1Nutraceuticals: The Front Line of the Battle for Consumer Health

Winning the Battle for Consumer Healthcare

Nutraceuticals: The Front Line of the Battle for Consumer HealthNutrition products can be an inexpensive and safe solution to tackle important unmet health needs.

2Nutraceuticals: The Front Line of the Battle for Consumer Health

Consumer healthcare has become the battleground where pharmaceutical and consumer goods firms compete for growth. With more people around the world dying from obesity than starvation, poor nutrition is now recognized as a major risk factor for chronic diseases. Most health systems are ill-equipped to deal with this trend.1 Increasingly, patients are being encouraged to take part in their own treatments, and a consumer market has been developing midway between the supermarket-based world of consumer goods companies and the scientific, pharmacy-based world of pharmaceutical firms.2

Evidence suggests that targeted nutrition might stabilize or even cure disease. The front lines of this battle are nutritional products that have been proven to help prevent or cure disease. These “nutraceuticals” present a tantalizing opportunity for breakthroughs to prevent and manage common health problems, offering consumer-focused solutions to issues that are currently addressed only by pharmaceutical interventions—or not at all.3 However, despite being a hot spot for growth, they still suffer from the same challenges as the rest of the sector, with market growth barely keeping up with the rise in gross domestic product.4

In this paper, the third in our Winning the Battle for Consumer Healthcare series, we delve further into the nutraceuticals market to understand the opportunities and barriers to growth. We also look at the successes and challenges faced by both consumer goods and pharmaceutical companies as they struggle to gain the upper hand in this exciting new market.

Revival of a Very Old Story?The link between food and health was established long ago. Hippocrates once said, “Let food be thy medicine and medicine be thy food.” Traditional medicine in Europe, Asia, Africa, and pre-Columbian America is rife with examples of foods used to prevent and cure disease. Under the influence of rationalistic Western medicine, however, food has come to be viewed chiefly as a source of nutrition (that is, energy, protein, and fat) to the exclusion of other purposes. Yet as changing demographics accelerate the proliferation of chronic diseases, a growing body of evidence suggests that targeted nutrition using naturally occurring substances might be able to stabilize or even cure many of the most challenging health problems (see figure 1 on page 3).

Dictionaries aside, searching for an authoritative definition of nutraceuticals is an exercise in futility. No broadly accepted legal classification exists, and each market research organization seems to apply its own criteria. At one end of the spectrum are functional foods and beverages, as well as dietary supplements, aimed primarily at maintaining health.5 At the other, more

1 Source: “Global Burden of Disease Study 2010,” The Lancet 380, no. 9859 (2012): 2053–2260 2 For a deeper discussion, see the first paper in this series, Science Versus the Marketers in Consumer Healthcare, at www.atkearney.com.3 The term nutraceutical, a combination of the words nutrition and pharmaceutical, first appears in the literature in the 1980s. Merriam-

Webster defines it as “a foodstuff (such as a fortified food or a dietary supplement) that is held to provide health or medical benefits (such as the prevention or cure of disease) in addition to its basic nutritional value.”

4 See the second paper in this series, Mobilizing for Action in Consumer Healthcare, at www.atkearney.com.5 A functional food or beverage is one that has been fortified with added or concentrated ingredients to improve health or performance

or to obtain a desired result—and is marketed as such. A dietary supplement, as defined by the U.S. Food and Drug Administration, is a product taken by mouth that includes vitamins, minerals, herbs or other botanicals, amino acids, or substances such as enzymes, organ tissues, glandulars, and metabolites.

3Nutraceuticals: The Front Line of the Battle for Consumer Health

medical end of the spectrum are products aimed at people with special nutritional needs. In the middle is an emerging gray area of products that have a physiological effect to reduce known risk factors, such as high cholesterol, or appear to slow or prevent the progression of common diseases (see figure 2).

Figure 1Many naturally occurring substances show evidence of potential health benefits

Note: Inclusion in this figure does not imply that A.T. Kearney endorses the use or potential benefits of any of the substances listed.

Sources: Lipi Das, Eshani Bhaumik, Utpal Raychaudhuri, and Runu Chakraborty, “Role of Nutraceuticals in Human Health,” Journal of Food Science and Technology 49, no. 2 (2012): 173–183; O�ice of Dietary Supplements, National Institutes of Health; WebMD

Dietary fiber

Select foods containing the substance

Fruits, grains, legumes, vegetables

• Lipid control• Arterial hypertension• Glucose control

• Weight control• Intestinal motility

Prebiotics Chicory roots, bananas, tomatoes

• Lipid control• Gastrointestinal disorders

• Cancer

Probiotics(for example, lactobacilli, gram-positive cocci, bifidobacteria)

Many naturally fermented foods (kefir, unpasteurized sauerkraut, soft cheeses, pickled cucumbers)

• Gastrointestinal disorders• Allergies

• Asthma• Cancer• Infections

Antioxidant vitamins(vitamin C, vitamin E, carotenoids)

Citrus fruits, peppers, nuts, seeds, cantaloupe, carrots

• Degenerative disease

Polyunsaturated fats Fatty fishes • Cardiovascular disease• Asthma

• Mental health• Diabetes

Polyphenols Tea, dry legumes, berries • Microbial infection• Neurodegenerative disease

• Diabetes• Cancer• Cardiovascular disease

Areas with established or emerging evidence of benefit

Naturally occurring substances

Examples of naturally occurring nutraceuticals

Figure 2Nutraceuticals play in the continuum between food and pharmaceuticals

Source: A.T. Kearney analysis

People with common health problems

Food

Target group

• Cholesterol-lowering products

• Products to slow progression of diabetes, dementia, or age-related muscle loss

• Supermarkets• Pharmacies• Internet

Core nutraceuticals

Broad definition of nutraceuticalsMedical nutrition

Patients with special nutritional needs

• Specialized infant feeding formulas

• Nutrition solutions for the frail or chronically ill

• Other clinical nutrition products

• Pharmacies (often requiring some medical supervision)

Pharma-ceuticals

Functional foods and nutritional supplements

Healthy people seeking to preserve wellness

• Probiotic yogurts• Weight-loss bars• Isotonic sports drinks• Vitamin and mineral

supplements

• Supermarkets• Internet

Examples

Channels

Fn

PPc

4Nutraceuticals: The Front Line of the Battle for Consumer Health

Annual sales in the narrowly defined core nutraceuticals market are approximately $150 billion, or roughly one fifth the size of global pharmaceutical industry turnover. A broader definition that includes categories such as infant nutrition, food intolerance products, diabetes control, medical nutrition, and weight management solutions reveals a market size of about $420 billion with a projected growth rate of about 7 percent over the next few years (see figure 3).

Growth hampered by misunderstanding the role of nutrition

While 7 percent growth might seem attractive, it is actually quite modest given the category’s potential. The fundamental barrier to faster growth is consumers’ and health professionals’ poor understanding of nutrition’s impact on health.

On one hand, many consumers who could benefit from nutritional products are unmotivated to change their diets and lifestyles to become healthier. For example, nearly 70 percent of all European Union citizens view themselves as being in “good” or “very good” health, as do three out of four in the United Kingdom—where more than 30 percent have high blood pressure and 25 percent are obese.6 This leads to a situation where supplements tend to be bought by people who generally do not need them, but not by those at serious risk of chronic disease who might actually benefit.

On the other hand, most health professionals are not well-versed in how nutrition can help manage diseases. Throughout their careers, doctors might only receive a few hours of training

Pharmaceuticals

Bakery products

Sports nutrition supplements

Nutricosmetics

Soft drinks

Core nutraceuticals (except nutricosmetics)

Cosmeceuticals

Medical nutrition

Infant nutritrition

Traditional Chinese medicine

Food allergy and intolerance products

Weight management products

Diabetes nutrition

Figure 3Nutraceutical sales are large and growing

Note: Bubble area represents projected market size in 2015.

Sources: Frost & Sullivan, World Health Organization, Kalorama Information, Infiniti Research, Transparency Market Research, Bourne Partners, Global Industry Analysts, Government of Canada, MarketsandMarkets, BCC Research, GBI Research; A.T. Kearney analysis

Nutraceutical market size and projected growth

Core nutraceuticals

Noncore nutraceuticals

Partially related products

Unrelated products

300

400

500

600

700

900

800

100

200

0−2 0 2 4 6 8 10 12 14 16 18 20 22 24

Estimated global market size ($ billion, 2012)

Projected annual market growth(% CAGR, 2012–2015e)

6 High blood pressure estimates refer to England only. Sources: Eurostat, Self-perceived health by sex, age, and labour status (object name hlth_silc_01; accessed 30 January 2014) for age groups 16+ years old, 2012 data; East of England Public Health Observatory, Modelled estimate of prevalence of hypertension in England, December 2011; OECD Health Statistics 2013 (accessed 30 January 2014)

5Nutraceuticals: The Front Line of the Battle for Consumer Health

on the role of nutrition, and they are often skeptical about its effectiveness as alternatives or adjuncts to pharmaceuticals. The same is true of those who care for the elderly, who are rarely aware of the role that appropriate nutrition can play in maintaining physical and mental health. Making matters worse is the fact that the evidence base is relatively weak, as the medical nutrition industry has been slow to recognize the importance of fact-based claims and struggles to fund the large-scale clinical trials typical of the pharmaceutical industry.

A solid regulatory framework is crucial for medical credibility, as it ensures high-quality products that can be relied on to do what they say they do.Another factor hampering growth is the need to combine appropriate nutritional solutions with broader behavioral change. For example, there are several nutritional solutions for type 2 diabetes, but they are ineffective without reducing caloric intake and exercising to build skeletal muscle. Some nutraceuticals can prevent or slow the progression of dementia, but social inter- action, exercise, and brain training are also important. Understanding how these behavioral changes interact with nutritional solutions is an emerging field that companies need to under-stand and rigorously document if they are to be taken seriously.

A final challenge is pricing. While nutraceuticals are generally far less expensive than innovative medicines, they are difficult to justify compared to generic drugs that often cost less than $1 per day and can provide effective control for many conditions.

A fragmented and ill-suited regulatory environment

The regulatory status of a product has a huge impact on its potential success. Where consumer self-pay and reimbursed markets exist side by side, the reimbursed market is invariably far more attractive in size and margin. In many countries, a product’s eligibility for reimbursement depends on its regulatory status, which also determines how it can be described, promoted, and distributed.

Additionally, a solid regulatory framework is crucial for medical credibility, as it ensures high-quality products that can be relied on to do what they say they do. There have been a number of product recalls resulting from the use of unapproved drug ingredients, especially in categories such as bodybuilding and weight management. At the same time, little attention has been given to creating a regulatory environment that can foster innovation.

Today, each of the major markets for pharmaceuticals has its own approach to regulation. In the United States, the Food and Drug Administration treats nutraceuticals as dietary supplements, focusing mainly on patient safety. China has separate processes to register functional foods and to import products, and the general regulatory climate is becoming more difficult for new entrants. There is no consistency at all across Latin America in either classification or approach, as some countries regulate nutraceuticals as foods and others as drugs. However, Brazil’s somewhat bureaucratic approach to registration of health claims could emerge as a standard. In India, regulations are still being developed.

6Nutraceuticals: The Front Line of the Battle for Consumer Health

Probably the best-developed market for regulation is Europe, where the European Food Safety Authority (EFSA) has created a positive list of permitted health claims based on individual ingredients. This has enabled European companies to build a good reputation for quality and should provide the best environment for innovation. Japan’s approach is similar but less well-developed, with very few claims allowed.

However, even in Europe the regulatory environment has not really kept up with technology.

Foods for Special Medical Purposes (FSMP) are only for patients who have specific, disease-related nutritional limitations, thus excluding foods with curative or preventive impact. EFSA-permitted food claims are limited to individual ingredients rather than combinations of ingredients. In a bizarre regulatory catch-22, any food that has a clinical effect is no longer a food and becomes a drug instead. This has led to a set of regulatory requirements that are impractical—and possibly irrelevant—for nutritional products. As consumer items, they need to include variation in flavor, consistency, and presentation, without excessive bureaucracy of re-registration. And pharma-ceutical-quality manufacturing requirements make them too costly to produce.

Pharmaceutical majors tend to concentrate on the less scientifically oriented end of the nutraceuticals spectrum.Good examples of products that have suffered from these limitations are Souvenaid® to treat Alzheimer’s disease or Vitaflo® for treating rare metabolic disorders.7 As a result of regulatory difficulties, products that are relatively cheap and effective are only reaching a fraction of the people they could help.

As long as these regulatory barriers remain, the sector’s growth will be limited. While it is certainly in the interests of regulators to get to grips with this new health field, the industry must also be far more vocal to bring about a positive regulatory environment.

Consumer Goods Already Ahead of the GameNutraceuticals, while providing some of the health benefits of pharmaceuticals, are significantly less expensive to develop and easier to distribute, making them attractive not only to food companies but also to pharmaceutical and biotechnology firms. For the former, nutraceuticals offer a chance to break into science-driven, higher-margin products where retailers’ private labels find it difficult to compete. For the latter, nutraceuticals are a revenue stream to offset lost sales as drug patents expire and new blockbusters fail to materialize.

For now, food companies are clearly in the lead in this market, accounting for about 90 percent of nutraceutical sales. They start with an inherent advantage in branding, consumer market expertise, and access to mass distribution channels, as these areas are crucial to success in their core business.

7 Souvenaid is a registered trademark of Nutricia, and Vitaflo is a registered trademark of Nestlé Health Science. All trademarks cited throughout this document remain property of their respective holders and are used for descriptive purposes only.

7Nutraceuticals: The Front Line of the Battle for Consumer Health

However, consumer goods companies face some significant longer-term challenges. They are generally weaker than pharmaceutical firms in the fields of scientific innovation, regulatory affairs, and medical market insight, and most would be shocked at the cost of creating robust clinical evidence to support claims. Consumer companies also typically find it difficult to manage medicinal product channels such as pharmacies and often lack experience convincing health professionals about the medical benefits of their products.

For many companies, the approach has been to gradually expand into adjacent areas. For example, corporations such as Coca-Cola and PepsiCo have been buying up players that specialize in functional beverages. However, those aiming to play big in the sector recognize that a consumer health company is quite different from either a consumer or a pharmaceutical company. They have created new divisions, often populated with people from pharmaceuticals and healthcare. A good example is Nestlé Health Science, created in 2011 to research and market personalized nutrition solutions that take into account an individual’s genetic and metabolic makeup. Another example is Nestlé archrival Danone. Its Nutricia Advanced Medical Nutrition subsidiary is now Europe’s leading medical nutrition company.

A few consumer companies have sought to form partnerships with pharmaceutical companies. Coca-Cola and Sanofi have teamed up to sell health drinks at French pharmacies. Sold under the Beautific® Oenobiol® brand to help strengthen hair and nails, improve skin, lose weight, and increase vitality, the product line—formulated by Coca-Cola and distributed by Sanofi—is a pilot to test demand for beverages with beauty claims. Another example is Innéov, a joint venture of Nestlé and L’Oréal focusing on nutritional concentrates for skin and hair (see sidebar: Beauty from Within). A further example is the joint venture between Procter & Gamble and Teva, PGT Healthcare, combining development and commercialization skills of the parent companies in the market for over-the-counter (OTC) medicines, vitamins, supplements, and other consumer healthcare products in all markets outside North America. Whether joint ventures between companies with such different cultures and operating models will ultimately be successful is yet to be seen.

Suppliers to consumer goods and pharmaceutical companies are also starting to get in on the game. For example, specialized ingredient manufacturer DSM has a portfolio of own-brand ingredients to support weight management and reduce the impact of cardiovascular diseases, and they are increasingly competing for deals to acquire nutraceutical assets.

Beauty from Within

Beauty from the inside out: This is the ambition of nutricos-metics, nutritional supplements that support the function and structure of skin, hair, and nails. With a global market of about $2.4 billion, the business is well-established in Asia and is gaining traction in Europe and North America, building on the premise that lifestyle can have a deep impact on the aging process.

A leading European player is Laboratoires Innéov, a 50/50 joint venture between Nestlé and L’Oréal that leverages the companies’ expertise in nutrition and skin and hair biology. Innéov provides a range of concentrated nutritional supplements to meet beauty needs, such as strength and volume for hair, skin prepared for the sun, and anti-aging skin care. Products are evaluated by dermatologists

and distributed through pharm- acies, where pharmacists can advise and educate consumers about nutritional supplements, their use, and the way they work in the body. Intense research about innovative active ingre-dients and clinical trials provide the scientific backup to the products’ claimed efficacy.

8Nutraceuticals: The Front Line of the Battle for Consumer Health

Pharmaceutical Companies: In Search of Direction?In contrast to the food industry, the pharmaceutical sector has approached nutraceuticals with a great deal of ambivalence. Pfizer and Novartis have sold their nutrition businesses, while the same Pfizer that sold Wyeth Nutrition to Nestlé invested an undisclosed sum to acquire Danish vitamins company Ferrosan and the U.S. dietary supplements maker Alacer, reinforcing what was already a billion-dollar line of business. Most other consumer arms of pharmaceutical companies are focused on OTC, though both Sanofi and GlaxoSmithKline have recently invested in mineral supplements businesses that could become a stepping-stone into medical foods.

With the notable exception of Abbott, which has a deep offer of products in pediatric, adult, and therapeutic nutrition, pharmaceutical majors playing in the space tend to concentrate their efforts on the less scientifically oriented end of the spectrum, around functional foods, dietary supplements, and sports nutrition. This creates a paradox, with pharmaceutical companies providing more lifestyle products and consumer goods companies more medicalized ones, leading both sets of players to work in areas where they are most competitively disadvantaged.

Nutraceuticals, when optimally balanced, can boost pharmaceuticals’ effects.The main explanation for this paradox, we believe, lies in what the two parties are seeking to achieve. While specialized nutrition plays much better to pharmaceutical firms’ core strengths and promises higher margins, its volume (around $40 billion) pales in comparison to the more consumer-oriented end of the nutraceuticals spectrum, which appeals to pharmaceutical firms looking for large revenues to replace billion-dollar blockbusters going off patent. However, consumer goods companies are keen to build their medical credentials and capabilities, with the aspiration to eventually achieve the higher margins available from “healthy” products across their consumer portfolio. As a result, they are happier to work with niche products typical of medical nutrition.

In the future, stricter regulations that raise the bar in terms of scientific data, resources, and time needed to prove health claims for all types of nutraceuticals should allow pharmaceutical firms to regain the advantage. Indeed, U.S. authorities have filed complaints against several food companies that have made unsubstantiated health claims, and since the introduction of new EU Nutrition and Health Claims Regulations, few functional and disease-risk reduction claims have been approved. However, pharmaceutical firms cannot merely wait for the regulatory tide to turn in their favor, as consumer companies are rapidly acquiring the capabilities to respond to these changes.

Breakthroughs in functional medicine suggest a number of opportunities for pharmaceutical companies. Functional medicine focuses on uncovering the underlying imbalances at the basis of the disease process (rather than on merely providing symptomatic relief) and rely on molecular nutrition for patient-specific solutions. Nutraceuticals can influence how a drug is metabolized and how the body acts on the drug. When optimally balanced, they can boost pharmaceuticals’ effects, thus opening a huge business opportunity through patented combinations of nutra-ceuticals and pharmaceuticals.

9Nutraceuticals: The Front Line of the Battle for Consumer Health

Pharmaceutical companies, then, should think of nutraceuticals as another tool and “delivery platform” in their arsenal to address health challenges. But it will require a new way of innovating, adopting a broad view of the management of mild to severe clinical conditions—from prevention to treatment—with a focus on offering consumers a credible alternative or complement to medication (see figure 4).

Winning the Battle for NutraceuticalsEvidence-based nutraceuticals sit at the center of the battle for consumer health, as they are both medicines and foods. They must address unmet needs along the patient pathway, while also appealing to consumers as something they want to buy.

One of the most important considerations is channel strategy. The current regulatory environment forces companies to decide early whether a product will thrive more effectively as a consumer-driven or a professionally driven proposition. At heart is the nature of the claim. A hard medical claim will drive the product down a professional route, requiring a professional evidence-based sales approach, coupled with reimbursement and insurance coverage, to be successful. However, such a positioning forbids direct patient marketing in most markets. A softer consumer claim could open up the consumer mass market, but reduces the credibility of the product among health professionals.

Regardless of the channel strategy, consumer goods and pharmaceuticals players will need to both draw on their own strengths and borrow heavily from the other industry’s capabilities.

Consumer goods companies already know how to create brand equity and reach the mass market. They will need to apply that know-how to nutraceuticals, using category approaches to make their products appealing to consumers and building product franchises that maximize consumer access and availability.

Figure 4Nutraceuticals will blur the lines between consumer goods and pharmaceuticals

Source: A.T. Kearney analysis

Healthy At risk

Consumer goods

Pharmaceuticals

Aware Undergoing assessment

Diagnosed and stable

Facingdeterioration or complications

Expanding scope along the consumer-to-patient pathway

Tomorrow?

Today

2

1

Pharmaceutical companies develop new delivery platforms to o�er consumer-focused nutraceuticals to address nascent health problems.

Consumer goods companies market nutraceuticals to prevent or control lifestyle-related diseases.

10Nutraceuticals: The Front Line of the Battle for Consumer Health

At the same time, there are several lessons to be learned from the pharmaceutical industry:

• Think big. Billion-dollar single stock-keeping units are not unusual in the pharmaceutical sector. Commit to the investments required to win on the big stage.

• Realize that science matters. Build robust evidence for clinical efficacy and cost-effectiveness, and develop proof points for nutritional products used in combination with pharmaceutical and behavioral therapies.

• Build capability in market access and in influencing government and health-system policies to reshape perceptions of nutraceuticals as valuable tools to address unmet health needs and provide alternative treatment options.

• Establish strong relationships with doctors and pharmacists to convince them of the value of nutraceuticals, either as reimbursed or consumer-paid products. Recognize that even in this digital age, professionals still expect a face-to-face sell.

• Structure to operate in disparate regulatory environments while maintaining a common scientific approach.

Pharmaceutical companies bring to the table a deep understanding of treatment pathways, which will serve them well to position medical nutrition therapy as a means to improve overall outcomes. Moreover, existing relationships with doctors and pharmacists mean communication lines are open to begin persuading them to endorse and use nutraceuticals. And the same health economics capabilities that are applied to support the pharmaceuticals registration process can be used to create compelling arguments for nutraceuticals based on a comparative analysis of clinical cost-effectiveness.

An innovative, growing nutraceuticals sector would serve governments’ interests.Still, pharmaceutical companies can take many pages from the consumer goods playbook:

• Adopt a consumer-centric view of health needs to produce products that are appealing to consumers in their own right.

• Understand how to unlock consumer behavior. Align with people’s aspirations for the future, not just their concerns over ill health. This means seeing consumers as individuals rather than “health states” to be addressed.

• Take a broader view of innovation to include packaging, presentation, and variants to improve attractiveness.

• Use multiple routes to reach consumers, including mass market and online channels.

• Build categories that can retain and generate value long after patents have expired.

However, there is a bigger battle to be won by the industry as a whole: to get nutrition recognized by both consumers and health professionals as a core component of preventing and treating disease and living longer, healthier lives.

The pharmaceutical industry, through organizations such as the Pharmaceutical Research and Manufacturers of America (PhRMA) and the European Federation of Pharmaceutical Industries

11Nutraceuticals: The Front Line of the Battle for Consumer Health

and Associations (EFPIA), builds dialogue with governments and regulators and seeks to educate health professionals and consumers. Firms with an interest in nutraceuticals would be wise to join forces to develop a strong policy agenda that could help the overall market develop effectively (see figure 5). It is in governments’ interests that the sector innovate and grow, as it offers real opportunities to address many health needs that are begging for a solution.

Nutraceuticals are one of the most exciting areas of health innovation, offering an inexpensive, safe, and effective answer for some of today’s most challenging health problems. However, individual companies, industry, health professionals, and government all need to adapt if these new solutions are to achieve their full potential.

Figure 5Policy agenda for nutraceuticals

Source: A.T. Kearney

Address regulation • Recognize a new class of nutrition-based products that, either alone or in combination with drugs, can have a therapeutic e�ect

• Allow combination products—not just individual ingredients—to be assessed for e�ect• Harmonize regulations internationally (for example, building on European approach)

• Develop new standards of evidence to better understand the e�ectiveness of nutritional solutions in large, diverse groups (alone and in combination with other therapies)

• Convince payers, governments, and public health authorities that nutritional solutions are an inexpensive and safe means to tackle important unmet health needs

• Shape consumer attitudes to recognize nutritional solutions as a way to prevent and manage disease and prolong a healthy life

• Educate health professionals in the use of nutrition for disease prevention and management to make them:

— More receptive to recommending consumer-based solutions — Less likely to immediately resort to drugs — More likely to use nutrition as an adjunct to other therapies

Develop robust evidence

Persuade health professionals

Convince consumers

Engage authorities

Action list

Authors

Jonathan Anscombe, partner, London jonathan.anscombe@atkearney.com

Markus Stricker, partner, Zurich markus.stricker@atkearney.com

Antonella Leone-Kammler, consultant, Zurich antonella.leone-kammler@atkearney.com

Michael Thomas, partner, London michael.thomas@atkearney.com

Emmanuel Hembert, principal, Zurich emmanuel.hembert@atkearney.com

A.T. Kearney is a global team of forward-thinking partners that delivers immediate impact and growing advantage for its clients. We are passionate problem solvers who excel in collaborating across borders to co-create and realize elegantly simple, practical, and sustainable results. Since 1926, we have been trusted advisors on the most mission-critical issues to the world’s leading organizations across all major industries and service sectors. A.T. Kearney has 58 offices located in major business centers across 40 countries.

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