bladder control, which usually must be managed by using bulkier products,� Mr. Gegelys said, Since the underwear is washable just like regular underwear, it can also offer a more cost-effective solution to those suffering from heavier incidents of urinary incontinence, he added.

SCA has also taken note of this trend. �In the past several years, adult pull-up products have become increasingly popular and have come down in price,� offered Mr. Carter. �The adult pull-up products can be quite cloth-like and similar to the user�s own underwear. This can be psychologically important among some incontinent people who are embarrassed by their condition. This type of product and other innovative product designs offer the user choices that were not available five years ago.�

Improvements in superabsorbent polymer technology and absorbent core design now allow adult incontinence products to be thinner, while improving overall performance. �Thinner products can be more comfortable to wear and offer increased dignity for ambulatory users,� said Mr. Carter. He added that the use of textile-like covers has increasingly become common on many adult incontinence products.

A textile-like sheet has two significant advantages, he explained. First, the textile covering is more skin friendly than plastic. This can lead to cooler-feeling and more comfortable products. Second, the textile covering reduces the noise that is inherent in many adult incontinence products. �This improves the dignity that is so often appreciated by the user,� Mr. Carter said.

Mr. Finlayson of PaperPak cited similar trends. �The biggest product change in the North American market during the past five years is the introduction of the pull-on style incontinence product. It is the closest thing to underwear that the individual can wear today. Convenient, comfortable, easy to use, and dignified�these products have changed the market. They�ve gone from non-existent to retail market leadership in the last five years.�

�Institutional and adult products are now following the shift in infant diapers from poly backsheets to nonwoven backsheets,� he continued. �With this move, new taping or closure systems are also being introduced. The move from thicker to thinner products with equal absorption has been a slower transition from infant to adult products.�

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What�s Good For Babies Is Good For Adults
In addition to cloth-like backsheets, adult incontinence manufacturers are offering other key product features originally designed to improve comfort and fit in baby diaper products. �Optimized and elasticized closure systems have been developed for improved product fit of adult briefs,� stated Dr. Feustel of Hartmann. �In addition, breathability of side panels in adult briefs has been implemented to reduce occlusive effects on the skin and help to normalize users� skin conditions,� he said.

For SCA, such product-enhancing features�dubbed �bells and whistles� in the baby diaper market�are indicative of an increasingly educated consumer. �The breadth of product and protection level choices now allows the purchaser (whether the actual user, caregiver or other) to select the product that best meets the needs of the user,� Mr. Carter suggested. This can lead to less leakage and improved satisfaction, all at lower cost. Proper selection of product and attention to application can lead to a significantly lower cost per day, he continued.

�Increasingly, users and purchasers are recognizing that what is important is the clinical and emotional outcome associated with use of a product. That it is better to focus on the cost per day, not simply the cost per piece of one product. Additionally, the needs of an incontinent person may vary during the day or from day to day. Having a variety of product types and protection levels allows the product to meet the particular needs of the user�at that moment,� said Mr. Carter.

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New Product News
As is the case in every consumer sector of the nonwovens industry, AI products are constantly being tweaked to achieve the highest possible performance at the lowest possible cost. One producer answering that call is Paul Hartmann AG, which has launched a new incontinence slip, MoliCare Premium, for the institutional and home care market. The product was originally launched last year in the institutional sector and was carried into the home care field in January 2005. The product features breathable side panels based on a nonwoven material.

Category leader Kimberly-Clark has upgraded its line of Poise incontinence pads for women, promising �New Superior Dryness� in its regular and extra absorbency versions. The products are designed to offer better dryness than competing maxi pads of similar lengths (9.5 and 8.5 inches respectively). Featuring a contoured pad design, the products� two-layer superabsorbent blue center has been made longer to more effectively pull wetness in and lock it away to help prevent leaks and neutralize odors. The pads are individually wrapped for convenience and discretion.

Slated for introduction this spring from PaperPak is the Attends 10-Barartic Brief. The product is designed to assist those individuals that need the protection a brief provides but have been unable to find one that fits them. The new product will fit up to a 90-inch circumference and offer superior skin protection and absorption.

The brief will feature larger Easy-Fit tapes, a soft nonwoven topsheet for skin comfort and breathable, stretchable side panels that provide more air flow for healthier skin. The briefs also contain PaperPak�s Accel-Dry fibers that channel fluids throughout the brief and keep urine pH levels low for superior skin wellness, dryness and odor control.

At the same time, PaperPak will be introducing a new Attends 10 Breathable Brief with a nonwoven backsheet and breathable side panels for improved user comfort. The brief will offer Easy-Fit tapes, a moisture-proof lining and patented Perma-Dry fibers that channel fluids throughout the brief and keep urine pH levels low.

In April, Attends Guards for Men, the first Attends product designed specifically for men, will be rolled out. The discreet, comfortable guard is specifically designed for men who may have slight leakage due to prostate surgery or similar procedures. The guards are thin yet absorbent and have an adhesive patch for a secure fit in underwear.

Also, PaperPak has recently introduced its smallest Attends product yet�Attends Light Pads Regular and Extra. The bladder control pads offer a more discreet option for light leakage. The soft, absorbent core with Hygard polymer absorbs fluids quickly and helps prevent odors. The leg gathers and contoured shape provide superior fit and comfort. They feature an adhesive strip for a secure fit and are individually wrapped.

Another company targeting the bariatric market is Humanicare, which offers two new products. One is the Dignity Plus brief size XX-Large, which has a maximum waist measurement of 68 inches. The other is the Dignity Fit Rite waist size extension panel. A pair of extension panels can be used on any standard tape tab brief to expand the waist measurement up to 20 additional inches. The panels are breathable and have reinforced landing zones allowing them to be unfastened and refastened to help ensure a proper fit. More than one set of extenders can be used per brief to expand the waist size in additional increments up to 20 inches each, so the product can be used to meet the needs of even the largest people.

Humanicare has also introduced the Dermateam skin care line, which provides cleansing, conditioning and protection in an easy-to-use, three-step numbered system. Additionally, the company is considering the use of existing technology to introduce new products to adjacent markets. No further details were available concerning these plans as we went to press.

The latest innovation from SCA is the Tena Flex belted one-piece brief, which combines an innovative product design with state-of-the-art features. The product is designed to meet the needs of wearers as well as caregivers and administrators. According to SCA, the combination of low skin coverage, a fully breathable product and belt and an advanced absorbent core design provides excellent containment and has been shown to help reduce skin issues. �There have been limited product trials in Europe that have shown actual skin improvement among residents wearing Tena Flex,� offered SCA�s Mr. Carter. �In some cases, improvement occurred in less than 15 days of product usage.�

The belted design of Tena Flex briefs reduces stress and strain on caregivers� backs. This can translate into greater job satisfaction, enjoyment and fewer lost hours due to back strain, SCA reported. The brief is designed to offer the following benefits to administrators: increased job satisfaction, fewer work-related lost time hours and a premium product that can reduce skin issues. The company hopes these benefits will in turn lead to the nursing home being seen as a high quality, premium home. �SCA is constantly looking for opportunities to improve existing products and introduce new products to better meet the needs of the long-term and home care channels,� Mr. Carter said.

�SCA has recognized that incontinent people come in all sorts of physical sizes, as well as many different levels of incontinence,� he continued. �For many years, we have provided a range of product types and absorbencies (protection levels) to meet the diversity inherent in the incontinent population. Another way SCA has focused on the incontinent person, rather than the problem, is fit. Extensive work has been done to better understand how incontinence products are worn and applied. The designs inherent in Tena products is a result of this work.�

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Where Do We Go From Here?
In the face of certain ubiquitous challenges such as increased competition and price pressures from both ends, suppliers are generally optimistic about the future of the adult incontinence market. After all, baby boomers will start hitting age 65 in 2011. It is anticipated that this group will be both more knowledgeable about health care options and have adequate financial resources to demand increased levels of health care, including AI products. That spells good news for producers.

Additionally, as SCA�s Mr. Carter pointed out, many baby boomers are expected to stay at home or enter assisted living centers, rather than go into traditional nursing homes. �This may cause a significant increase in sales in the retail and home care channels,� he said. �This is supported by the fact that almost all the growth in beds for the elderly has been in assisted living centers versus traditional nursing homes.�

Hartmann�s Dr. Feustel�s version of the future looks slightly less bright, although growth is projected to continue in the coming years. In countries such as Germany, the modernization of the health system strongly influenced business development, according to Dr. Feustel. �The reimbursement rules for incontinence products have been changed to lower rates. Assuming further cost saving steps will be implemented in the coming years, further price pressure will be placed on manufacturers,� he forecast.

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