Efficacy Expectations and Adherence: Evidence of Consumer Biases and Heuristics in Pharmaceutical Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 329

a broader lay theory on judgments of medication effi cacy. For example, the “no-pain,
no-gain” theory is based on consumers' intuition that desirable results require unde-
sirable associated by-products, such as in the fi nance sector (Pain 2009 ), politics
(Corn 2008 ), education (Rendón et al. 1998 ), and business law (McMorrow 2002 ).
In the pharmaceutical domain, this lay theory suggests that pharmaceutical products
require detrimental attributes that impact consumers negatively in some way to be
inferred to be effective. For example, Kramer et al. ( 2011 ) fi nd that medicines that
are associated with frequent side effects are likely to be perceived as more effective
than those with rare or no side effects, given consumers' beliefs that more powerful
medicines will be associated with more frequent or severe side effects. Similarly,
medicines that taste bad are likely inferred to be relatively more effective.
Conversely, medicines without associated detriments, such as those that taste good, are
likely to be perceived as weak, as implied by the phrase “no-pain, no-gain.”

11.2.3.6 Paradigms of Illness and Medicine

Wang et al. ( 2010 ) demonstrate that consumers hold lay theories about the nature of
their illness and the nature of potential remedies (e.g., response effi cacy beliefs)
which ultimately drive preferences and consumption decisions. When attributing a
particular cause to their symptoms is easy (e.g., diagnosis certainty is high), consum-
ers tend to prefer a treatment that targets the specifi c cause directly (e.g., medication
that focuses on particular parts of the body). Alternatively, when attributing a single
cause to their symptoms is diffi cult, consumers face high diagnosis uncertainty and
tend to prefer treatments that are attentive to the entire body. Consumers further hold
beliefs about which medicines are optimal under the aforementioned conditions,
such that Western medicine (e.g., prescription drugs) and Eastern medicine
(e.g., herbal alternatives; Traditional Chinese Medicine and Ayurvedic) are pre-
sumed to be more effi cacious in the former and latter cases, respectively. Furthermore,
consumers hold beliefs about the nature of these alternatives and generally presume
that Western medicine focuses on alleviating symptoms while Eastern alternatives
focus on curing illness (since the entire body, and perhaps mind, is involved in the
healing process).
In general, perceived effectiveness of herbal medication is lower than that of
prescription drugs. In fact, research has found evidence of a naturalness heuristic ,
from which consumers perceive natural products to be less intrusive, mild, and less
potent (Rozin et al. 2004 ). Ironically, the limited potential effects translate into posi-
tive evaluations of such remedies; in a survey of American adults, over 25 % were
using herbals on a daily basis and over 80 % indicated an intention to take herbals
in the future (Carlisle and Shafi r 2005 ). In one study, participants were presented
with three chemically identical options of water—either obtained from its source,
fi ltered through bedrock, or fi ltered by humans—and asked to rate their attractive-
ness. Not only did people rate the fi rst option as most attractive but also more willing
to pay over a 50 % premium for it. In line with research on the naturalness heuristic,
research has found the word natural elicits positive associations (Rozin et al. 2005 ).