Pharma is marketing to the wrong mind

For decades, pharmaceutical marketing has been built on a simple premise: if we present the right data, to the right audience, in the right way – behaviour will change. It’s a logical assumption. It’s also increasingly ineffective.

Because it rests on a flawed belief: that decisions about health are made consciously.

When, in reality, up to 95% of behaviour is driven by instinct, not conscious thought. It’s fast, automatic, and pattern based.

But pharma marketing – from market research to digital media campaigns – is built almost entirely for the opposite “conscious” system: rational, data-driven, and analytical. And increasingly, even when marketing aims to be emotional, through storytelling, patient journeys, and empathetic messaging, it still requires people to actively process, interpret, and reflect. Because, whether it’s rational or emotional, most pharma marketing is still designed to be noticed, understood, and considered.

However, instinct doesn’t work that way. It doesn’t pause to evaluate. It doesn’t weigh trade-offs. It doesn’t reflect on a story. It reacts instantly. That’s why rational messaging often feels hard to process and emotional messaging often feels nice and may even test well – but neither rapidly changes behaviour.

Because both are still asking the brain to think. We are trying to persuade the slowest, most sceptical part of the brain, and expecting it to override the fastest, most powerful one.

This is why it’s currently so difficult to change HCP and patient behaviour.

This also explains why when you ask any HCP how they prescribe, they’ll describe a rational, patient-by-patient process. And consciously, that is what they believe they are doing. But much of prescribing is habitual and runs on autopilot. Instinctive prescribing is driven by a robust network of associations in the mind – built over years, reinforced through repetition. And unless those associations are rewired, behaviour won’t change, no matter how strong the data is.

Patient adherence and persistency are the same problem in disguise. We treat adherence like a rational decision: educate more, remind more, support more. But adherence isn’t rational. It’s instinctive. Patients don’t re-evaluate their treatment every day. They default to it if it fits their life, they continue; if it creates friction or feels burdensome, they stop. Adherence isn’t about knowing. It’s about what becomes automatic.

Making instinct actionable: How brands actually drive instinctive choice

If behaviour is instinctive, then the question becomes: What shapes instinct? A brand is not a set of messages or attributes. It is a living network of memories and associations – built over time – that determines what feels familiar, what feels right, and what gets chosen. Identifying the positive and negative associations in this network is critical for diagnosing what the true drivers of choice are for the Core audience and what the implicit barriers of choice are for the Growth Target (those who prefer competitors.) The delta between the associations for the Core audience and for the Growth Target provides a crystal-clear roadmap for what must be done to change behaviour.

For that network to drive behaviour, it must do three things:

1. Be salient (come to mind first)

To be instinctively preferred, your brand needs to have more associations and physically occupy more space in the mind than your competitors. If your brand isn’t instinctively retrieved in the moment of decision, it doesn’t exist.

2. Be relevant (more drivers than barriers)

Brands need a higher ratio of positive to negative associations. What your brand means in the mind can either drive action or create resistance – so, shifting that balance is critical to influencing choice.

3. Be distinctive (feel different enough to change behaviour)

If your brand feels interchangeable, instinct defaults to habit. Distinctiveness is what gives the brain permission to choose differently. Even in “class effect” categories, distinctiveness can be built – through the right cognitive cues, codes, and associations that make your brand feel meaningfully different.

Many pharma brands today underperform on all three. They’re not the first to come to mind. They have significant implicit barriers, beyond the conscious ones they recognise, so they’re not actively managing them. And they lack distinctive brand assets. As a result, behaviour doesn’t change. Or it changes slowly – requiring significant time and a disproportionate media investment.

The good news: Behaviour can change faster than you think

Behaviour change doesn’t have to take months or years – it can happen rapidly, often within weeks, when you focus on three things:

1. Identify the instinctive drivers and barriers to prescribing and/or adherence.
2. Activate instinct with verbal and visual triggers – cognitive shortcuts that work universally to supercharge your brand with the precise positive associations that reduce implicit barriers and strengthen the pathways that drive instinctive choice.
3. Embed these triggers consistently across all touchpoints, so they are reinforced until they become automatic.

This isn’t just more effective communication. It’s behavioural rewiring at scale.

Perhaps most importantly, instinctive marketing enables brands to punch above their weight. Brands do not actually have to be superior; they just need to be perceived as superior in the moments that drive choice. And that can be achieved even in categories where clinical differentiation is limited. By embedding powerful cognitive shortcuts that build the right associations, brands can create a meaningful advantage – without increasing spend.

Competitive advantage is no longer just about scale. It’s about shaping instinct. In a world of increasing parity, the brands that win won’t be the loudest – they’ll be the ones with the instinctive edge.

Rational marketing makes people think something. Emotional marketing makes people feel something. Instinctive marketing makes them do something.

About the author

Heather Coyle is president of Triggers, a behavioural science–based brand strategy firm that helps Fortune 500 companies understand how instinct shapes decision-making and growth. She leads Triggers Health, partnering with pharmaceutical, health technology, and provider organisations to uncover the unconscious drivers influencing decisions across the healthcare ecosystem, translating behavioural science into strategies that accelerate growth. A formative experience with ovarian cancer deepened Coyle’s commitment to improving healthcare and continues to shape her mission to help the industry better understand how patients and clinicians make decisions in the real world. With more than 30 years of healthcare experience, Coyle has held senior leadership roles at Coordinated Health (now part of Lehigh Valley Health Network), Evoke Health, and CDM Princeton. Coyle is an MM+M Hall of Femme inductee and an HBA Rising Star.