How Comfizz Took Off on Amazon Without Running Ads | EP. #248

Lorraine Alikhanizadeh 00:03
We've got a sort of four-year plan with everything that we want to achieve. We've costed it all out, and we've got a sort of staff hierarchy of who we're going to need to hire to be able to get there.

Narrator 00:14
Welcome to the E-comm Show podcast. I am your host Andrew Maff, owner and founder of Bluetuskr. From groundbreaking industry updates to success stories and strategies, get to know the ins and outs of the e-commerce industry from top leaders in the space. Let's get into it!

Andrew Maff 00:29
Hello, everyone, and welcome to another episode of the E-comm Show. As usual, I am your host Andrew Maff, and today I am joined by the amazing Lorraine, who is the co-founder over at Comfizz. Lorraine, how are you doing? Are you ready for a good show?

Lorraine Alikhanizadeh 00:41
I am absolutely ready. Yes, thank you. Thanks for having me.

Andrew Maff 00:45
Yeah, I am super excited to have you on the show. It was probably a year ago or so that we had someone on the show with, you know, a product line that was very much catered toward apparel. The brand definitely had a medical side of things, and it's very interesting. It's a completely untapped market. It's very helpful. It's also just very cool. So I'm super excited to learn more about you. I always like to start these off pretty stereotypically and just give you the floor. So tell us a little bit about yourself, your background, and how you got started with Comfizz.

Lorraine Alikhanizadeh 01:22
Yeah, sure. Well, it was an accidental business. My background...

Andrew Maff 01:27
Those are good ones.

Lorraine Alikhanizadeh 01:28
Yeah, my background is in science. I studied physiology and biochemistry. I didn't really go into that field. I was more of a full-time mum, while my husband had a small business sourcing high-performance sportswear. Then my dad, who had struggled for 20 years with ulcerative colitis, an inflammatory bowel disease, was told it would eventually probably end in him having surgery to remove the affected bowel and leave him with an ostomy bag to collect waste. He was obviously not keen on that, but that day came, and when it did, after his surgery, he went from being a very proud, outgoing, sociable man to someone who had really lost his confidence. He withdrew and was very self-conscious of the ostomy bag. He kept holding it because of the weight of it dragging. He thought people could see it. So, as I alluded to, my husband was already in sourcing high-performance sportswear. Bear in mind this was 20-odd years ago, so it was the era when the body armor base layer market was beginning to— So he had access to those fibers and fabrics and technology. We just thought, well, let's make some underpants that are high-waisted to go over the stoma site and make them seamless so that they can have some compression and hold the weight of the bag at the front without digging in and being uncomfortable. Very simple concept. It was only meant for my dad.

Lorraine Alikhanizadeh 01:49
So with that, we came up with a design, asked the factory to make half a dozen pairs, and he was completely transformed. It sounds ridiculous; it's just an undergarment. But he said he actually started to forget that he had an ostomy because he couldn't feel it. It flattened the bulge, so he felt like people couldn't see it. Anyway, long story. He had his outpatient appointment with his nurse, who saw his garments. At the time, there was nothing. There were no ostomy support garments. The only thing that existed in the market at the time was a very heavy girdle-type belt, and that was for people who had developed a hernia. So there was no everyday solution for people with ostomies. We accidentally stumbled across it. She asked us if we would make some samples and go to some support group meetings, which we gladly did, and it just grew and grew. The more we talked to other patients, the more we recognized a need for a different style of product. And then we recognized that people's circumstances are different. Some people are sedentary. Some are going back to a manual job. Some want to get back to sports and the gym. So the level of compression needed varied. We developed the products and introduced a tiered, level 1-2-3 system of compression, which again did not exist in the market. It's very, very niche, but there is now a small selection of competitors who have developed similar products, and they're calling them level one, level two, level three. Well, that's cool. It's fine, as long as as many patients as possible get the choice of garment that suits them. I'm happy.

Andrew Maff 05:14
Yeah.

Lorraine Alikhanizadeh 05:15
So that's how it all began. Yeah.

Andrew Maff 05:17
Yeah. Hey, look, it's always a good thing when you start getting competitors coming out. Obviously, it's not a great thing, but it's also nice to know that you basically created something so awesome that so many other people wanted to start doing it too. I'm actually pretty close to this. My wife also has ulcerative colitis, so we've had these discussions in the past. Luckily, hers is in a pretty good spot. But when I saw this, I was like, "Oh, this is genius!" So, obviously, you had the big benefit of being able to source pretty easily, which I wouldn't even know where to begin doing. So that's great. How did you start getting it off the ground? What was the approach in terms of letting the market know that this product line existed?

Lorraine Alikhanizadeh 06:07
Well, literally, to begin with, we didn't have a website. We just spoke to nurses, and they invited us to exhibitions and open days and, you know, support groups. We realized slowly that it was going to be something that could be a business, so we got a little website built. This wasn't really an ecomm website; it was more of a magazine page to let people know. And yeah, that was the start of it. I'm trying to think. We do now have some distributors in the ostomy market who sell and provide the bags and accessories, but not support wear. They've approached us for a range of support wear, so we've got some international distributors. What I didn't say as well is that gradually we got the garments accepted into the NHS supply chain.

Andrew Maff 07:07
Okay.

Lorraine Alikhanizadeh 07:08
So in England, if you've got an ostomy, your prescriptions are free of charge, so people can get up to six garments a year on prescription. That's quite an easy sell because they don't have to put their hands in their pockets. They just get them from their doctor. We've now got a base in Germany because after Brexit, the shipping became a nightmare. With all the taxes and everything, it became very expensive. So we set up a base in Germany, and we're trying to get the products onto the German health service so that it becomes more widely available for the German market. But in terms of European customers, they can get their products shipped from within Europe, so it's a bit easier. So we've got that bit going. Yeah.

Andrew Maff 08:00
Nice. Have you started to venture into anything in North America, the States, Canada, Mexico, anything out here?

Lorraine Alikhanizadeh 08:07
We are now on Amazon.

Andrew Maff 08:10
Okay.

Lorraine Alikhanizadeh 08:10
We started that quite ignorantly, not understanding Amazon and the minefield that Amazon is.

Andrew Maff 08:17
Yeah.

Lorraine Alikhanizadeh 08:18
We did it, and this was mainly just the UK. We listed products, and they just sat there, selling a few. We decided that there was potential in that, and we got an external consultant who knows more about Amazon to clean up our listings. We're brand registered, so we've got some A+ listings, and it's just blown it out of the park. It's going crazy. It's really exciting because we're just in the UK, and we can't believe how many we're selling. We're doing it through Amazon now. We're not fulfilling, although we've got our own warehouse. We're not fulfilling the orders ourselves, because as soon as we switch to FBA, it changes the game. So once we've got all the listings cleaned up and everything sorted with the taxes and everything legal, we're going to switch on pan-European. And then, you asked the question about America. We're going to list on Amazon.com. We have an account ready to go. We just want to get everything clean and working in the UK, and then we'll expand it out. So I'm expecting big things.

Andrew Maff 09:31
Oh yeah, I mean, look, if you saw those types of results in the UK... I know a lot of brands in the States. I want to say the UK is anywhere between 10 and maybe 30% at most of their sales compared to what they're getting in the States. I mean, it's obviously a significantly larger population, so that's going to happen. But that's awesome.

Lorraine Alikhanizadeh 09:58
Actually, we're not doing any ads yet on Amazon.

Andrew Maff 10:02
Oh, really? You have it all organic right now, which just means that there's that much search volume and those little competitors, which is fantastic.

Lorraine Alikhanizadeh 10:09
Yeah, yeah. I'm surprised how much search volume and demand there is because it's so niche. But there's also obviously less competition, so I'm excited about that avenue going forward.

Andrew Maff 10:22
Oh yeah, I mean, look, the best products are always the ones that solve a problem that people are actively looking for, and there just isn't anything that exists. And this is obviously one of those products, which is great. How are you handling all the growth operationally? I assume you've been able to source pretty fine, for the most part at least.

Lorraine Alikhanizadeh 10:41
Yeah, yeah. We don't manufacture ourselves. We design everything in-house, and then we have it manufactured across two factories in Europe. But we're always keeping our fingers in a few other manufacturers to cover our bases, basically. Their capacity way, way exceeds what we need, so we're good there. Yeah.

Andrew Maff 11:03
Good. And so you've expanded the product line. It's more than just underwear. You've got a whole list of stuff. Can you tell me a little bit about how you expanded into that and what the thought process was there?

Lorraine Alikhanizadeh 11:18
Yeah, I mean, it basically started with, like I said, the boxer shorts for my dad, and we made a unisex boxer that ladies and men could wear, and it was high-waisted. But for some people of a certain stature, it was too high-waisted, so we did a standard waist, and then we introduced a brief version for ladies only. And actually, when we were exhibiting at an open day, we had a mannequin on a tabletop, and it was a female form. So we put a little boob tube across the top, nothing to do with ostomies, but people started going, "Oh, that would be perfect to go around the middle over my stoma, and I could wear this with it, and I could wear that with it." And I'm like, "Oh yeah." So we then created the waistband, and we do it in multiple colors. We do it in multiple depths for different people, and now we do it in light level one support and medium level two support, just by talking to patients, by being out there talking to nurses and healthcare professionals. Some people have multiple stomas, unfortunately, and sometimes they're quite high-sited on the abdomen, which wouldn't be practical with underwear. You'd have underwear up to your armpits.

Lorraine Alikhanizadeh 12:39
So we introduced the vest, which gives support from the top down. It's a long-length vest that is really supportive and covers every eventuality. What else do we do? And then we did the belts. What we found out, again, because we just stumble across things, is that one of the biggest complications once you've had bowel surgery to create an ostomy... It's an opening in the abdomen that the bowel is pulled through and then stitched up. But they've had to go through all the main abdominal muscles, which has created a weak spot, and intra-abdominal pressure is very high, so a very high proportion of people will end up with a hernia pushing through around the ostomy site. That causes more problems than the ostomy because it's painful, it's unsightly, and it creates an uneven surface for the ostomy bag to stick to, so then they get leaks. The bag comes off. It's a really difficult side effect.

Lorraine Alikhanizadeh 13:49
So we actually did a small study, an independent study with a nursing department in London, where they looked at their incidence of hernias in their patient population for the 12 months prior to the study, and they were very proactive in educating patients on how to prevent them. So their incidence of hernias was about 26%. Nationally, it's 50% and up, sometimes as high as 70%. So we did this study where they introduced our garments immediately post-operatively, on discharge, before the patient goes home, to wear for support instead of regular underwear. Then they followed them up at three months, six months, and nine months, and as they recovered from surgery and got more active, if it was appropriate, they would step up to level two support, and they monitored the incidence of hernias in that population. At the end of 12 months, it was a small study. There were only 100 patients involved, but the incidence of hernias was something like 2%.

Andrew Maff 14:57
Oh wow!

Lorraine Alikhanizadeh 14:58
Compared to 26%. So we really, really push that message now, to try and get people to understand. And we're trying to educate nurses all the time that we exist. We're only a small company, so it's nonstop talking to nurses, trying to make sure that they understand what we do and why. A lot of nurses wait; they don't think the patient needs support wear until they've got a hernia. No, no, no, no. You could actually prevent it. I mean, there needs to be more research and bigger studies to really nail that down. But from what we've seen, we really believe it can reduce the incidence of hernias, and it certainly improves quality of life.

Narrator 15:39
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Andrew Maff 16:12
Oh yeah, the concept around the product line. My head always goes to marketing stuff, so I apologize.

Lorraine Alikhanizadeh 16:20
No, no, mine too. That's what I do!

Andrew Maff 16:25
Going straight to the nurses obviously makes a ton of sense. It's like, "Hey, we're telling the patient, this is probably the best thing to do." But then the other thing I'm thinking is that this is a very tight-knit community. My wife and I do a lot with the Crohn's and Colitis Foundation around here, and they all know each other. It's like a club. They're all best friends, and they all stay in touch. Some of them have different groups and things like that. And I can see that obviously, if someone has found a solution and they're attending these groups, then all of a sudden word of mouth goes, and it just starts to spread in the community. Do you do anything with affiliate marketing or anything along those lines?

Lorraine Alikhanizadeh 17:04
No, actually, I haven't. I've thought about it, but I've never done it. We're thinking about some sort of subscription model because our patient groups, sorry, my group of patients who get their products on prescription through the NHS... We have a system where we text them every 12 months because it's compression. They're allowed six garments every year. It varies depending on where you live, but roughly six garments. They need to renew them because the fibers will gradually wear down with washing and wearing. They're fine after 12 months, but they won't be as compressive as they were when they were new. So we message them to say, "Hey, it's been 12 months. You're allowed a new prescription. Would you like the same as last year?" and so on, and we get about 50% conversion on that.

Andrew Maff 17:56
Yeah.

Lorraine Alikhanizadeh 17:57
So I'd like to try to do that. It won't be as high a conversion with purchasing customers, but still, I don't chase people up every 12 months to remind them. So I thought that might work with a subscription-type model, or at the very least an automated reminder.

Andrew Maff 18:14
Oh yeah, the automated reminder would make a lot of sense. I was actually just at an event with a guy named Jay Meyers. He runs Bold Commerce, one of the most popular apps in Shopify, and it's all subscription stuff. They just released a new one, which I'll go ahead and plug, called Repeat, and it's very cool. But it's one of the things he was talking about in his presentation, which makes a ton of sense. We had this big peak of subscription where everyone was trying to put their product on subscription, and the problem was that the average consumer started to see subscription as causing them more work as opposed to less, which is the usual thought. They're like, "Oh, if I have to pause it, or I'm going out of town, and then the next thing I know, I've got five things of protein sitting around because I didn't take them fast enough." For certain products, obviously, that's very different, but their concept is still focusing on LTV and the CAC ratio, while really leaning into what can be done from an automated reminder perspective, one that reminds people that hey, now's probably a good time to re-up or buy more. Some people do bulk purchasing and things like that, but it's interesting. I always like to have both as an option. I think it's great.

Lorraine Alikhanizadeh 19:38
Yeah, I was thinking I could do a standalone blog explaining all about compression and why it needs renewing and why it's advisable and what we recommend, maybe one to wash, one to wear, and then every six months you keep it going so you never have to think about it, and that we offer a renewal reminder service. Then every time we send them the reminder, we can link the blog to educate them on why we're sending them a reminder. That's my plan. That's one of my next jobs.

Andrew Maff 20:09
That's not a bad idea. Yeah, there's definitely always something to do. In your scenario, you've got people who are actively looking for solutions like this, so Google Ads and Microsoft Ads would be great, because I'm sure there's an older audience to this, and then obviously SEO and the whole AI visibility thing would make a ton of sense. But then simultaneously, you have people who don't even know that there's a solution out there for it. So then you've got social media and social ads and affiliate marketing and influencers, and you've got so much room. So it's a little bit more of "where do you start, and what do you focus on?" With all of that growth, obviously you've got a ton of stuff. What are the future plans? I know this isn't exactly a seasonal product, although I could see people gifting it. But are there any major plans for Q4 or anything in 2027?

Lorraine Alikhanizadeh 21:07
Well, first of all, it's geographical growth. We want to expand to other countries, because there are about 250,000 people with an ostomy in the UK. I think there are 800,000 in the States, and there are 25,000 new surgeries every year. It just keeps adding. So it's a never-ending pool of customers, and it doesn't just affect British people.

Andrew Maff 21:38
Yeah.

Lorraine Alikhanizadeh 21:39
So we need to figure out how to tap into international markets. We've got a couple of international distributors; they're just small companies, but we need more established companies in more geographical areas. We've got a sort of four-year plan with everything that we want to achieve, and we've costed it all out, and we've got a sort of staff hierarchy of who we're going to need to hire to be able to get there. So there's all that going on in the background, and we've just hired a new person to come in and help with the admin, which will free my husband up to focus more on product development and distributors and procurement and all that stuff.

Andrew Maff 22:27
Yeah.

Lorraine Alikhanizadeh 22:30
We want to, like I said, Amazon is a big one at the moment. We're just seeing the sales do this, so we need to focus on that this year. We've got the base in Germany. We want to do the subscription model. We actually, my son, it's a family business, and my eldest son is a bit of an engineering genius. In the garage, just out of his head, he designed and built a compression test rig that was the first of its kind in the world that can measure the actual compression of a whole intact garment, what the wearer would experience.

Andrew Maff 23:15
Cool.

Lorraine Alikhanizadeh 23:16
We just built it for our own in-house QC, so that when we're getting products from the factory that we want to be level one, and we've decided level one is, you know, I don't know, 300 to 600 pascals of compression. Nobody knows what that is, but we do, and we know that our garments need to sit in there. And we're thinking that actually we're sitting on something here, that maybe we could develop different products in other markets that would like to know how much compression a garment gives. So that's a bigger project. That's obviously not for the end of '27. But yeah, I know there's lots and lots of stuff going on. We've just built a single landing page portal for the nurses because we've recognized that nurses are almost like reps for us. They're the gatekeepers of every new ostomy patient, and they're very busy. For them to remember us and think, "Where's the Comfizz number? I want to order some samples. I want some brochures. I want to refer this patient to them," the portal is to make it easy for them, so they can just go on, give us the details, submit, and then we'll contact the patient and take it from there. If they want brochures, we'll just send them. So this new person that we've hired, their job is going to focus on growing those nurse relationships, directing them to the portal, and getting more referrals from nurses.

Andrew Maff 24:57
Yeah.

Lorraine Alikhanizadeh 24:58
Because that's all new customers. Once they're in our database, then we'll do our thing with marketing to try and keep them. But just where to start? There's too much.

Andrew Maff 24:59
I know. So much going on.

Lorraine Alikhanizadeh 25:15
And the AI is crazy.

Andrew Maff 25:18
Oh yeah, you've got to start factoring that in. How are you going to use that?

Lorraine Alikhanizadeh 25:21
Yeah, I've just changed some things on the website. We used to list all our products, categorized into briefs, light sport and medium sport boxes, light support and medium support belts, and tops. We'd categorize them by the style of the product and the level of compression. Then with this whole AI thing, with people asking questions, we added a different navigation. We've kept the old one, but we added a navigation by sort of need: support wear for swimming, support wear for work, support wear for exercise, support wear for intimacy. For problems that people might have, you might want something that gives you a better night's sleep because you're worried about the ostomy during the night. What do you search for if you don't know the product range? You don't know that a waistband might be the best product. So we do that for you, and that's increased the conversion rate. It took a while, but it has increased the conversion rate. So that was fun.

Andrew Maff 26:26
Yeah, that's awesome. There's so much you could build out. Even having some AI on the site that can help answer some of the questions or anything like that. Who knows? It's very exciting.

Lorraine Alikhanizadeh 26:41
AI though, as well, because my inbox is just constantly filling with different things to do. I'm like, "I don't know." I'm not really technical on that side. As soon as you choose one, another one comes out, and you think, "Well, is that one better?"

Andrew Maff 26:54
Oh, tell me about it. That's the worst part. It's the new shiny thing, like, "Ah, do I need that one? Do I need that one? Do I need that one?"

Lorraine Alikhanizadeh 27:01
Yeah, yeah. I'm sticking to Claude and ChatGPT at the moment.

Andrew Maff 27:04
Yeah, the classics at this point.

Lorraine Alikhanizadeh 27:07
Yeah, yeah.

Andrew Maff 27:09
Lorraine, this was awesome. I obviously don't want to take up too much more of your time. I know you're super busy, and you also have a lot of exciting stuff going on. This was great. I really appreciate it.

Lorraine Alikhanizadeh 27:18
Really enjoyed it. I appreciate you asking me on.

Andrew Maff 27:21
Yeah, no worries. I would love to give you the floor. Tell everyone where they can find out more about you, and of course, more about Comfizz.

Lorraine Alikhanizadeh 27:27
Yeah, well, I guess the best way is to simply go to the website, which is comfizz.com, spelt C-O-M-F-I-Z-Z.

Andrew Maff 27:37
Beautiful, Lorraine. Thank you so much for joining. Everyone who tuned in, thank you as well. Please make sure you do the usual thing: rate, review, subscribe, all that fun stuff on whichever podcast platform you prefer, or head over to theecommshow.com to check out all of our previous episodes. As usual, thank you all for joining us, and we'll see you next time. Have a good one!

Narrator 27:56
Thank you for tuning in to the E-comm Show. Head over to theecommshow.com to subscribe on your favorite podcast platform, or on the Bluetuskr YouTube channel. The E-comm Show is brought to you by Bluetuskr, a full-service digital marketing company specifically for e-commerce sellers looking to accelerate their growth. Go to Bluetuskr.com now for more information. Make sure to tune in next week for another amazing episode of the E-comm Show!