At the conclusion of Alfred Hitchcock’s North by Northwest, just after the iconic struggle on Mount Rushmore, Eva Marie Saint’s character is hanging off the edge, almost falling to her doom, when Cary Grant grasps her hand and pulls her up, and suddenly they’re in a train car with him pulling her to the upper bunk. You hear the train rumbling, they kiss and tumble lovingly onto the bunk, and then the camera cuts to an exterior of the train entering a tunnel. End of movie.

If North by Northwest had been made today, we might’ve seen a hot, sweaty, movie star sex scene between Eva Marie Saint and Cary Grant instead. But the movie was made under the Hays code, which placed strict limits around what could and could not be shown on the screen. With creative people being what they are though, film directors of the time developed a whole new visual language to get around the rules, using visual innuendo and suggestion to communicate what could not be conveyed directly. Hitchcock himself was one of the most skillful practitioners of this art. In Notorious, he evaded the code’s three-second kiss rule by having his characters break their kiss briefly every three seconds, then come back together, for a total of two and a half minutes. Would North by Northwest have been better with a hot, sweaty, movie star sex scene at the end? Not likely.

What does all this mean to pharmaceutical brand marketers? It means we need to stop making excuses about the regulatory limitations under which we must function and start thinking more like the Hitchcocks and Sidney Lumets and Elia Kazans, yesterday’s masters of the covert visual language of cinema. They were able to find innovative ways to touch the emotions of their audiences while working under constraints at least as rigorous as those we face, and so they have bequeathed to us an entire toolbox of methods through which we can use the visual medium to state our case through innuendo and quiet suggestion.

How to Borrow From the Great Films

Some of us, consciously or not, are doing this already. These four great examples demonstrate how to successfully use a film technique from the past—but in a pharma context.

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1. The Latuda spot with the film noir-esque window blinds shadow. Almost every Bogart film had sharp horizontal blind shadows in interior scenes to convey a sense of moodiness. In this spot, the shadows represent the woman’s depression. She’s about 50% dark and 50% light, and can’t seem to get out of her home at the beginning. Once the drug is referenced, the shadows continue to follow her around and about, without any real-world light source. But she is depicted doing normal everyday things—working, meeting with a friend, walking her dog, strolling on the beach with her family. The window blinds—the underlying illness—are still there, but the drug has helped her get back to normal life in spite of it. Without the window blinds, this spot might not survive the regulatory gauntlet; it might be viewed as over promising. But with them, it’s a perfect balance.

2. The Spiriva spot showing the elephant takes a similar approach. The elephant embodies the condition. At first, it sits on our heroine’s chest. But once she talks about the product, the elephant is off her chest. However, because COPD cannot be cured completely, the elephant never leaves her side. In a way, it’s almost creepy that this baby-sized elephant is following her around just waiting to crush her chest again, but she delivers her lines so effortlessly and with such care, we see she isn’t worried, so we aren’t as worried. She also does a nice product reveal by opening up her hands, which evokes almost a metaphorical MOA feeling—the hands open just as the lungs do.

3. The Tamiflu “Small House” spot from last year is another good example. Aside from being visually brilliant, this spot takes the unusual approach of never “resolving” to post-prescription. It focuses on how the disease state makes sufferers feel larger than normal, maybe even claustrophobic, because of the flu symptoms. And it ends with the prescription being written, so no resolution is needed. By avoiding the post-drug depiction, Tamiflu doesn’t have to worry about how much smaller our guy needs to be. I’d be willing to bet they filmed a version in which he walked back into his house normal-sized, but that imagery was killed by legal as an overpromise. But that may have been for the best; this is one of the most comedic pharma spots I’ve ever seen, and it breaks through in large part because of that.

4. Cialis and the two bathtubs, of course. Those ubiquitous bathtubs evoke the two twin beds in the parents’ bedroom from the “Leave It to Beaver” era of television. Two bathtubs, two naked people, not in the same bathtub but in the same frame, so we know what’s going on without an overpromise of efficacy.

Amp Up the Emotion—And Push Past The Limits

What I haven’t seen are pharma commercials that use the full arsenal of cinematic storytelling. Marketers in the consumer space are not so self-limiting, though. Vicks VapoRub recently ran a spot that had no dialogue at all—just a mother hearing her son cough in the middle of the night, she goes into his room, gives him some VapoRub, he feels better, they share a touching moment, we get a shot of the hero brand, fade to black. The spot uses all sorts of cinematic tricks to amp up the emotion—extreme close ups, shallow depth of field, tinkling magical bells, facial reaction shots. And again, not a word is spoken. This combination of techniques might not be applicable to all prescription brands, but I can certainly imagine scenarios in which an Rx brand could connect with its patients using touching visuals alone with no words at all, and without running afoul of any regulatory requirements.

Going outside the healthcare world, one might find a recent spot for the new Audi A6 that borrows heavily from Hitchcock’s, The Birds. We are introduced to a group of frightened businesspeople looking out of their office building to see scary techno-drones waiting for them in the parking lot. They run outside to their cars and are attacked, complete with the obligatory broken glasses and screaming woman. As one of the other people struggles to get into his car—a BMW, naturally—our Audi driver is able to hop in, voice-program his GPS and hit the road in seconds, managing to destroy a couple of the drones with some slick maneuvering. Lesson learned: Not all high-tech is scary, and some of it is even simple and fun. This spot manages to be comedic while still conveying tension and speaks to a core truth regarding how people feel about new technology. It also does a masterful job of highlighting the Audi’s differentiating characteristic—high-tech that is easy to use.

At AbelsonTaylor, we haven’t quite gotten to the point of using classical cinematic tools in all of our spots, but they are definitely a top-of-mind option. In developing a campaign for the skin care product Aczone, our client Allergan wanted us to show some of the feelings of insecurity people with acne can experience. After exploring several visual concepts, we landed on the idea that our protagonist could be surrounded by people with hand mirrors for heads, all reflecting close-up depictions of the spots on her face. At the beginning of the commercial, the mirror heads are used to create a feeling of discomfort, but once our protagonist has taken Aczone, the mirror heads are replaced with other mirrors and reflections in which she is happier to see her face. Using mirrors as a reflection of self has a lengthy history in cinema going back as least as far as the memorable closing scene of Orson Welles’ The Lady from Shanghai in 1947.

As an industry, though, we have a long way to go. Too many of our spots are plain boring—the dog on the beach, the patient in the doctor’s office, the un-charming cartoon graphics all mixing together into a long tableau of uninspired meaninglessness—and all because of our paralyzing fear of the folks in legal/regulatory. Those folks and the limiting strictures they represent won’t be going away any time soon, so we can either keep complaining about it or we can invert and subvert the barriers around our creative process to touch the emotions of our audiences, just as those old directors did and just as creative people have been doing for centuries in the face of a thousand different flavors of censorship. Need some tips? Tune in to AMC.

  • Mitch Apley

    Mitch Apley is the Senior Director of Broadcast/Print Production at AbelsonTaylor. He is a filmmaker at heart, and his passion for creative, clear and correct health and wellness communication knows no bounds.

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