Efficacy Expectations and Adherence: Evidence of Consumer Biases and Heuristics in Pharmaceutical Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 334

language profi ciency) are particularly vulnerable to marketing communications.
In fact, 45 % of the American adult population has literacy skills at or below the
eighth grade reading level and more than 80 % of patients older than 60 cannot read
or understand prescription labels (Institute of Medicine 2004 ). As a result, such con-
sumers are less likely to adhere to pharmaceutical recommendations communicated
through packaging, inserts or black box warnings; instead, they are likely to rely on
lay theories such as those we discussed in this chapter. Research on vulnerable
populations has investigated the reaction of consumers to experiences of vulnerability
(e.g., homelessness, old age, immigration, etc.) in the consumption context (Baker
et al. 2005 ; Hill 1995 ), but limited research has examined how such populations
respond to health messages and the role of heuristics, biases, and lay theories on
their judgments and decisions. Learning, for instance, what types of lay theories are
more likely to be employed by these individuals may improve overall health and
well-being in these populations.
Finally, there has been an increased popularity in alternative medicine in recent
years in the United States. A 2007 survey by the federal government found that
more than one-third of adult patients and nearly 12 % of children in the United
States used alternative therapies such as acupuncture, reiki, and herbal supplements
(Aratani 2009 ). As our discussion of the trial and adoption stage illustrates, one
reason alternative medicine may be popular is that effi cacy expectations infl uence
actual effi cacy. As such, adherence to such regimen is likely to also be a function of
perceived effi cacy and, thus, susceptible to the same heuristics and biases discussed
in this chapter. One interesting question that may be answered by future research is
that integrative medicine, through which patients are treated by both conventional
and alternative medicine, may be more effective as it fosters an open dialogue
between the physician and the patient, thereby enhancing adherence to medicinal
regimen.
In this chapter, we have identifi ed the factors that affect adherence at two stages
of the consumer evaluation process: awareness and trial/adoption. Though not
mutually exclusive, these factors were classifi ed as driving effi cacy expectations
and effi cacy judgments at the two stages, respectively. Given the detrimental conse-
quences of non-adherence in either of these stages (in terms of health risks to the
consumers and losses for the pharmaceutical industry in general), it is without doubt
that efforts to enhance effi cacy perceptions are key in creating value for all constitu-
ents in the pharmaceutical marketing chain—from manufacturers to end users.
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