Efficacy Expectations and Adherence: Evidence of Consumer Biases and Heuristics in Pharmaceutical Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 325

better than healthy options (Raghunathan et al. 2006 ), since the underlying intuitions
are fi rmly held. With regard to pharmaceutical products, Roullet and Droulers ( 2005 )
found that drugs that were perceived to treat a benign illness were expected to have
brief action, low risk, low price, limited side effects, OTC status, symptomatic
treatment, and limited effi cacy. In another study, consumers perceived effective pain
relievers to be quick and more likely to cause aversive side effects (Burke et al. 1988 ).
Thus, consumers rely on various lay theories when they infer the effectiveness of
medications, which ultimately determines initial adherence: the decision to choose a
particular medication. However, many of the intuitive beliefs have “spillover effects”
into the trial and adoption stage; that is, effi cacy expectations emanating from many of
these lay theories may act as a reference point from which effi cacy judgments are
made. In this section, we present research fi ndings that demonstrate the effects of the
most commonly employed lay theories that would primarily affect consumer expecta-
tions about a medication's effi cacy at the awareness stage. In the following section, we
discuss such intuitive beliefs that have the aforementioned “spillover effects,” marking
the transition from the awareness stage to the trial and adoption stage, where adherence
is characterized by proper medicinal usage with regard to dosage and duration.

11.2.3.1 Product Attractiveness

Pharmaceutical executives have noted that pharmaceuticals are lagging behind the
consumer industry with regard to packaging (e.g., best practices and innovative
solutions). In addition to serving an informational purpose, packaging is a major
determinant of brand loyalty: a “tangible manifestation of an emotionally charged
relationship to the brand” (Wade and Vrain 2005 , p. 114). With the entrance of gener-
ics, pharmaceutical executives are now stressing the need for more eye-catching,
memorable graphics and original design.
While the intuitive and seemingly indisputable claim that creating aesthetically
appealing products is desirable in a competitive industry, research has found
evidence of an attractiveness bias that suggests that highly attractive products may
be, under certain circumstances, perceived less favorably (Batra 2009 ). When exter-
nal product information is not available (e.g., brand reputation), consumers are
skeptical of the effi cacy of products with extremely high, vs. moderate, levels of
visual attractiveness; this phenomenon is perhaps the result of a “ too beautiful to be
good ” lay belief that results in an inverted U-shaped relationship between attractive-
ness and effi cacy perceptions. However, when strong brand information is present,
product attractiveness is shown to positively correlate with perceived effi cacy. Inferring
lower effi cacy from attractiveness was also found to be a cognitive process, such
that under high cognitive load, people use affect-based processing with more attrac-
tive products being perceived to yield better performance, even for weak brands
(Batra 2009 ).
On the basis of the aforementioned fi ndings, whereas lesser known brands would
benefi t from moderately attractive product packaging to induce perceptions of
product effi cacy, well known, reputable brands would benefi t from attractive and