Direct to Consumer: Q&A with Mark Spellman and Loreen Babcock

The TV spot begins on an ominous note. "This time last year, Jack was diagnosed with high cholesterol." Zoom to an empty chair surrounded by family members sharing a holiday dinner. "He thought he was fine. He wasn't."

Sure sounds depressing. But don't worry: Jack is fine. He was just in the kitchen carving a turkey.

Unit 7's Mark Spellman and Loreen Babcock say when it comes to using emotion in advertising, fear plus hope is the most effective formula.

Turns out ads like this one—for MyHeartKit.com, an unbranded campaign for Lipitor (atorvastatin)—are so effective because they tug at the heart strings of consumers. Agencies are now hoping to leverage this approach by tapping behavioral psychologists to instill fear, hope, and humor in their ads—though the results have not all been as stellar as the Lipitor spot, which was created by Unit 7.

Pharmaceutical Executive sat down with CEO and chairwoman, Loreen Babcock, and Mark Spellman, director of research and behavior psychology, to learn the secret to Unit 7's success—and how the rest of the industry can better reach patients and caregivers.

Loreen Babcock

How should companies gauge the level of emotion to use in advertising?

SPELLMAN: Companies should be modulated. We know from public health campaigns that the formula that works best is fear plus hope.

The most successful messaging in the history of public health was directly emotional. There was an HIV campaign a while back where literally the specter of death—the grim reaper—is shown at the beginning of the ad: a direct, honest, emotional confrontation that communicates that what's at stake is life and death. And the answer—the hope—is HIV testing.

I'm not saying you should bring the grim reaper into a cholesterol ad—but the point is that the ad was very emotional, with a direct appeal both to fear and to hope.

How does Unit 7 tie emotion into its DTC campaigns?

BABCOCK: How we interpret emotion creatively is based on the insights we're working with. For example, with the cholesterol category—a fairly mature one—it was a big challenge for us to understand what we were going to do differently to bring even more people into a market that's been using the same stimuli for a number of years. We took a a little bit riskier approach that in a subtle way gave the consumer a moment of pause.

The TV spot for Lipitor hints that the empty chair at Thanksgiving dinner was vacated by a deceased patient. But fear not-the chair's owner is actually in the kitchen, carving the bird.

You're talking about the unbranded Lipitor campaign, right?

SPELLMAN: Yes. The ad starts out at a Christmas dinner, and there's an empty chair shown at the beginning—the point being that the head of the table is vacant.

BABCOCK: The empty chair gives the viewer that moment of understanding that it could be them who is not there one day. Our job was to get people to reassess—either that what they're currently doing may be wrong or that they are doing nothing at all.

There is also a campaign on the market for people with an overactive bladder. And this one touches viewers who are afraid that their friends might know that they've had an accident. It's one of the first campaigns that we've seen that starts to lean on fear. Overactive bladder has been marketed in a pretty light way—so that people don't feel overly offended going in to discuss it. But this new approach starts to use the feeling of concern that you wouldn't want people to know that you have accidents.

Has that commercial been positively received?

BABCOCK: I think that it's being viewed as successful. This is a campaign in a category that we've never seen use fear. The industry is starting to discover where that balance is—the fear to the resolution. And where does that work? And what's the right balance for different categories? That's where the thinking has to evolve.

SPELLMAN: If you're going to use the negative emotion, you also need a strong enough hope message to motivate positive behavior.

Volkswagen took some heavy hits in the press for an ad that appealed heavily to fear. Two people are in a car talking, and all of a sudden they are slammed by another car. I recall that the ad didn't get very good reviews because it didn't balance the jarring emotional experience with enough of a hope message. On the other hand, the overactive-bladder ad did a good job of using emotion. In fact, it goes one step further—shame—which is probably the most difficult emotion of all.

But does it then balance the shame feeling with enough hope? In the Lipitor ad, you get the touch-of-mortality fears, the "Oh, dear, is this guy gone?" But there's enough hope in the ad that you're not left with a negative emotion. Because too much fear, too much shame, is only going to bring up defenses and put people back in denial.

Do agencies also use the opposite emotion—humor—in advertising?

SPELLMAN: Yes, I think the Rozerum ad [see Ad Stars, page 66] is a brilliant example because it captures the theme that some sleeping medications don't let you dream—because you don't sleep—while this medication does let you dream. And they give the dream theme in a very natural, humorous way.

I guess my question would be, did they have balance with the negative emotions involved? And do they also then give a course of action that's clear? I think the ad does a wonderful job of playing up the positive. I'm just not sure if it balances the equation with negative feelings around insomnia—how awful it is—and if they're clear enough about how their product is the solution.

BABCOCK: Another part of that answer is where the category is and what the brand goals are. For example, if the target is the very low-hanging fruit, fear doesn't necessarily have to enter the picture because the audience is going to be a little bit more knowledgeable and accepting of the product.

Emotion has a place, but deciding if and how to use it depends on where the brand is from a business point of view. Emotional advertising is a great tool when a brand is no longer bringing enough new people into the category, and every ad starts to fall into the same zone of everyone just looking happy and smiling. That doesn't help the consumers understand what the real issue is in a way that can motivate them.

In recent years, there's been a lot of debate over the use—and possible abuse—of DTC advertising. Do you think there's still a place for consumer drug advertising?

BABCOCK: There is something to be said for helping people become aware of what their options are. We can help ease that process for them, to help them understand what their options are, and how they can get more information. I think that's where the greatest value is of DTC advertising lies.

We hear this all the time from people: "Help me understand how to synthesize all the information, to make sense of it, so I don't go into my doctor's office with reams of paper and end up frustrating him or her because I'm so unfocused."

SPELLMAN: If direct-to-consumer marketing is a good thing, it's because it improves patient education and the quality of the doctor-patient conversation. I recently attended a focus group, and the people looking at the materials said, "Wow, this is great. Based on what I've read in these materials, I can sound at least halfway intelligent with my doctor. I can hold up my end of the conversation. This really gives me the confidence to go in there and have that conversation."