The New York Times reports that NeilMed Pharmaceuticals manufactures’ Sinus Rinse, “an over-the-counter nasal irrigation product that has relieved millions of sinusitis sufferers from throbbing headaches and the nose-clogging effects of seasonal sinus infections.” While “much has been written” about nasal irrigation and the importance of gravity, “with Sinus Rinse … gravity plays no part, and there is no need to tilt the head. Instead, the user fills the bottle with warm distilled water, mixes in a packet of isotonic sodium solution, and squirts the slightly salted water gently up one nostril until the solution drips out the other side.” The process is then repeated with the other nostril. NeilMed Pharmaceuticals also produces a neti pot, which is used by tilting the “head at a 90-degree angle and quite literally” pouring “water into the nostrils, letting gravity force the water up into the sinus cavity, and back again.” The Times notes that “both solutions appear to be effective.”
For wits ranging from primary-school science teachers to Madison Avenue advertising teams, the phrase “the nose knows” has long proved irresistible. It might also be used to describe the unusual path taken by Dr. Ketan Mehta, a pulmonary and critical-care physician in this Sonoma County city, to entrepreneurial success.
The soft-spoken Dr. Mehta and his wife, Nina, are the masterminds behind Sinus Rinse, an over-the-counter nasal irrigation product that has relieved millions of sinusitis sufferers from throbbing headaches and the nose-clogging effects of seasonal sinus infections.
Since 2000, their privately owned company, NeilMed Pharmaceuticals, has evolved from a pet project into a 250-employee player in Santa Rosa’s $1.5 billion medical technology sector and a leader in the $6 billion United States market for sinus treatments.
Much of this growth has come in the last two years. Although the Mehtas declined to disclose revenue figures, Dr. Mehta estimates NeilMed has tripled sales of Sinus Rinse and its other products during that time. The gains came as the company expanded from its regional base to sell its line of nasal-oriented wares nationally in supermarkets, drug store chains and big-box outlets like Wal-Mart and Costco, as well as in Europe, Australia, Canada and New Zealand.
“There is no huge secret to what we are doing here,” said Dr. Mehta, NeilMed’s founder and president. “It is a simple product and a lot of people can copy it; what sets us apart is the way we execute our plan.”
NeilMed, named after the Mehtas’ 15-year-old son, began in the 1990s as a side project to Dr. Mehta’s private practice. Dr. Mehta was suffering from sinusitis at the time, and after having sinus surgery in 1993, he set out to devise a product he could use to rinse his sinuses.
In his spare time, he experimented with various prototypes. Finally, in 1999, he invested $100,000 of his own money and developed a combination that worked.
What he came up with was a plastic squeeze bottle, a plastic straw and a screw-on plastic cap designed to fit against the opening of a nostril. He called it Sinus Rinse, applied for a patent and started production immediately.
Sales were slow at first — mostly direct transactions conducted personally by Mrs. Mehta, the company’s chief executive, with pharmacists in Northern California and the West. At the same time, the Mehtas generated interest in the product by hawking it at allergy conferences and sending samples to allergists and ear, nose and throat doctors across the country.
The strategy generated steadily rising revenues for Sinus Rinse. The company moved into a nondescript office and factory near the Charles M. Schulz Sonoma County Airport and turned its first profit in 2006. Then, in early 2005, Dr. Mehta decided to diversify the company’s product line and developed his own version of the neti pot, an age-old Indian yogic tradition for nasal irrigation.
That April, fortune struck.
On a segment of “The Oprah Winfrey Show,” Dr. Mehmet Oz, a regular guest, extolled the virtues of nasal irrigation, hailing neti pots as the answer to just about any sinus-related ailment. Across the country, demand for these miniature tea kettles soared. NeilMed was ready and cashed in, selling tens of thousands of neti pots in a matter of weeks.
“It is funny to think about, but really, without ever appearing on her show, we owe a lot to Oprah Winfrey,” said Dr. Mehta, who left India in 1981 to study medicine in the United States.
Mrs. Mehta agreed. “We were well known among doctors and pharmacists before that show,” she said, “but Oprah Winfrey introduced us to the masses.”
Much has been written in the scientific press about the benefits of “positive pressure” nasal irrigation over the kind of “negative pressure” nasal irrigation that neti pots provide. The difference revolves around gravity.
To use a neti pot, one tilts one’s head at a 90-degree angle and quite literally pours water into the nostrils, letting gravity force the water up into the sinus cavity and back again.
With Sinus Rinse, however, gravity plays no part and there is no need to tilt the head. Instead, the user fills the bottle with warm distilled water, mixes in a packet of isotonic sodium solution and squirts the slightly salted water gently up one nostril until the solution drips out the other side. Then she repeats it with the other nostril.
Both solutions appear to be effective. Last year, a study by researchers at the University of Michigan showed sinus patients who used a nasal rinse reported fewer symptoms than those who used over-the-counter sprays.
Dr. Mehta said NeilMed sales figures suggested that customers prefer the newer technique. He noted that Sinus Rinse represented about 65 percent of NeilMed’s sales, while the company’s neti pot products represented roughly 30 percent. The remaining 5 percent includes a variety of other products such as NasaMist, an isotonic saline spray, and NasoGel, a moisturizer.
Dr. Winston Vaughan, an ear, nose and throat specialist and co-director of the California Sinus Institute in Palo Alto, Calif., shares the medical community’s enthusiasm for NeilMed’s products. Unlike many others in his specialty, Dr. Vaughan said he was now likely to suggest in all but the worst cases that his sinusitis patients try nasal irrigation and some of these other remedies first, resorting to surgery only as a last resort.
These products “get the junk moving and decrease the amount of mucus that can potentially serve as a source of infection or blockage.” Dr. Vaughan said, adding that because the water-based solution in Sinus Rinse contains nothing more than isotonic saline, “it does not add any medication to a patient’s treatment regimen,” so there is no need to worry about how it interacts with medication.
These kinds of reviews have the Mehtas excited about the future; despite a sagging economy and a downward trend in consumer spending, Dr. Mehta said he expected growth to continue in the years ahead.
Still, the nasal irrigation market is rife with competing products, including SinuCleanse from Med-Systems in Madison, Wis.; Nasopure from BeWell Health in Columbia, Mo., and SinuPulse Elite, developed in Switzerland. Dozens of manufacturers offer neti pots, as well.
Anticipating expansion, Dr. Mehta is looking for a larger space in Santa Rosa to move his operation. In recent weeks, the Mehtas have also started considering the possibility of relocating the company to North Carolina, where the tax burden is lower.
One aspect of operations that is unlikely to change is NeilMed’s approach to business negotiations. Unlike most pharmaceutical companies, which hire brokers as liaisons with supermarkets, drug chains and big-box stores, Mrs. Mehta still handles these negotiations herself.
Though Mrs. Mehta acknowledged that she received e-mail messages and phone calls at all hours of the day and night, she said NeilMed customers had come to appreciate how hands-on and accessible she is — something larger medical technology companies simply can’t offer.