Why behavioural science is fundamental to a successful OTC switch

Switching from prescription drugs to an over the counter status can make pharmaceuticals more accessible, convenient and affordable. The change can have a significant positive effect on people’s lives. When nicotine replacement therapies in the US switched to OTC there was 150%+ increase in their purchase and use in the first year. Increased access helped tens of thousands of smokers quit, providing $2 billion in social benefit every year.

However, even once approved by the regulators, making a successful switch from Rx to OTC is no simple task. In the UK we’re no stranger to self-medicating, paracetamol has been available over the counter for almost 70 years. Yet still only half of us will take non-prescription drugs as soon as we get sick. There are myriad barriers to consumer use of OTC drugs, particularly drugs new to the market and many of those barriers are subconscious. They can’t be articulated by the customer and uncovered using traditional research methods. When medication makes the switch from Rx to OTC consumers might consciously or subconsciously assume changes in dosage, effectiveness, or volume limitations. This could be impacted by a lack of discretion in the store, or a feeling that the switch diminishes the perceived importance of the medicine as a treatment. It could be one of these reasons or many of them.

In this category it’s important we understand and recognise which behavioural biases and heuristics are at play, because while consumers may be familiar with OTC medication, they often default the decision making to professionals.

Status Quo

Consumers want continuity in their medication, switching from Rx to OTC can subconsciously create barriers because the switch is not just a change in accessibility, but a switch in the mindset of using the medication. Rather than a doctor providing instructions, we have to make our own decisions on dosage size, frequency, and what adjustments to make and when. These details may all be contained in-pack, yet there is an additional mental effort on behalf of the consumer as opposed to deferring to a doctor.

Messenger Effect

There is a comfort that comes from seeing a medical professional, even if they can’t provide a solution right away. There’s opportunities for tests to be conducted and further appointments. If a proscribed medication doesn’t work there’s recourse to return to the doctor to try something else. But OTC medications remove a layer of that comfort, a decision needs to be made personally, and new consumers may well need convincing a solution is for them.

Social Conformity

OTC like any consumer product is also impacted by word-of-mouth and social proof. If the consumer knows someone with the same issues or symptoms but is not taking certain medications they may start to question why they continue to use the product when someone else uses a different product for the same condition.

Effort/Availability

When accessibility increases we can feel that the importance of the medication reduces as there is now significant less effort to obtain it. In some circumstances that means our perception of the need for medication can become less significant, which in turn can lead to consumers experimenting with dosage without guidance, open to less effective or natural options and suggestions from non-medical professionals, and ultimately convince ourselves that we don’t need the medication. If another brand dominates the OTC space then you are immediately benchmarked against them and entering a competitive set that you previously weren’t in.

When a product makes the switch consumers can feel very differently about that product, and these changes in perception can often hard to pin down in traditional research. Using behavioural science we can however dig into what cannot be articulated. So when approaching these projects you need to consider:

1. There is a wider context to consider; cultures, traditions or even taboo’s play an important role in how we manage medical complaints and medicines.
2. The information we source when we switch from doctors advice to self-medicating can come from a number of places: from friends and family to references in films and TC programmes or even signals on pack.
3. Behaviours are subconscious so asking them directly is pointless – we design our research to reveal true behaviour by asking them to react and not tell us how they would react.
4. Emotion plays an important role; we are dealing with the emotional value of brand and retailer, feelings about the condition, and how people want to be perceived over how they feel they are being perceived. But feelings are often difficult to articulate and need to be encouraged in a way that doesn’t make them feel vulnerable.
5. Some decisions are being made in milliseconds using heuristics or biases and we need to understand how to leverage these and in some cases overcome them.
6. Brands appear in the stories we tell to ourselves that can predict future behaviour. Narrative research allows us to access these stories to better predict future behaviours and motivations.
7. As humans we can only absorb so much information; giving them a realistic setting and not expecting them to pay equal attention to everything.
8. Real decisions are made in the moment; we can use techniques that make them feel comfortable and unobserved.
9. Distractions are everywhere; recreating this atmosphere where there are other things fighting for their attention.
10. Price is important but not the only factor; value can justify a higher price point so testing the levers of value and the impact on willingness to pay.

Even when a formula is the same people can feel very psychologically different about a medication. Once any changes are made to packaging, cost, or doses sizes these differences can become magnified. This can impact trust and perceptions of efficacy. What does this mean for switching prescription to OTC?

The messenger of these changes can be important. Physician endorsement or validation and ability to ask questions from a pharmacist can allow consumers the comfort of professional advice. Representation of the user in packaging and advertising can help build a brand narrative and sign post key demographics of use of medication. If you can’t keep a consistent or price point that doesn’t disadvantage the user, then packaging needs to indicate “premium”. Subscription models can be created that come some way to stimulate the same feel as a regular doctor checkup. By continuing to medicalise the benefits and move away from a “lifestyle choice” you can keep the perception of the importance of the drug even if it is now more available.

For each biases or change in perception there is a counter strategy you can employ. The challenge is understanding which of those your switch is most likely to encounter. The only way to truly understand that is through behavioural science. So, if you have a switch project coming up, drop us a line and we will be happy to chat through some of our own experience and what that means for your research.

Get in touch at hello@irrationalagency.com