April is the cruelest month-especially if you're an allergy sufferer. The trees blossom, grasses awaken from their winter slumber, and pollen floats across the land. As warm weather arrives in much of the country, the sound of birds chirping is accompanied by a jarring chorus of people sneezing and sniffling and blowing their noses.
A whopping 51 percent of Americans take prescription or nonprescription allergy medication, though many take the over-the-counter brands to relieve similar stuffy-head symptoms of colds and the flu. As a group, the buyers of allergy medicines are demographically democratic: upscale suburbanites and downscale city dwellers, single parents and couples with children, college students and mature, blue-collar workers. The highest concentration are nonprescription buyers who live in the South, partly because lower incomes there encourage residents to self-treat rather than to visit doctors for the costlier prescriptions.
But geography and weather also play a role. Warm temperatures create a longer growing season for tree pollen. The humidity encourages the growth of mold and dust mites. "Below the Mason-Dixon line, people are just exposed to allergens for a greater length of the year," says Dr. Mark Dykewicz, director of training programs in allergy and immunology at Saint Louis University School of Medicine. "In the North, you get hard freezes so plants die off. In the Southwest, the climate is so arid that there's less mold and pollination."
Communities with lots of retirees also tend to be poor allergy markets because seniors tend to have "less robust allergic responses," notes Dykewicz. By contrast, areas with lots of young children, whose immature immune systems have plenty of sensitivities, consume a disproportionate amount of allergy medication. (Indeed, the map looks surprisingly like the profile of U.S. households with children under six years old.) This age split explains why big cities such as New York and Chicago tend to be weak allergy markets, many of their families with young children having long ago moved to the 'burbs. And it's one factor that's helped turn Waco, Texas, where nearly one-third of the residents are under 35 years old, into an allergy medicine boomtown, while neighboring Abilene, where about the same percentage are over 65, is a frail market for allergy meds.
Such geodemographic patterns are likely to change in coming years thanks to innovations by both pharmaceutical researchers and marketers. Sales of prescription antihistamines-already high in metro areas-doubled between 1995 and 1998 to $2.13 billion, according to IMS Health, a health care information company. While the first generation of prescription allergy drugs to be sold over-the-counter-like Allerest, Sudafed Plus, and Chlor-trimeton-were widely popular, people still complained of drowsiness. A breakthrough came in 1985 with the arrival of Seldane, a non-sedating antihistamine. Seldane was a bestseller until 1991, when doctors reported that the drug could cause life-threatening side effects if it were taken with certain antibiotics or even grapefruit juice. Seldane-maker Hoechst Marion Roussel responsibly bought newspaper ads urging its millions of customers to switch medications.
Five years later, the company introduced Allegra, one of the new generation of allergy drugs that, like Claritin and Zyrtec, provide relief without grogginess. Drug companies have pushed hard to get out the word through direct-to-consumer advertising, especially since 1997, when the Food & Drug Administration relaxed its rules on TV advertisements for prescription medicine. Since spots for Allegra first aired three years ago-when the FDA prohibited the company from mentioning that Allegra was allergy medication-revenues have jumped more than 1,400 percent, to $316 million.
Schering-Plough's Claritin, the number-one allergy drug with three times the sales of Zyrtec, or $1.15 billion, has found success using Good Morning America exile Joan Lunden as its celebrity spokesperson. Industry analysts predict more high-profile, direct-to-consumer advertising will elevate sales for prescription allergy medication even higher, particularly in the nation's most populated cities. There, an increasing number of people are expected to face airtight homes and office buildings, which foster mold and dust mites, as well as dirty outside air which also triggers sensitive noses.
Already, drug sales that once peaked with the spring and fall pollen seasons are remaining strong year-round. "People no longer complain of just the twice-a-year sneezes," reports Diane Parks, vice president of marketing at Hoechst.
Now people can suffer in silence the year-round.