Placebo pills routinely beat Big Pharma medications in clinical trials. As more drugs fail to make the cut due to increased “placebo effects,” what does this say about the inner workings of the human brain and what does any of this have to do with marketing?
Since 1962, double blind testing with placebos has been the norm for medications wishing to pass muster from the US Federal Drug Administration (FDA). However, over the years the placebo effect has been more pronounced with fewer drugs passing clinical trials. To be sure, unusually high responses to placebos have been blamed on ineffective compounds, but there might be other causes at work.
A Wired Magazine titled, “Placebos Are Getting More Effective. Drugmakers Desperate to Know Why” cites some of the challenges facing Big Pharma. Over the years, drug makers have diligently worked to uncover why–for some patients–the act of taking a placebo works as good (or sometimes better) than a promising compound. In fact, according to the article, researchers are discovering, “the body’s response to certain types of medications is in constant flux, affected by expectations of treatment, conditioning, beliefs and social cues.”
For example, for some patients the simple act of watching another person gain relief from a medication sets “expectations” that the medication will indeed provide relief. And since consumers have been bombarded with billions of dollars in drug advertising over the years, Big Pharma has also increased expectations that simply taking a pill will solve a patient’s ills. In addition, a kind and empathetic doctor can also boost the placebo effect.
To help remove the noise from the above variables, drug makers have taken to testing medications in countries across the globe. However clinical researchers are discovering that even this isn’t a perfect solution as doctors are “paid to fill up trial rosters quickly which may motivate them to recruit patients with milder forms of an illness.”
Part of the challenge for drug makers is defining the illness in question. The Wired article notes that many new drugs today target “higher cortical centers that generate beliefs and expectations, interpret social cues and anticipate rewards.” Defining “depression” in a patient is often difficult enough, but then try and see if that same definition holds for patients in different countries and communities! It’s tough stuff.
In a sign that the white surrender flag has been waved, drug makers have now all but acknowledged the benefits of placebos. What they’re looking for now is, “the best placebo response plus the best drug response.”
A key lesson from this article is that the human brain is very powerful and scientists don’t quite yet understand exactly how it works. Why or how does the human body improve its condition from the simple act of taking a medication (placebo or not)? Why do patients improve their conditions of depression when a doctor–knowingly–prescribes them a dose of medication that’s too low to be effective?
Another interesting discussion avenue is how customer expectations can be defined and created. For example, the Wired article mentions that drug makers have long known that simply coloring pills can help create expectations of efficacy. Yellow pills may create “doses of sunshine”; red pills let patients know they have potency, and green pills help reduce anxiety. Pills stamped with a brand name also offer a patient assurance and comfort.
Helping our companies understand, create and manage customer expectations is where the marketing function can add significant business value. But as Stan Lee of Marvel Comics fame reminds us, “With great power comes great responsibility!” Marketers must be willing to resist the urge to manipulate customer expectations in an unethical and immoral manner–especially if our products and services are no better than a comparable “do nothing” placebo.
Questions:
- In recent tests, durable warhorse drugs like Prozac have been beat by placebos. If you worked for Big Pharma, how might you suggest that your company “test out” consumer expectations–to see if your drugs actually worked?
- It would be difficult to argue that consumer expectations haven’t increased over the past ten to twenty years. What is a good strategy to manage expectations …. keep them low and over deliver?
- Does experimentation with control groups have a place in your marketing function? If so, how? What are you learning?
Tags: Branding, customer expectations, experimentation and testing, neuroscience, placebo effect, social cues
Experimentation has pretty much confirmed that “visual cues” are critically important to consumer acceptance of food products. Vanilla flavor with traces of [black] vanilla bean, for example, is preferred over vanilla flavor alone (i.e., without the black flecks of vanilla bean). Carrot cake with small [tasteless] orange bits is preferred over carrot cake without the bits. Etc. And the preferences are significant. This principle is pretty well known in food marketing.
Also, years ago we introduced “lemon refreshed” Mr. Clean, and the yellow, lemon-scented product beat the non-scented product for cleaning efficacy and for shine by enough to warrant a total brand relaunch around the lemon scent. (It also beat Top Job and Ajax — both ammonia scented — for shine connotation (i.e., doesn’t dull waxed/shiny floors). This was particularly important because the brand was yellow and could have consumers expecting that it would “yellow” their floors.
There are other examples, of course, but there isn’t much doubt that the visual cues can do a lot for consumer perception of efficacy.
Hi, Paul. I’m not a pharma marketing specialist, yet it appears from your post that pharma studies are similar to CPG research. One can determine how packaging, color, and expectations affect consumer buying patterns and in this case, efficacy.
From the article:
“These new findings tell us that the body’s response to certain types of medication is in constant flux, affected by expectations of treatment, conditioning, beliefs, and social cues.”
Many CPG consumer decisions are dictated by emotions, which are centered in the Limbic system of the brain. So, the more we learn about the brain as it relates to marketing, the more marketers can affect expectations, conditioning, beliefs, and social cues to get the desired response.
If we really open a can of worms, don’t all marketers have a “great responsibility” in resisting “the urge to manipulate customer expectations in an unethical and immoral manner?”
The results in CPG, of course, may not affect an individual’s health in the same manner as medication, but there are other areas where manipulation can have a detrimental effect.
e.g.
- fast food and obese people
- credit cards to consumers already in debt
- beer to people with alcoholic tendencies
I’m not sold on control or focus groups, Paul. Over the years, I’ve seen answers influenced by the way questions are framed, as well as the prejudices of questioners. I’ve also seen people in groups influence each other’s answers. This hardly yields solid information. Can these groups be of use? Of course. But they have to be as free from bias as possible and then, respondents’ answers can’t be suggested. (Please see consumers’ responses to small car researchers’ questions in my previous post). The power of suggestion has been discussed in many circles, not only where marketing is concerned. So where does that leave marketers if they choose to put most of their research efforts into these kinds of findings? Not on very solid ground. Research has to come from many sources. I personally like to see how consumers interact with products when marketers are viewing them from outside the room. . .and can hear their comments in an impromptu manner. That is far more meaningful.
I saw that wired article. That is absolutely fascinating. It is especially interesting that drug companies always thought of the placebo effect as sort of something to overcome rather than something to understand.
I mean if a placebo is beating blockbuster drugs, it would seem a good idea to study this effect very carefully.
As for expectations, I wonder what would happen if they did studies pitting one placebo against another placebo with the variable changed having to do with expectations not pharmacology?
Michael, thank you for taking the time to comment. I love that you added your expertise, especially around your launch of Mr. Clean. You are exactly right in that visual cues can appropriately set “expectations” with our customers.
On occasion, I enjoy watching the television show Hell’s Kitchen. To test his chef’s palette, Gordon Ramsey makes them put on a blindfold and then spoon feeds them different foods. Some foods, like eggs seem like they’d be the easiest to taste and discern, even with a blindfold, but it’s amazing how often these seasoned chefs get it wrong.
Just more confirmation of how important consumer expectations really are.
Elaine, thanks for commenting and some terrific questions. I 100% agree that in all instances, marketers have a responsibility to resist the urge to manipulate customer expectations in an unethical and immoral manner. That said, I’m also a firm believer in personal responsibility and offering choice. I’m about halfway through Nudge by Richard Thaler, a great read on making sure choice is available with an appropriate “nudge” in a responsible direction –without coercion.
The next question from here is, who defines “responsible”?
Ted, when it comes to experimentation, you really hit one of the key struggles of the pharma industry – how to remove bias. Because as you know, what people report they do or how they say they behave, is often wildly different than reality. The pharma industry now has accepted that the placebo effect is here to stay, and now they’re looking for how to test “placebo PLUS” effects. Discovering and removing bias is always going to be a challenge in experimentation.
You said, “Research has to come from many sources” and I completely agree. Multiple types of research are needed to fill in a more complete picture of consumer behavior.
Neil, I really appreciate your contributions to the discussion.
You said, “if a placebo is beating blockbuster drugs, it would seem a good idea to study this effect very carefully.” In fact, while Big Pharma is guarded about their findings, they are in the process of pouring money into understanding the placebo effect. If these findings are ever made public, it will definitely be a welcome addition to the field of behavioral studies.
Thanks, Paul, for the insightful and informative post.
In my own point of view, what makes some things work for us is the inner belief that they will.
For example, we like to buy a certain brand or style of shoes because we “feel” comfortable wearing them even though others describe them as horrible.
We like to wear a certain style or line of clothes because we “feel” they are really nice although the people at the cleaners snicker when we get them.
I believe that the same goes for placebos. If we put our minds and hearts into believing that something shaped like a pill, tastes like a pill and is given by a medical practitioner as a pill, can cure us — then why not?
SGA, thank you for commenting on an important factor in the placebo effect – the power of belief. That’s why some patients improve their condition when doctors knowingly prescribe them a dose that’s too small to be effective.
The simple act of BELIEVING that a pill can help improve a condition, whether it actually can or not, plays a huge factor in the overall effectiveness of drug therapy. The power of expectations is extremely relevant in our daily marketing decisions. The tricky part I believe, is uncovering those expectations and then creating an experience to match or exceed them.
“Helping our companies understand, create and manage customer expectations is where the marketing function can add significant business value.” Well-articulated, Paul, and the issue among the many you raised I’d like to tackle.
Many products fall short when it comes to meeting customer expectations, don’t they? They’re just one more commodity in an overcrowded marketplace. To use your illustration, what about the products the consumers nixed in favor of placebos? What does that tell the producers and their marketers about their products? Where is the trust? Where is the perception of their value? Little wonder that Gerzema & Lebar’s research findings in the book “The Brand Bubble” point to the widening gulf between the financial markets valuation of brands and consumers’ valuation of them. As brand values dilute in the minds of consumers the world over, where does that leave companies? It is my hope that this economy has forced companies to examine how they’re doing business from their core. Nevermind cutting expenses here and there. It’s time for a fundamental question to be answered: “What’s our purpose? How can our product or service improve people’s lives?”
Claire, I absolutely love this quote from you, “It’s time for a fundamental question to be answered: “What’s our purpose? How can our product or service improve people’s lives?”
In the name of market share, capacity utilization and/or additional revenues, some companies continue to churn out marginal goods. And while this strategy keeps the factories humming, in terms of brand dilution, some companies are doing more harm than good without a clear strategy for innovation and meeting the needs of future customers.
In addition to answering your question, I think many companies would be surprised to know the answer to: “Who’s our customer?”
Interesting point you bring up, Paul, regarding placebo effect.
My current doctoral research addresses this issue indirectly. I’m exploring audience reception to an ad campaign for fictitious (satirical) medications that cure ’social ills’ such as lack of patriotism, xenophobia and other ‘conditions’. The intent is to generate public discussion about social and political issues. Here is a link to the fake drugs I’ve created:
http://www.lisaerdman.com/annual_checkup/print.html
http://www.youtube.com/watch?v=kPQDbYVBt8Y