Restoring Consumer Continence: and other trends in the adult incontinence care market

By Tim Wright, Editor | March 11, 2013

Aging populations in key regional markets, increasing consumer awareness and acceptance, and innovations to personalize products to specific consumer segments are driving the global incontinence care market.

The global incontinence care market, which includes absorbent products such as disposable underwear, adult diapers and under pads, has been growing throughout the last decade. In fact double-digit growth rates have been seen in the absorbent products segment, which accounts for more than 90% of all incontinence care product revenues.

The mature economies of the U.S., the European Union and Japan continue to dominate the regional market revenues. Aging populations and expanding waistlines in developed countries and regions are contributing to a growing incontinence market.

“Longer life spans, which may be a result of greater access to better medical care, is one market driver,” says Jan O’Regan, director of strategic initiatives at Cotton Incorporated. “Obesity is another factor. It puts pressure on all bodily systems especially for individuals who may not have strong pelvic floor muscles due to childbirth, lack of exercise or other medical conditions.”

While both the U.S. and EU aging populations are on the rise, Japan’s aging population is experiencing a significant increase.

According to Japan’s Ministry of Health and Welfare, by 2015, one in four Japanese citizens will be 65 or older. In 30 years time, Japan will have three people over 65 for every one person under 15. Shockingly, in 2012, adult diapers outsold baby diapers in Japan.

However, unlike the aging population issue hanging over Europe, Japanese elderly are healthier and less likely to be plagued by age-related illnesses as early as their European and American counterparts.

The changing face of adult incontinence

What was once a taboo topic is no longer. Consumer education programs and the savvy marketing tactics among manufacturers have helped deconstruct misperceptions about adult incontinence.

The subject of adult incontinence has long been associated with the elderly. However, this simply is not the case. While it is true that incontinence is more prevalent among older people, incontinence can strike anyone. “While age is a risk factor, people of all ages and genders can encounter a situation or event that puts them at risk for having bladder and bowel control problems,” says Nancy Muller, executive director, National Association For Continence (NAFC).

In the U.S., 75-80% of the market is comprised of women, according to a clinical assessment of people who have incontinence. “The fastest growing demographic in the U.S. for incontinence is African American obese women age 20-30,” says O’Regan.

According to NAFC, overactive bladder (OAB) affects about 17% of the adult population, or approximately 34 million people.

“Before old age men are more likely to develop incontinence from traumatic events or surgery,” says Muller, explaining the gender gap in incontinence. “The reason women are more likely to have stress urinary incontinence is due to issues related to pregnancy and childbirth. Even in a woman who recovers from the trauma of pregnancy and childbirth when they are young without any issues, permanent tissues have been weakened. This makes women much more vulnerable to have problems later in life.”

A few years ago NAFC conducted a study where it unearthed the real attitudes of pre-menopausal women when it comes to incontinence. “Instead of women describing feelings of embarrassment associated with a stigma, they were more likely to describe feeling annoyed and frustrated,” says Muller. “Women surveyed were most fearful to travel and did not like feeling restricted. While I can’t say there is no longer a stigma attached to the subject of incontinence, this is changing as the older generation passes on and are being replaced by baby boomers.”

Self-care is one of the overarching macro trends in the healthcare industry these days and this plays into continence care because consumers are starting to get more involved in product selection. Manufacturers are focusing on catering to individual customer segments by gender, age group and activity level to best meet the needs of their target population. This has proved to be a successful strategy reaping rich rewards for market participants.

“In very recent years manufacturers of absorbent products are stepping up to the plate in terms of being sensitive to consumers in this category,” says Muller.

K-C is doing this the most aggressively with its line of disposable underwear products. The new products—Depend Silhouette for Women and Real Fit for Men Briefs—both have innovative new features that offer protection and, both look, fit and feel like real underwear says the company.

The launch of these products was accompanied with an ad campaign aimed at baby boomers and featured younger celebrities. National Football League players DeMarcus Ware, Clay Matthews and Wes Welker were featured in one commercial and in another commercial Lisa Rinna of “Days of Our Lives” models the product under a clingy dress at a red-carpet event.

A new social security for seniors?

One of the key trends in the global incontinence care market is product innovation, which is boosting product adoption and consequently, market penetration.

For the 25 million Americans who experience incontinence, Reassure is offering a form of security for those social situations when comfortable, absorbent and above all, quiet, protection is essential. The company’s line of Reassure Premium Cotton Pads features a 100% pure Cotton Core that provides comfortable and absorbent performance without the rustling sound that can accompany some synthetic pads. The pads also provide additional peace of mind with a Gel-Dry Polymer technology that locks away wetness and odor. Hypoallergenic and free from inks and dyes, Reassure Premium Cotton Pads are also ideal for people with sensitive skin.

The desire to offer consumers the widest variety possible led Reassure to launch the Premium Cotton Pad products. “We were surprised to learn from research that just over one-third of incontinence product users assume that their pads are made of cotton,” says Bruce Grench, president, Reassure, LLC. “When the data showed that nearly two-thirds of the market would prefer their pads to be made of cotton, we decided to engineer the cotton core and include it in the Premium line.”

The inclusion of cotton provided benefits beyond meeting consumer expectations of fiber content. “Individuals with bladder or bowel leakage and sensitive skin may be vulnerable to perineal dermatitis if their skin is easily irritated by the synthetic films and bleached, wood-based fibers common in nonwoven products,” explains Muller. “Innovations such as this, fabricated with cotton, offer protection and comfort without sacrificing absorbency and other, important performance characteristics.”

Grench points to another advantage. “Cotton is quiet and that is very important to our customers,” he says. A recent survey revealed that nearly 75% of incontinence product users cited “quietness while wearing” as an important product benefit.

“Today people are living longer and being more physically and socially active well into their golden years,” says Grench. “With products like the Reassure Premium Cotton Pads, incontinence doesn’t have to be a barrier to participating in your own life.”

In collaboration with Cotton Incorporated, the Reassure Premium products were granted a license to display the Seal of Cotton on their packaging. “People recognize the Seal of Cotton and it establishes a connection between the product and all the positive attributes they associate with cotton,” says O’Regan. She cites in-house research that shows well over half of incontinence pad consumers would like to see fiber content information. “Nothing telegraphs fiber content more readily than the Seal of Cotton.”

Reassure Premium Cotton Pads are available online at leading bladder control suppliers, including www.hdis.com and amazon.com, in two performance levels: Moderate Plus, for light absorbency; and Ultimate, for moderate absorbency. In addition to the 100% Pure Cotton Core and Gel-Dry Polymer, the hourglass-shaped pads feature Leakage-Guard Elastic and are latex-free.

Domtar gets aggressive

Personal care player Domtar Corp.’s fourth-quarter 2012 profit fell sharply on weak pulp and paper prices and higher energy and fiber costs, but the company says it’s encouraged by the performance of its personal care products division and is on the hunt for more acquisitions in the segment.

“There’s no doubt we’re out looking for compelling, value-added acquisitions in that personal care space,” Domtar president and CEO John Williams said on a conference call.

To offset the weak performance of the mature pulp and paper market, Williams has over the past two years spearheaded a strategy of diversification into adult incontinence products. The company completed two acquisitions in personal care recently.

First, Domtar signed an agreement to buy privately held Attends Healthcare Limited, a European supplier of adult incontinence products in Europe, from Rutland Partners for $235 million. Then Domtar bought the North American arm of Attends from KPS Capital Partners for $315 million.

“This 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.”

Attends Europe sells and markets a complete line of branded and private label adult incontinence care products. The company distributes its products in several channels with its own sales organizations in nine European countries. Attends Europe operates a 374,000 square foot manufacturing facility with eight production lines, a research and development center and distribution plant in Aneby, Sweden as well as distribution centers in Scotland and Germany.

In line with its strategy to push into the adult incontinence market, Domtar also purchased EAM, the maker of airlaid-based absorbent core material once owned by Rayonier. The deal was valued at $61 million.

“The acquisition of EAM Corporation gives us long term research capabilities to further differentiate our full line of adult incontinence products while integrating the best available technology to grow our existing businesses,” says Williams. “EAM’s patented airlaid manufacturing process provides the performance, quality and cost competitiveness that we believe to be keys to success in the personal care market.”

Most recently owned by Kinderhook Industries, EAM Corporation produces airlaid and ultrathin laminated absorbent cores with brands such as NovaThin and NovaZorb used in feminine hygiene, adult incontinence, baby diapers and other medical, healthcare and performance packaging solutions. The company operates a 71,000-square-foot facility with state-of-the-art research campus and production lines in Jesup, GA. EAM Corporation has annual sales of approximately $45 million in more than 50 countries and a total of 53 employees.

Medline expands AI site in response to growing healthcare market

After less than one year, Medline Industries is expanding its 600,000-square-foot, state-of-the-art adult incontinence product manufacturing facility due to customer demand the company says. Since opening, the facility, located in Lithia Springs, GA, has expanded capacity 50% and added a fifth machine, bringing the total investment in this facility to well over $100 million. In addition, Medline has hired about 120 new employees and plans to add more positions to support the additional production lines.

“We’ve had tremendous response from our customers to the new adult incontinence products we’re making here,” says Dan Love, president of Medline’s personal care products division. “As the population ages, there is more and more demand for innovative products like our new FitRight brief, which help people manage their incontinence with dignity.”

Medline, the largest privately held manufacturer and distributor of healthcare supplies in the U.S. and a provider of disposable incontinence products to the long-term care and hospital markets, built the new facility to produce its newest and most innovative adult incontinence brand of products called FitRight.

Today, more than half of all homebound older persons and more than half of all nursing home residents have some form of incontinence. This problem will become even more profound as the graying of America continues. By 2030, one out of every five Americans will be 65 or older.

State-of-the-art equipment at the new manufacturing facility enables Medline to make products more energy efficient compared to more traditional machines. Technologically-advanced packaging equipment makes the packaging 20% smaller and therefore more “green,” enabling more product to fit in the cases and on the trucks for more efficient and environmentally-friendly shipping and delivery.

The new facility includes a 300,000-square-foot warehouse and distribution center where millions of adult briefs are shipped every week from 90 docks to Medline’s 34 distribution centers located around the country.

SCA sets sights on high growth markets

As part of its growth strategy in the adult incontinence sector, SCA has recently strengthened its presence in Asia and Latin America.

Most recently, SCA acquired Everbeauty, a Taiwan-based hygiene products company with sales in China, Taiwan and Southeast Asia. The company produces and markets baby diapers and incontinence care products with strong brands such as Dr. P for incontinence care and Sealer for baby diapers. In incontinence care, the company holds the number two position in China and the number one position in Taiwan.

The company has also continued its drive to be a leader in the South American hygiene market. The Stockholm, Sweden-based hygiene products maker acquired the remaining 50% stake in PISA (Papeles Industriales S.A.) making it the sole owner of the Chilean hygiene company. The purchase price was reported at $76 million.

PISA’s annual sales are approximately $115 million. While its primary activities lie in the away-from-home and consumer tissue markets, SCA has been using the PISA’s sales and distribution networks as a means to introduce its TENA adult incontinence products since acquiring the initial 50% stake in the company in 2003.

“The time is ready for us to take the next step in our expansion in Latin America, where the PISA acquisition further strengthens our presence in this important growth market,” says Jan Johansson, SCA CEO and president.

In recent years, SCA has made its plans to expand in Latin America clear. In September 2011, the company acquired Descart, a family-owned maker of incontinence products in Brazil. At the time of the acquisition Johansson said that it was the result of a long-term effort to establish itself in Brazil.

Beyond Latin America and Asia, SCA has also focused on growth in Turkey with two major acquisitions.

In the fourth quarter of 2012 SCA’s sales of incontinence care products, under the TENA brand, rose 9%.

On the new product front, SCA added two offerings to its TENA product range through the acquisition of two healthcare companies: Dutch JoyinCare B.V and Swiss Medical Solution AG. The products include self-tests for early detection of urinary tract infections and wet gloves.

“We are very pleased to extend TENA’s personal care product range with these innovative solutions,” says Margareta Lehmann, president, Incontinence Care Europe, SCA. “They improve care and save time both for patients and caregivers. This fits very well with our strategic ambitions to strengthen TENA’s leading position and increase our competitiveness by bringing relevant innovations to the market.”

The self-test for urinary tract infections can replace a demanding and time consuming urine sampling routine and the product can easily be part of already existing routines. “The test is simply placed into and taken out of the pad with usual diaper change. It’s a user friendly solution with quick results,” says Lehmann.

The second product, the wet glove, has raised a lot of interest in the Dutch market. The routines developed in the Netherlands to wash patients with impregnated disposable wash gloves are very successful. Some 25% of all Dutch acute- and long-term care institutions are using wet gloves, mainly for immobile/bedridden patients but also for patients who are still mobile but less easy to wash in a conventional way. The Dutch Ministry of Health has promoted these washing routines since they contribute to saving time and improving care.

“The wet glove can reduce the risk of infections and save time. It is used during the daily washing routine in a nursing home or hospital and replaces water and soap. Since it’s a no-rinse product, no further actions are needed by the nurse after the washing routine,” says Lehmann.

NationalIncontinence.com Expands Selection of Washable Incontinence Underwear

National Incontinence, a major supplier of incontinence products, has expanded its selection of washable incontinence underwear for men and women with bladder control problems.

“We’re always looking for new, quality products for our customers. While disposable products are convenient, they can get costly,” says Renee Mercer, president of National Incontinence. “For a more economical and environmental-friendly solution, our customers now have many washable underwear options to choose from, that not only feel comfortable, but also effectively protect against unexpected leaks.”

The new washable underwear are from Wearever, a provider of reusable adult incontinence products. Available in both male and female styles, the reusable underwear provides discreet protection against light to moderate incontinence. Women can choose from stylish floral patterns and lace trim panties, in additional to plain, neutral-colored underwear. Men can also pick from reusable classic incontinence briefs or a boxer-brief style.

Each pair of panties and briefs come with a sewn-in Unique-Dri pad that absorbs liquid without the need for disposable incontinence pads or inserts. The washable underwear also features antimicrobial fibers that kill odor-causing bacteria. Wearever underwear can be machine washed and dried up to 250 times says the company.

“Our goal is to provide the best incontinence supplies at affordable prices. I believe these new washable underwear will quickly become a favorite for many of our customers,” Mercer says.

National Incontinence provides products throughout the U.S. for people of all ages with bladder control problems. They have helped more than 100,000 patients with bladder issues. Their pediatric division, the Bedwetting Store, is now the largest distributor of pediatric enuresis products in the U.S.

Ontex acquires Serenity brand of incontinence products

As this issue went to press it was announced that Belgium’s Ontex, one of Europe’s leading manufacturers of private-label hygienic disposable products, acquired the Serenity brand of incontinence products from Artsana Sud S.p.A., a leading manufacturer and distributor of incontinence products in Italy, and part of the Artsana Group.

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