With increased interest in personal healthcare management accelerating due to the COVID-19 pandemic, 2020 saw the highest growth rate in the dietary supplements category since 1997. Incredibly, part of this growth was because 30 percent of consumers in this category were new to the regular use of dietary supplements, according to Nutrition Business Journal (NBJ). Along with the overall growth of the supplement category came new insights on consumer attitudes and behaviors. The 2020 New Hope Network NEXT Data and Insights Survey found that 77 percent of consumers said personal health was more important to them in 2020 than in 2019, and 33 percent now believe that taking dietary supplements is more important than it was a year ago. By applying these new insights from 2020, the industry has an opportunity to better understand drivers of growth for the category that can support growth through the end of 2021 and beyond.
Overall trust in the supplement category
When it comes to choosing the personal healthcare products consumers use regularly, one of the most important factors is trust. In fact, the 2021 Edelman Trust Barometer found that consumers are seven to eight times more likely to buy brands they trust. While increased awareness and concern for personal health in 2020 likely contributed to better health behaviors, how consumers select a product is influenced by trust in any given personal care category.
Improving trust would be a key indicator of consumer engagement and acceptance and would represent an influential metric for industry. With year-to-date rebalance of growth rates trending lower than in 2020, there are concerns that this new high of consumer interest could fade over time. By addressing how trust can be developed, our industry can influence health behaviors and category engagement. With higher and sustainable metrics of trust and growth, dietary supplement manufacturers can enhance strategic growth drivers for the category.
The 2020 NEXT Survey found that 47 percent of the general population lacks trust in the use of dietary supplements, with 10 percent of this group saying they lost trust for the category in just the last two years alone. To increase the number of monthly supplement users beyond the current estimate of nearly 60 percent of adults (NHANES 2018 data/CDC statistics), we must support the use of supplements with compelling and credible science to help address those consumers with less trust. (PLoS One. 2019; 14(6): e0218398) The good news is that as recently as 2018, industry surveys suggest that approximately 80 percent of current users are confident in the category. The real opportunity for growth lies in determining how to increase confidence of the 47 percent of Americans today who don’t trust dietary supplements.
It’s not enough to let increasing awareness alone translate to consumers’ trying and regularly using dietary supplements. With so much information online and easily accessible, consumers want to understand everything there is to know about a health issue, a product and its benefits, and the company making it before deciding what to purchase.
The dietary supplements category is now a mainstream consumer category with more than 70,000 products on the market. The volume of products and available information can be challenging for consumers and practitioners to sift through in order to make the best selection. Providing credible and balanced scientific information to consumers will increase confidence levels and support product decision making and use.
Healthcare as a category is driven by a prevalence of credible information to help consumers confirm the quality of their products, formula benefits, and indications of use. Seventy-three percent of consumers consider transparency—defined by more easily accessible information on quality assurance and potential health outcomes—more important than price. And 40 percent of these consumers say that no transparency leads to such little confidence that they will stay out of a consumer health category like dietary supplements.
There is also a distrust in dietary supplements among some healthcare professionals. Research suggests that only 50 percent (and up to 70 percent in selected specialties) recommend the use of supplements, with less than 40 percent confident in their use. (PLoS. 2019 and Nutr J. 2009 Jul 1;8:29) However, that lack of confidence may be due to a lack of education around the category. Recent surveys assessing healthcare providers level of knowledge on dietary supplements show average scores of 56.5/100. (PLoS. 2019, Nutr J. 2009, and Pew Trust Survey) The need for professional education, alongside consumer education, is critical to building trust in the category, as consumers will continue to turn to their healthcare providers for information.
Creating a path forward
The good news is that there are tangible steps that can be taken. Industry can focus on three key areas to leverage transparency that builds consumer trust in the category: credible information and education, increasing compliance with current good manufacturing practices (cGMPs) and regulatory reform.
First, we must start with credible and balanced communications and education. As an industry, we know we have strong supporting evidence with good science and relevant clinical insights for many of our products and ingredients. However, exaggerated or misrepresented product claims contribute to a lack of confidence and erodes trust among consumers and healthcare providers. Balanced and accurate communications must be the standard of the industry.
All companies in the category should also take advantage of the great resources and information from National Institutes of Health (NIH) Office of Dietary Supplements (ODS), Centers for Disease Control and Prevention (CDC), FDA Office of Dietary Supplement Programs (ODSP), USDA Health and Human Services (HHS), along with other agencies and institutions. Collectively, we can encourage the category to strive to deliver a robust standard of information and continuously update this information through ongoing investment in research and educational programming.
Industry investment can help advance category information and create a high level of consumer confidence that will support category growth. Increasing support for conducting more clinical studies, outcomes research and innovative developments will help fill gaps of scientific information and build greater confidence, especially with the scientific and clinical community. This research can be integrated into strong educational programs and the network of supporting companies that provide services to industry, including analytical laboratories, marketing agencies, education and business consultants to expand reach and influence. With new resources and more education, we can grow the understanding and trust of the category among consumers and healthcare providers.
The second key focus area for building trust is industry compliance to cGMPs. By ensuring cGMPs are met or exceeded and manufacturing facilities are certified to confirm high quality products across the industry, we will be able to significantly build trust. While the majority of companies in the category fully meet or exceed FDA regulatory requirements and cGMPS, s”bad actors” mostly in a few select categories (e.g. energy, sexual performance, rapid weight loss, sports performance) find ways to circumvent compliance and consumers become aware of it, which hurts the credibility of the entire industry.
As an industry, we need to find ways to encourage all players to comply and strengthen their supply chains to ensure high quality products. Importantly, all companies must recognize that they bear the responsibility for their own as well as their third-party manufacturers for qualification and compliance. A key component of cGMPs, this requirement can be more robust across the industry and can go a long way to avoiding issues that hurt the category.
The third focus area is regulatory reform. While credible information and cGMP compliance are important for industry to build trust and confidence, without updating regulatory capabilities at FDA and/or within companies, many of the issues hurting category credibility will remain. With more than 70,000 products on the market in the supplement category, more regulatory resources will help support the level of category confidence. This will help avoid overstated and unsubstantiated claims, reduce risks of adulterated or misbranded products, and improve levels of compliance across the category.
By modernizing the Dietary Supplement Health and Education Act (DSHEA), we can address all of the above issues and improve the overall credibility and trust of the category. A key element of DSHEA modernization includes mandatory product listing, which will give FDA and consumers a full and transparent view to all products in the category. With enactment of such a listing, FDA will have a far greater line of sight into enforcement gaps, which in turn holds the promise of a more credible dietary supplement category that will serve more consumers. The most responsible companies in the category already meeting cGMP would not have an issue with clearer enforcement authority by FDA and the opportunity to remove inappropriate products from the marketplace. This can be a relatively simple yet effective tool to help support increased trust and credibility for consumers and healthcare professionals.
The future of the dietary supplement category is bright. Improving trust and credibility through credible information, cGMP compliance and regulatory reform will result in greater consumer acceptance and use among Americans. From our lessons about consumer behaviors in 2020 and our insights about the future of the category, we can make the changes necessary to build trust in dietary supplements and grow the category.
John P. Troup, Ph.D., is the vice president for scientific affairs and dietary supplements at the Consumer Healthcare Products Association (CHPA). With more than 25 years of category and clinical nutrition experience, he is responsible for leading the association’s initiatives on dietary supplements, working to shape policy, and leveraging credible nutrition sciences and clinical insights that will fuel the growth of this important consumer health care category. Prior to joining CHPA, Troup served as a member of the senior management teams at several Fortune 50 consumer nutrition health businesses, including Pfizer, Novartis and Unilever.