The Persistence Blindspot in Natural Health: How to Reduce Customer Churn and Maximise Sales in a Fast-Changing Sector

Natural health products are evolving from the naturopath-recommended niche of old to occupying a space where evidence is driving demand for a new class of products. The new era of natural health is signalled by smart minimalist branding, evidence-backed effectiveness claims and a streamlined direct-to-consumer sales model. It appeals to a wider audience than the traditional natural health customer – those who value a preventative approach to health, are savvy about nutrition and who seek to maximise their healthspan and wellbeing. 

The natural products for today’s consumer distinguish themselves with clear purpose-led brand propositions and an understanding that consumers want proof and credible testimony. Investment in evidence and branding creates a virtual cycle of buy-in. Some forward-thinking pharmacy chains have recognised the potential in evidence-based natural health products and can leverage the trusted relationships they have with their customers to capture this growing market segment. 

Even so, success isn’t easy. Here’s why:

Reaching potential customers is easier than ever – social media platforms, relatively cheap global reach, endorsement and influencer culture can turn a minnow product into a whale overnight. This can help to build a base of bought-in customers, and sets the stage for subsequent product launches, all maintaining the focus on purpose and evidence. However, after acquisition, no matter the product, there is a universal tendency for consumers to reduce or stop taking treatment over time. This creates the ‘leaky bucket’ problem of endlessly needing to replace customers to maintain sales forecasts.

Persistence: a small change equals a disproportionate gain.

The prescription medicine industry has been the focus of much research into supporting treatment continuation (or the opposite – known as non-persistence to treatment). Based on thousands of published trials, the evidence is clear – whether taking a treatment for a medical condition or engaging in preventative or supportive health – most people reduce or stop taking the products at some stage. We’ll explore the reasons why shortly. 

The example below from published literature demonstrate the normal scenario of non-persistence. More starkly, the business impact is that everything above the curve is lost opportunity. 

What is surprising is the gains that can be made from just a modest increase to persistence. If the level of persistence is improved by just 7% (absolute) in the first month or so, then it is natural for that gain to propagate over time with little/no further intervention. Therefore early intervention is critical and optimal. 

So what is the business impact of such a lift? The typical 7% gain outlined above translates into compounding gains – sales are lifted by 16% at 12 months, 20% at 24 months. It is always worth addressing non-persistence to treatment.

Notice the long tail of sales uplift created by intervening early in the normal decay curve. Yes, you need to invest in the intervention, but addressing persistence is double bang-for-buck. You don’t have to address lack of sales through the one traditional lever available – customer acquisition, which also happens to be the costliest.

What can natural health companies learn from behaviour change experts?

What is clear is that it’s more important to plug the gaps in the leaky bucket than keep pouring more in the top. So how to address the challenge? The answers lie in the literature relating to health-related behaviours and the theoretical frameworks that have been developed that explain why people do what they do. The good news is that the validated predictors of target behaviours (like ‘take a natural health supplement’) can be used to develop interventions that help to modify behaviours. Good news part two – behaviours can be modified (not in a mind-control-Dr-Who way) but through evidence-based interventions. Good news part three – in the medicines space there is plenty of evidence for success using this approach. 

Let’s deep dive the body of research into changing health behaviours, and apply a natural health product lens to bring the potential to life. 

Better than a Volkswagen van, but still a COM-B. 

To move from problem to solution, we first ask ‘why’ of the issue, and then explore ‘how’ to address it. 

The why – evidence from the medicines space tells us that non-persistence can be explained (in simple terms, see the references for the full detail) in terms of a person’s: 

  • Beliefs around the treatment – the need for it and how effective they think it is
  • Perceptions about the illness they have or are trying to prevent – such as what caused it, how severe it might be and what consequences it brings
  • Practicalities of the treatment – paying for it, accessing it, how convenient or difficult it is to take, remembering to take it (at a certain age we can all relate to this one!)
  • Motivation to take the treatment – what is the individual’s ‘why’ and how strong it is

If we understand ‘why’ people are more likely to abandon treatment then we can use that knowledge to develop the ‘how’. This is where COM-B comes in. It is a model that describes what needs to be present to achieve a defined behaviour (in this case – ‘take a natural health treatment to support X’) and can be used to guide interventions that seek to shift behaviour. 

In COM-B, the B is the target Behaviour and COM is

  • Capability
  • Opportunity
  • Motivation

COM-B helps identify barriers and drivers, and provides a framework for identifying the optimal techniques to improve the behaviour. Beliefs, perceptions, capability, opportunity and motivation are highly individualised – people don’t conform to ‘types’ and therefore interventions must be personalised to each individual profile.That said, it is possible to use COM-B to identify a person’s particular likelihood of continuing treatment, and develop interventions that use ‘behaviour change techniques’ or BCTs to help tackle barriers and support a target behaviour – in this case, treatment persistence. 

Of the 93 BCTs available to designers of interventions (often health psychologists, behaviourists or health coaches) here are some that are particularly relevant to addressing non-persistence:

  • Goal setting
  • Planning actions (i.e. when I will do the behaviour)
  • Anticipating barriers and planning how to overcome them 
  • Anticipating future outcomes
  • Anticipating future consequences
  • Self monitoring (of taking treatment / of benefits of treatment)
  • Monitoring & feedback 
  • Social support
  • Conserving mental resources
  • Discrepancy between current behaviour and goal
  • Comparison of outcomes via credible source 
  • Problem solving 

The key to success is ensuring the barrier and the BCT are matched to each person’s specific profile – a personalised approach. COM-B has been referenced in thousands of scientific papers, meaning natural health producers can rely on the weight of evidence and focus on adding personalised support to their brand proposition.

Taking personalisation to the people – via digital platforms.

Digital (and specifically mobile) technology has the smarts and scale to achieve the kind of person-centred health that can ensure personalisation to help improve the experience for someone taking a new natural health product and support them to continue treatment.

Digital platforms, like Pukeko Health Platform, can also manage all the other demands needed to deliver a personalised offering – such as the inclusion of a healthcare provider (a health coach or practitioner for instance), data privacy considerations and linking to other services – such as subscription fulfilment.

Creating meaningful and effective connections with natural health customers is not limited by technical capabilities.  Quite the opposite – it can unlock further value such as informing research and development, helping uncover the next person-centred product with data-driven insights. 

Leveraging digital platforms to deliver personalised treatment support enables science-led natural health companies to realise the full value of each unique consumer. The evidence-based frameworks that underpin behaviour change interventions, coupled with digital capability can help turn the persistence blindspot into virtuous sales growth. 

Pukeko Health Platform is a digital health platform that combines proven behaviour change frameworks with engaging content and powerful technology to support large-scale uptake and continuation of evidence-based natural health products.