Efficacy Expectations and Adherence: Evidence of Consumer Biases and Heuristics in Pharmaceutical Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 330

Reasons for choosing herbal medicine over pharmaceuticals include perceived
“naturalness” and lower perceived severity of side effects, in that order.
An interesting fi nding, however, is that when respondents are inquired about
their willingness to take a particular medication, those presented with a “hybrid
alternative” (e.g., a drug made by a pharmaceutical company from the leaves of a
South American tree) reported greater willingness to take the product than those
presented with an all-natural alternative (e.g., made from the leaves of a South
American tree) and those presented with a manufactured alternative (Carlisle and
Shafi r 2005 ). As such, pharmaceutical marketers could benefi t from incorporating
natural ingredients into their products and emphasizing their presence.

11.3 The Trial Stage: Spillover Effects of Effi cacy

Expectations from the Awareness Stage

Our previous discussion centered on the factors that affect effi cacy expectations that
primarily determine adherence at the consumer awareness stage. However, such
expectations undeniably affect effi cacy judgments in the trial and adoption stage as
well. Specifi cally, risk/benefi t perceptions, lay theories of attractiveness, inferences
based on color, intuitions about the marketplace, beliefs in market effi ciency, and
lay theories of medicine in general not only determine if consumers decide to pur-
chase and initiate use, but also determine the reference point from which actual
effi cacy—after consuming the medicine—is judged. If initial expectations are set
particularly high, for instance because of a detrimental product attribute which sig-
nals to the consumer that the medication should be effi cacious (e.g., no-pain, no-gain),
consumers judge experienced effects from this high reference point. Effi cacy judg-
ments that fall below this reference point (regardless of whether it is a valid base
measure in the fi rst place) can result in negative affect, poor effi cacy judgments, and
misuse (e.g., in terms of dosage or frequency). Non-adherence through improper
usage, in turn, can result in the reduction of a medication's actual effectiveness,
propelling judgments of ineffi cacy, and ongoing non-adherence. Therefore, in this
section, we focus on the factors that infl uence consumers' effi cacy judgments after
they start taking the medications.
Pharmaceutical marketers need to understand the factors that affect effi cacy
expectations at the awareness stage and effi cacy judgments at the trial/adoption
stage because actual effi cacy—which is rigorously tested prior to release—often
considerably diverges from perceptions. Irrefutably, perceptions that a product is
not providing expected results affect many constituents in the pharmaceutical value
chain, including manufacturers, end users, and physicians (Bowmane et al. 2004 ).
For the former, consumer dissatisfaction leads to negative word-of-mouth, lack of
brand loyalty, and lost sales; for the latter, patients' ineffi cacy perceptions may lead
to opinions of incompetence and induce switching service providers.