This week in Switch

Apotek Hjartat pharmacy chain has decided to place all loperamide-based medicines behind the counter in an attempt to combat misuse of the ingredient. This follows 11 reported deaths linked to loperamide overdoses in Sweden in 2016. Apoteket AB pharmacy chain is also said to be considering the move, urging pharmacists to keep loperamide medicines BTC if they suspect theft, as well as considering limiting the number of packs permitted per transaction. Loperamide remains available without a prescription in Sweden.

This is not a great week for Switch. Another strike against loperamide -- this time in Sweden -- follows the MHRA warning in the UK in October 2017. Let's hope this doesn't lead to a reverse-switch. And Leo's Dovonex (Daivonex in some countries), which has long been on my wish list for future mid-size switches, will not go OTC in one of the leading switch markets, UK, despite regulatory approval. In the meantime, the upscheduling of codeine continues apace, with New Zealand following in Australia's footsteps. No wonder that ASMI is looking to reverse the tide with its latest pre-budget submission. With the US showing little appetite for Switch at present, I begin to wonder if this remains a pillar of growth for the industry. I hope I'm wrong.

The news from China is equally bleak. The economy grew at 6.9% in 2017, the fastest rate of growth in two years, but the number of births has fallen from 17.9mn in 2016 to 17.2mn in 2017. This is the first decline since Beijing relaxed its one-child policy, suggesting that the reform has failed to reverse declining fertility rates, which economists believe poses a long-term threat to the country's development. Seems like we will have to look in other nooks and crannies for growth opportunities. More and more I see the future of CHC playing best in adjacent categories, emerging niches and with alternative strategies.