Why traditional brand-building is no longer enough in the OTC market—and what matters now

The rules of the game in the consumer healthcare market are undergoing a fundamental shift. Brands that want to remain visible today must optimize their presence where consumers are actually looking—and that is increasingly in AI-powered systems. Our BrandTelligence approach shows how this can be achieved.

The current growth model is reaching its limits

For decades, the formula for success in the OTC market followed a simple pattern: gradually raise prices, launch product extensions, and invest in TV campaigns. But this model is coming under pressure. In the German market, prices are rising by about five percent, while sales volume is declining—the overall market is actually shrinking. Added to this is growing pressure from private labels and budget brands: When a generic drug for €9.95 contains exactly the same active ingredient as the brand-name product for €35, the price-conscious consumer thinks very carefully before making a purchase.

That alone would be challenge enough. But three developments are further accelerating the shift.

Three forces that are transforming the market

The channel is shifting. E-commerce is growing, Amazon is gaining prominence, and online pharmacies are becoming a major distribution channel. Online is no longer just a secondary channel—for some product categories, the online share is already 35 to 40 percent.

Consumers are making different choices. It’s no longer just about Brand A or Brand B. Consumers are looking for experience and results. They don’t just want to treat symptoms; they want to live better. The experience surrounding the product is becoming a differentiator—and that can go far beyond the pill itself: combined with health data from wearables like Garmin or Apple Watch, personalized recommendations can be provided that completely transform the perceived value of an identical product.

AI is fundamentally changing discoverability. And this is perhaps the most important point: the way people search for health products is rapidly shifting from traditional search engines to AI-powered systems. According to an analysis of 21.9 million search queries by Conductor, Google AI Overviews now appear in over 25% of all Google searches—up from 13% in March 2025. ChatGPT is now used by 810 million people daily, while Google AI Overviews reach 1.5 billion users monthly. Gartner predicts that by 2028, half of all online searches will be conducted via an AI assistant—and that traditional search volume will already drop by 25% by 2026.

The consequence is dramatic: Around 93% of AI search sessions end without the user visiting a website. The AI provides the answer—and the click to the brand’s website never happens. Anyone not mentioned in that answer simply does not exist for the searcher.

The uncomfortable truth: AI doesn't create a brand experience

This is the key difference from everything brand managers have learned so far: An AI has no shopper-brand experience. It doesn’t recognize brand loyalty built on 20 years of TV advertising. It only finds what’s available as structured, relevant content—and makes recommendations based on that.

This poses a huge risk for established brands that rely on their heritage. At the same time, it’s a huge opportunity for smaller players: With good GEO (Generative Engine Optimization), an agile provider can outpace significantly larger competitors in AI visibility—because market share in AI search isn’t based on the advertising budgets of the past decades, but on who delivers the better content. Research findings from Princeton University confirm: Content featuring statistics, citations, and structured data achieves 30–40% greater visibility in AI responses.

Market figures show just how big this trend is becoming: The GEO market is currently valued at $848 million and is projected to grow to $33.7 billion by 2034—an annual growth rate of over 50%. Already today, 54% of U.S. marketers plan to implement GEO within the next three to six months.

And when the next step arrives—Agentic Commerce, where AI agents make purchasing decisions independently—brand-building alone will be even less sufficient. Google has already created the ability to shop directly from AI mode with the Universal Checkout Protocol. McKinsey estimates that by 2030, AI agents could facilitate consumer transactions worth $3 to $5 trillion. What does not exist as relevant content simply does not exist for AI.

From SEO to BrandTelligence: A Holistic Approach

There are many terms circulating in the industry—SEO, AEO, GEO. At its core, however, it always comes down to the same thing: content that is relevant, precise, and presented in the right format. At OTC-Cube, we call our approach BrandTelligence because it goes beyond traditional SEO and encompasses a brand’s entire digital visibility.

We like to compare this to cooking: A good chef needs the right utensils, high-quality ingredients, and the right spices. That’s exactly how we work: We combine the best tools—Google, Gemini, Bing AI, Perplexity—with a solid data foundation from search engines, competitive analyses, and user queries. Depending on the objective, we optimize content either for visibility or for specific conversions.

Specifically, this means: We analyze a brand’s entire e-journey—from discoverability in Google and AI search systems to visibility in e-pharmacy, product content, purchase, and conversion. To get the full picture, we also align offline activities such as advertising campaigns. All these data sources feed into a comprehensive analysis that reveals where the specific levers lie.

Why a one-time optimization isn't enough

A key lesson from our work: AI visibility is not static. Recent data from Superlines, which analyzed 34,234 AI responses across 10 platforms, clearly demonstrates this: Within just five weeks, a brand can lose around 36% of its AI visibility—including citations, brand visibility, and share of voice. Furthermore: About 70% of AI overview content changes for the same search query, and with every update, nearly half of the cited sources are replaced. Anyone who treats BrandTelligence as a one-time project—optimize once and then forget about it—will be back where they started after just a few weeks.

Particularly important: The differences between AI platforms are enormous. The same brand can have a citation rate of 27% on Grok and less than 1% on ChatGPT—a difference of over 600x. Without monitoring across all relevant platforms, you’re missing the full picture.

That’s why we monitor the results continuously: weekly monitoring, automated alerts for changes—such as when GEO visibility drops, a competitor becomes significantly cheaper, or a product is no longer available. This allows brand managers to react immediately, rather than finding out weeks later through a chain of agencies.

This is precisely where a structural problem lies for many companies: The customer identifies an issue, approaches their marketing manager, who contacts their agency, which in turn commissions a service provider for optimization. This four-step process is simply too slow for a world where visibility changes on a weekly basis.

Establish clear responsibilities

Companies that take their digital visibility in AI search seriously need clear internal responsibilities. GEO optimization cannot simply be delegated to an external agency and forgotten—the results change too quickly for that. There needs to be someone within the company who manages this area, analyzes the data, and can respond within days, not months, when necessary. BrandTelligence must be embedded as an ongoing process within the company—with regular monitoring, defined escalation procedures, and the ability to act quickly.

This also includes a technical component that many overlook: AI crawlers must be able to read your content. The number of active AI bots has doubled since August 2023, and they now account for around 25% of all web requests. Anyone who protects their website with aggressive bot blocking is shooting themselves in the foot: if the AI can’t read the content, it won’t recommend the brand either. 86% of all AI citations come from brand-driven sources such as the brand’s own website. Your own content is therefore the most important lever—but only if it is accessible to AI systems.

Scalable across Europe – relevant locally

A key advantage of BrandTelligence: The approach works across languages in every European market. Headquarters can centrally manage the analysis for all countries and receive alerts in English, while local teams work in their respective languages and can make adjustments directly. This makes BrandTelligence particularly valuable for international CHC companies operating in multiple markets simultaneously.

The data also confirms the relevance of this multi-market approach: According to Superlines analyses, AI visibility varies by a factor of 2.8x depending on geography—the US citation rate is over 10%, while in other markets it is sometimes significantly lower. Those who focus on just one market miss the big picture.

Bottom line: Get started now, before you lose your head start

The shift toward AI-powered search is not a future scenario—it’s happening right now. AI referral traffic already accounts for over 1% of total website traffic and is growing by about 1% each month. The quality of this traffic is remarkable: according to Semrush data, visitors from AI search convert 4.4 times better on average than traditional organic visitors. Those who invest early in in the systematic optimization of their digital visibility gain a head start that becomes harder to catch up with every month. Those who wait risk losing brand positioning built up over years in just a few weeks.

BrandTelligence is not a sprint, but a marathon. But those who start now have a clear advantage—and achieve their goals faster and more sustainably.