Expensive branded cold and flu medicines may offer little advantage over cheaper alternatives, as many products contain similar active ingredients, according to pharmacy experts.
With flu season bringing sore throats, headaches, blocked noses and fever, many people turn to over-the-counter remedies. However, the higher price of a familiar brand does not necessarily mean it is more effective.
Professor Jayne Lawrence, head of the pharmacy division at the University of Manchester, says there is very little difference between many branded and cheaper medicines.
She says she would personally choose lower-cost alternatives, noting that these products have also undergone testing.
Similar Ingredients, Significant Price Differences
Cold and flu medicines generally fall into three categories:
Established brands such as Lemsip and Sudafed.
Supermarket and pharmacy own-brand alternatives.
Single-ingredient medicines containing paracetamol or ibuprofen.
The price differences can be substantial, even when products contain similar ingredients.
According to the comparison published in the report, a pack of 16 Lemsip All-In-One Max Strength tablets costs around £7.30, compared with approximately £2 for Tesco’s own-brand alternative.
Both contain 500mg of paracetamol, which helps relieve pain and reduce fever but does not treat the underlying infection.
Do the Additional Ingredients Work?
Many combination cold and flu remedies contain other ingredients designed to address specific symptoms.
Phenylephrine
This ingredient is used as a decongestant and is intended to reduce swelling in blood vessels inside the nose.
However, Professor Lawrence says there is limited evidence that oral phenylephrine effectively relieves nasal congestion because much of the medicine is broken down before reaching the bloodstream.
In 2024, the US drug regulator proposed removing oral phenylephrine from cold and flu medicines, citing concerns about its effectiveness. The proposal had not been finalised at the time of the report.
Guaifenesin
Some remedies also contain guaifenesin, which is intended to loosen mucus in the airways.
Evidence about its effectiveness remains mixed. Some studies report improvements in chest congestion, while others find little or no benefit.
A Reckitt spokesperson, whose company owns Lemsip and Nurofen, said the ingredients in its products are approved by regulators and formulated to address multiple symptoms, including fever, congestion and coughs.
Can Caffeine Make Painkillers More Effective?
Some maximum-strength cold and flu medicines contain up to 65mg of caffeine per tablet, roughly equivalent to a cup of instant coffee.
Caffeine acts as a mild stimulant, and research suggests it may enhance the effect of paracetamol and help it work slightly faster. However, the additional benefit is likely to be modest.
Many brands are also available as flavoured powders that dissolve in hot water. These products usually cost slightly more per dose than tablets.
A warm drink can provide soothing relief, and one study funded by a pharmaceutical company suggested that the medicine may enter the bloodstream more quickly in this form. However, it remains uncertain whether this produces a noticeable improvement in symptoms.
Why Do Branded Medicines Cost More?
The price of medicines is not determined by their ingredients alone.
A former manager at a major UK pharmacy chain said well-known brands and premium own-label products often receive prominent shelf positions, while cheaper alternatives are placed on lower shelves.
The former manager said customers frequently requested familiar brands even when they were informed that less expensive products contained similar ingredients.
The Proprietary Association of Great Britain (PAGB), which represents the consumer healthcare sector, argues that recognised brands help shoppers make choices and provide reassurance at a time when health misinformation is widespread.
The report highlights that consumers may be paying significantly more for familiar branding, even when cheaper products offer comparable active ingredients.