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101PHARMACEUTICAL SCIENCES
NEUROMARKETING AS A HEALTH TECHNOLOGY ASSESSMENT AND PHARMACY
COMPONENT: A REVIEW
Nemchenko A.
Doctor of Pharmaceutical Sciences, Professor Head of Organization and Economy of Pharmacy Department National university of pharmacy, Kharkiv, Ukraine
Nazarkina V.
Candidate of Pharmaceutical Sciences, Associate Professor Organization and Economy of Pharmacy Department National university of pharmacy, Kharkiv, Ukraine
Kurylenko Yu.
Phd student Organization and Economy of Pharmacy Department National university of pharmacy, Kharkiv, Ukraine
Podgaina M.
Candidate of Pharmaceutical Sciences, Associate Professor Organization and Economy of Pharmacy Department National university of pharmacy, Kharkiv, Ukraine
Podkolzina M.
Candidate of Pharmaceutical Sciences, Associate Professor Organization and Economy of Pharmacy Department National university of pharmacy, Kharkiv, Ukraine
ABSTRACT
The use of neuromarketing methods has recently gained significant popularity around the world. The scientific areas' collaboration in the study of psychology, neurobiology, anatomy, neuroeconomics has been successfully applied in the development of neuromarketing and its impact on the cognitive functions of the patient's brain. Since this area is relevant, we have analyzed publications from Pubmed and Medline databases (213) and those that correspond to the purpose of the study and present the results of the application of neuromarketing methods in healthcare and pharmacy have been selected. Based on a logical analysis, we identified positive and negative aspects of the impact of neuromarketing in the advertising of medicines for the patient and society as a whole, and a SWOT analysis was compiled. In order to interconnect the methods of neuromarketing and patient's selection in the process of health technologies assessment (HTA), a neuromarketing model, as HTA component, has been proposed taking into account the decision about technology financing at all three levels. It was revealed that the use of neuromarketing methods should be scientifically justified and regulated by the appropriate regulatory framework.
Keywords: neuromarketing in health and pharmacy, health technology assessment, medicine, medicine's advertising.
INTRODUCTION
Health reforming is one of the priority policies of the leading countries of the world. The development of health technologies, especially in the pharmaceutical sector, needs to be controlled and regulated in low- and middle-income countries [1]. Regulation is necessary because every year the market for pharmaceuticals is expanded, new treatment technologies are appeared, and medical and pharmaceutical services market competition is growing. However, the majority of large medical and pharmaceutical holdings forget about the ethical, social and legal aspects of healthcare technology functioning.
Recently, neuromarketing has been increasingly used in the creation of commercials or slogans for medicines [2,3]. However, this direction and its methods have not been fully studied in terms of the impact on the patient. Despite the rapid development of neuromarketing and its methods in pharmacy, the relationship between neuromarketing methods and the conse-
quences of their application in the HTA decisions making processes remains unresolved in Ukraine. The purpose of the investigation - is analysis of the neuromarketing methods, as HTA component, and their application in the pharmaceutical sector.
MATERIALS AND METHODS The scientific articles' materials from Pubmed, Medline, and analytical companies' reports had been used in the research [4,5,6].
RESULTS
The rapid increase in mortality from socially dangerous diseases, the drug market monopolizing by the large pharmaceutical companies, as well as increasing of the supplying with the generic drugs of various groups, are forcing manufacturers to use new technological and marketing tools to attract potential consumers: doctors, pharmacists and patients to their pharmaceutical products. Neuromarketing methods can be widely used during innovative technologies enter the market and can be used in HTA [7,8].
The development of medical information technologies and communications entailed the formation of new areas of marketing, namely neuromarketing [9]. Research on neuromarketing began by scientists in 1990. However, the term was firstly introduced in 2002. Neuromarketing is a commercial marketing communication using methods of neuropsychology and biology [10,11]. In neuromarketing, a number of consumer's reactions to the proposed product are used, the most common of which are: sensorimotor, cognitive and affective.
So, sensorimotor reactions were firstly described in the theory of cognitive development of Piaget, which is based on the development and reactions of human intellect [12]. The key points of the theory are the processes of assimilation and adaptation. Assimilation is the perception of new information and its comparison with new ideas, and adaptation is the receipt of information and its application with old ideas [13,14]. Cognitive reactions are aimed at the process of cognition, understanding and comprehension, as well as the processing of information receiving [15,16]. Affective reactions as analytical categories define behavior associated with experience, feeling and emotions [17,18].
That is, neuromarketing is aimed at studying how the nervous system and the brain react to various advertising techniques using medical methods and not only. In our opinion, the application of neomarketing methods in HTA can be represented by the model as shown in Fig. 1. Thus, in the process of new healthe technology assessment after research, it is advisable to apply neuromarketing methods to analyze patient responses.
It is necessary to take into account ethical standards, social and psychological aspects, as well as an assessment of technology financing. That is, if the state or a large pharmaceutical corporation is interested in developing of a new health technology, it is necessary to justify the level of financing from the state budget and include the technology in the reimbursable list. An important criterion for the harmonious implementation of health technology is feedback, that is, feedback from
Neuromarketing in medicines
patients who are not self-medicating, but who consciously use the medicines.
According to the Evaluate Pharma World Preview data, the medicines market will increase by an average of 6.5% every year and it is forecasted volume in 2022 will be 1.12 trillion dollars [19,20]. Thus, neuromarketing methods can be used not only to evaluate a new technology that is entering the market, but also to create the "correct" promotion of medicine advertising and to familiarize patients with effective and safe drugs [21,22]. It should be noted that the advertising of medicines in the countries of the world is strictly regulated. So, prescription medicines advertising is provided by law not in all countries. For example, a policy of tougt advertising in Poland is currently underway. The U.S.A. Food and Drug Administration (FDA) has created a number of drug advertising requirements. According to established FDA requirements, advertisements for pharmaceutical products must not be false or misleading; it should reflect the risk, benefit and all the side effects that are described in the annotation when using the medicine [23,24]. With regard to medicine advertising in the European Union countries (EU), according to Directive 92/28 / EU, the advertising of prescription drugs and those containing narcotic or psy-chotropic substances is prohibited, that complies with the definitions of international conventions. It is also should be noted that in the EU advertising of medicines for the treatment of certain categories of diseases is prohibited, namely: tuberculosis, diabetes, cancer, sexually transmitted diseases, etc. and most of the medicines that are reimbursed by the goverment also. Therefore, when introducing medicines advertising using neuromarketing methods, there are a number of risks, not only for pharmaceutical holdings, but also for potential patients.
To assess the strengths and weaknesses, as well as the threats and opportunities for advertising for new health technologies using neuromarketing, we have conducted a SWOT analysis based on the results of relevant studies [25,26].
Table 1
Strengths - informing the patient about various medicines that are already in the market and about those that are entering the market; -increasing of competition among producers of the same market segment; - visualization of the medicine (emphasis on the dosage form or convenient packaging). Opportunities - the development of health technologies using neuromarketing methods can be used in the future for the benefit of the patient, taking into account the organization of advertised medicines necessary for the treatment or prevention of individual diseases
Weaknesses - the intrusiveness and futility of advertising (for example, broadcasting on the radio each 10 minutes or a constant video clip on television at certain times); - lack of information in the advertising of medicines; - the absence of an associative range of medicines in advertising on the symptoms of diseases; - the influence of neuromarketing in the advertising of medicines has not been fully studied, therefore, it can carry both a positive and a negative result. Threats - self-medication; - unwillingness of the patient to visit a specialized specialist -doctor; - the use of neuromarketing methods can adversely affect the patient's psychosomatics and thereby aggravate already existing symptoms of the disease; - high marketing costs and decreasing of costs for quality, effectiveness, packaging and design of the drug.
It is worth noting that all the points given in the of advertising taking into account the behavioral SWOT - analysis indicate that there should be a balance aspects of potential medicine's users.
rinctar
Patient
Pharmacist
ZMET - analysis (Zaltman Metaphor Elicitation Technique) extraction from unconscious themetaphorical images that affect the understanding of , incomins inform.
Health Technology Assessment
I, Formulation of the problem
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Figure 1. The neuromarketing model as a component of the health technology assessment (shortened scheme)
DISCUSSION
The influence of marketing techniques, in particular neuromarketing in medines' advertising, has been described in many scientific papers. So, Mnushko Z.M. together with the co-authors had been considered key aspects of marketing techniques, in particular, non-traditional marketing methods in the process of promoting pharmaceutical products to the market [27].
For example, in the Orzan G., Zara I., Purcarea V. paper it is said that neuromarketing methods affect the unconscious and conscious choice of the consumer [28]. Morin C. had concluded that neuromarketing offers advanced methods for the direct study of human brain reactions without requiring the cognitive or conscious participation of an individual [29]. Zurawicki, Leon Ziad, F. Gellad had summarized data on the impact of advertising aimed at a wide audience [30,31]. The study by Wolbring, G., Diep, L., Yumakulov, S., Ball, N., Leopatra, V., Yergens, D. had discussed the
impact of marketing techniques using various technological interfaces on healthcare, as well as on consumers with limited capabilities [32]. The authors of the article Javor, A., Koller, M., Lee, N., Chamberlain, L., & Ransmayr, G. had drown a connect between neuromarketing and neurology, and its effect on the pathophysi-ological needs of patients with socially important diseases (e.g., Parkinson's disease) [33]. Carl Erik Fisher in collaboration with co-authors had described the contradictions regarding the involvement of neuromarketing in the practice of medical workers, scientists and other entities [34]. From the point of view of the authors of Harit Kumar, Priyanka Singh, neuromarketing is a branch of psychiatry and can be considered as a study of human behavioral factors [35]. In the work of Nico-lae Al. Pop the role and importance of neuromarketing methods in the development of neuroscience, as well as in market research had been examined. The study was based on an analysis of 67 neuromarketing companies
from around the world that are members of the NMSBA [36].
Andra-Victoria Radu together with a co-author, had described the impact of marketing on consumer preferences in the pharmaceutical industry [37]. By Un-guryan L.M. the influence of neuromarketing methods on consumers is examined through observations in pharmacies inone of the largest industrial centers of Ukraine. It has been established that neuromarketing methods should be improved in most pharmacies [38]. The authors Gromovik B. P., Unguryan L. M. in their work had identified the possible advantages and disadvantages of the ethical nature of neuromarketing for pharmacy, as well as the influence of sensory marketing methods on consumer choice [39].
The authors of Malyi V., Timanyuk I., Rogulia O. had revealed that the use of neuromarketing makes it possible to manipulate the minds of buyers and make rash purchases [40].
CONCLUSIONS
In general, an analysis of scientific articles on the declared topic has shown that the authors did not come to a unified point of view regarding the positive or negative impact of the neuromarketing methods usage in the advertising of pharmaceuticals and HTA, therefore this direction requires further study and control. However, despite the many contradictions, of course, neuromarketing with the right, controlled application can help in HTA in favor of the more appropriate technol-
°gy.
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