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The placebo effect in marketing: Unexplored influence of brand name Daria Chigirinova University of Kassel 1 Abstract The given study investigates the influence of brand name on the actual efficacy of the products. It was noticed long ago that marketing actions could affect the perception of a product and even the subjective experiences of a consumer such as taste or quality. However, recently it was proved with a series of experiments that marketing actions are able to influence the actual effectiveness of a product. Such effect was linked with theoretical background and processes of placebo phenomenon from medical sphere and received the same name – placebo effect. This phenomenon is quite new and thus has numerous gaps in the research, one of which is intended to be filled by the given study. The first research question investigates the possible influence of a brand name on the effectiveness of a product, whereas the second research question is designed to understand the effect of expectancies on the magnitude of the placebo effect produced by the brand name. The empirical part of the given research presents a crossover between-subject experiment, aimed at evaluating the influence of Red Bull® brand name on the effectiveness of the energy drink. 2 Introduction Stewart-Williams and Podd (2004) describe placebo effect as a genuine psychological or physiological effect produced by a substance or a procedure that has no inherent power to create that effect. Placebo is a phenomenon that has been broadly studied in the field of medicine and psychology. Substantial results were achieved in studies regarding the placebo effect in curing pain (e.g., Montgomery & Kirsch, 1996). Recently the placebo effect has also received much attention from the side of marketing researchers that strive to deepen their knowledge about the influence of various psychological concepts on consumers’ behavior. It is well known that manipulations with various marketing variables (e.g. price changes, packaging, distribution channels) can significantly influence consumer’s beliefs and expectations and hence change their perceptions of a product, their consumption experiences and even purchase behaviors (Shiv, Carmon, & Ariely, 2005a). Even though the placebo effect has been studied a lot in the past 60 years (Beecher (1946) was one of the pioneers studying placebo effect as an important medical phenomenon), there are still gaps in the research that need to be filled. Due to the difference of scientific contexts exploring this phenomenon from a marketing point of view could help reveal new factors that mediate the placebo effect. Shiv, Carmon, and Ariely (2005a) conducted a researched aimed at extending the scope of effects that marketing actions are capable of evoking. They found out that speculation with different marketing variables (in particular, price promotions) can not only influence the subjective experience of a customer but even alter the actual efficacy of a product. Placebo effect in marketing has not been studied through yet and hence there are a lot of directions of research that could be developed. One of possible directions that I’m going to develop in the given paper is the influence of brand name on the actual efficacy of products. 3 Theoretical background According to numerous researches the main two concepts that lie in the basis of placebo effect are expectancy theory and classical conditioning (e.g., Montgomery & Kirsch, 1997). Classical conditioning is defined as a particular form of learning when an organism is being exposed to conditioned and unconditioned stimuli which results in relevant change in organism state or behavior (Stewart-Williams and Podd, 2004). According to the expectancy theory, placebo substance produces effect because recipient expects it to have an effect. (StewartWilliams and Podd, 2004). Usually these two theories are treated as competing approaches. For instance, Kirsch (1991) argues that expectancy theory can explain the process of placebo response whereas classical conditioning is unable to fully account for placebo effect. On the other hand, Voudouris et al. (1990) tried to prove that classical conditioning processes are superior when explaining the framework of placebo effect. Stewart-Williams and Podd (2005a) suggest that classical conditioning and expectancy theory shouldn’t be viewed as opposite approaches, but as two theories that support each other when creating placebo effect. They propose that classical conditioning processes shape placebo effect and expectancies help to mediate it. Based on this assumption the following framework of placebo effect is used in the given research. Salient beliefs that (both intrinsic and extrinsic) activate response expectancies together with expectations related to other factors (e.g. selfefficacy beliefs) produce subjective and behavioral outcomes (Shiv, Carmon, & Ariely, 2005b). 4 Research question The influence of marketing actions on consumers’ behavior has been discovered long ago. Numerous studies provide evidence that brand name (Allison & Uhl, 1964), advertisement claims (Lane, 2000) or other marketing attributes could affect consumers’ perceptions of products. On the one hand, as already mentioned above, the phenomenon of placebo effect in medicine is a well-elaborated notion. Nevertheless recently, these two concepts have been merged relatively and there is not much research regarding the influence of marketing actions not only on subjective experiences but on physical effectiveness of products to which they are being applied. Research conducted by Shiv, Carmon, and Ariely (2005a) provided evidence that advertisement is able to reinforce price-quality attitude which could lead to actual change in effectiveness of a product. However there is no profound research that examines the possible influence of a brand name on objective changes in effectiveness of a product. Thus the significance of the given thesis derives from the variety of gaps in research of the problem stated above and the necessity of exploring the new area of connection of psychology and marketing sciences. To conclude the purpose of this research is to understand the influence of brand image and brand perception on the effectiveness of a product. Hence, the main hypothesis of the thesis is: H1: The level of brand awareness of a product influences the actual effectiveness of this product. Moreover, expectations that act as one of the factors triggering the placebo effect and their influence on the changes in actual efficacy of products is another problem that I am going to examine in this paper. It is hard to underestimate the role of expectations in governing placebo effect. Even researches that argued that classical conditioning theory accounts for placebo affect (e.g., Voudouris et al., 1990) stated that expectancies played a certain role as well. The possible significance of the development of this problem lies in the practical relevance: expectations of a customer regarding the effectiveness of a product can be easily stimulated by the marketing actions. On the one hand, customer could receive the stimuli that encourage expectations unconsciously (e.g. through well-established brand-name) or consciously (e.g. via advertisement claims). 5 To sum up, the second goal of the given research is to understand and examine the influence that expectancies have on the magnitude of placebo effect. Hence the second hypothesis of this study is the following: H2: The level of expectations about the effect of the product influences the magnitude of placebo effect. 6 Literature review TOPIC Placebo effect in marketing actions TITLE Placebo Effects of Marketing Actions: Consumers May Get What They Pay For Placebo effect in marketing actions Placebo: From Pain and Analgesia to Preferences and Products. Placebo effect in marketing actions The Quality of Price as a Quality Cue AUTHOR Shiv, B., Carmon, Z., & Ariely, D JOURNAL Journal of Marketing Research, 2005, XLII (November), 383–393. Becerra, L., & Borsook, D. Journal of Marketing Research, (2005), XLII (November), 394–398. Rao, A. R. Journal of Marketing Research, (2005), 42(4), 401–405. CONTENT The authors conducted a series of experiments to prove the influence of marketing actions (in particular, price promotions) on the actual efficacy of products. Moreover the research focuses on the role of expectations in mediating placebo effect (higher expectancy level lead to greater placebo effect). One of the main findings is that non-conscious expectations about the pricequality relation can influence consumers and encourage placebo effect. The authors also revealed a number of important statements regarding the placebo effect in marketing: - buying product with a discount produces greater placebo effect than paying more for a product -favorable ads can reinforce negative price-quality perceptions -drawing attention to positive marketing claims (encouraging expectations) stimulates the amplitude of the placebo effect. Becerra and Borsook develop the idea presented by Shiv, Carmon and Ariely (2005) by linking the effect that price changes can produce on the actual efficacy of a product and the pricing strategies for medications. An interesting idea of interdependence between whether the medicine is generic or branded and the efficacy of this drug is suggested. However, no actual experience is performed. Rao (2005) comments on the research of Shiv, Carmon, and Ariely (2005) and develops the concept of placebo effect 7 Placebo effect in marketing actions The Placebo Effect in Marketing: Sometimes You Just Have to Want It to Work. Irmak, C., Block, L. G., & Fitzsimons, G. J. Journal of Marketing Research, (2005), XLII (November), 406–409. Placebo effect in marketing action Price, Placebo, and the Brain. Berns, G. S. Journal of Marketing Research, (2005), XLII (November), 399–400. Placebo effect in medicine Mechanism of placebo pain reduction: An empirical Investigation. Montgomery, G., & Kirsch, I. Psychological science, (1996). 7(3), 174–176. Beecher, H. K. J.A.M.A., (1955), 159(17), 1602– 1606. Hróbjartsson, A., & Gøtzsche, P. C. The New England journal of medicine, (2001), 344(21), 1594– Placebo effect in medicine Placebo effect in medicine The Powerful Placebo Is the placebo powerless? An analysis of clinical trials in marketing by focusing on the price-quality relationship. Authors conducted an experiment with energy drink revealing the importance of motivation as an important factor contributing to placebo effect in marketing. Berns (2005) provides an overview of the results achieved by Shiv, Carmon, and Ariely (2005) focusing on the processes in brain that contribute to placebo effect. The authors conducted an experiment with placebo anesthetic cream in order to investigate the placebo effect in pain reduction. The results suggest that placebo of local anesthetics are not mediated by global mechanisms of placebo effect. Global mechanisms (such as anxiety reduction and endogenous opioids) are opposed to the second group of factors contributing to placebo effect – flexible mechanism (classical conditioning and expectancies). The author provides evidence of high degree of therapeutic effectiveness of placebo (produced in 35.2% of cases) by investigating 15 studies in various areas from pain reduction to simple cold with over 1000 participants involved. Beecher (1955) stresses the importance of “double blind” technique (when neither the subject nor the observer is aware of the agent that is being used) and other requirements for a successful use of placebo in medical trials. The article provides an overview of 130 clinical trials investigating the effect of placebo in medicine. The 8 comparing placebo with no treatment. 602. Placebo effect in medicine The importance of placebo effects in pain treatment and research. Turner, J. A., Deyo, R. A., Loeser, J. D., Von Korff, M., & Fordyce, W. E. Placebo effect in medicine Effect of caffeine on motor performance predicts the type of response to placebo. Fillmore, M., & VogelSprott, M. Efficiency of energy drinks The effects of Red Bull Energy Drink on human performance and mood. Alford, C., Cox, H., & Wescott, R. Efficiency of energy drinks A taurine and caffeinecontaining drink stimulates cognitive performance and well-being. Seidl, R., Peyrl, A., Nicham, R., & Hauser, E. authors conclude that placebo has no significant effects. The article provides an overview of the relevant literature with an objective to identify the importance of placebo effects in the J..A.M.A., (1994), treatment of pain. The authors 271(20), 1609– examine placebo effects of 1614. medical treatments and sham surgeries. The factors influencing the placebo responses both form the patient and provider sides are examined and assessed. The authors conducted an experiment to examine the relationship between the participant’s expectations regarding the effect of Psychopharmacolo caffeine on a motor skill and gy, (1992), 106(2), the type of placebo response. 209–214. The results stress the importance of expectancies in terms of learned association in the direction of placebo effect. The authors conducted three experiments with 36 participants in total in order to test an effectiveness of Red Amino Acids, Bull® energy drink. The drink (2001), 21, 139– improved aerobic endurance, 150. anaerobic performance and such mental performance indicators as choice reaction time, memory, concentration. The authors conducted an experiment in order to measure the effectiveness of three main ingredients of energy drinks: caffeine, taurine, glucuronolactone. The Amino Acids, effectiveness was assessed by (2000), 19, 635– measuring motor reaction 642. time, attention capacity, mood changes and subjective feeling of well-being. The results suggest that energy drinks containing above mentioned ingredients have positive 9 Theoretical background of placebo effect The placebo effect: dissolving the expectancy versus conditioning debate. StewartWilliams, S., & Podd, J. Theoretical background of placebo effect The placebo puzzle: putting together the pieces. StewartWilliams, S. Theoretical background of placebo effect The role of conditioning and verbal expectancy in the placebo response. Voudouris, N. J., Peck, C. L., & Coleman, C. Theoretical background of placebo effect Classical conditioning and the placebo effect. Montgomery, G. H., & Kirsch, I. Influence of Influence of Beer Allison, R. I., Marketing Brand & Uhl, K. P. effect on cognitive performance and mood. The authors provide an extensive overview of the literature regarding the placebo effect. They define and separate such notions as placebo, placebo effect, nocebo. The main focus of Stewart-Williams and Podd (2005) is to understand which of two main theories that are Psychological believed to contribute to the bulletin, (2004), placebo effect – classical 130(2), 324–340. conditioning and expectancy theory – is the basis of placebo processes. The main conclusion is that one shouldn’t separate these two theories when finding the basis of placebo effect. On the contrary, the relationship of two theories gives rise to placebo effect. The author gives an overview of four concepts that are Health psychology, hypothesized to contribute to (2004), 23(2), placebo effect: expectancy 198–206. theory, emotional change theory, classical conditioning, and the biological approach. The article examines the contribution of classical conditioning and verbal expectancies for placebo Pain, (1990), 43, effect. The authors came to 121–128. the conclusion that conditioning might produce greater placebo response than expectancies created by verbal stimuli. The authors conduct an experiment in order to test two opposing models of the process of placebo response: Pain, (1997), 72, expectancy theory and 107–113. stimulus substitution model. The author also answers the question of how conditioning affects analgesia. Journal of The authors conducted an Marketing experiment aimed at 10 Actions Identification on Taste Perception. Research, (1964), 1(3), 36-39. Influence of Marketing Actions The DoubleEdged Sword of Signaling Effectiveness : When Salient Cues Curb Postpurchase Consumption. Zhu, M., Billeter, D. M., & Inman, J. J. Journal of Marketing Research, (2012), XLIX(February), 26–38. Influence of Marketing Actions The Effect of Price, Brand Name, and Store Name on Buyers’ Perception of Product Quality: an Integrative Review. Rao, A. R., & Monroe, K. B. Journal of Marketing, (1989), 26(3), 351–357. identifying the influence of brand name on taste perception. The market of beer has been chosen as an example. The results suggest that taste perception arise primarily with the help of marketing actions rather than from physical product differences. From a managerial point of view it means that physical product differences had little to do with the various brands' relative success or failure in the market. The authors examine the influence of price and brand name on the customer’s evaluation of the product using meta-analysis. The results suggest that the dependence between price/brand name and perceived quality is positive and statistically significant. Authors investigate the influence on highlighting the effectiveness of a product using various marketing tools. On the one hand, it stimulates initial purchase but might have a negative post-purchase experience that would hurt pong-term sales. However Rao and Monroe (1989) argue that this happens only if the effectiveness cues are salient in the consumption context and are removed in the consumption context. 11 Methodology Research design The given research presents a confirmatory study. The hypotheses stated above will be tested through an experiment using crossover between-subjects design. The questionnaires designed to measure the brand awareness and expectations level are analyzed using descriptive statistics techniques. Selection of participants. 120 participants voluntarily agreed to participate in the experiment. All of them are students of University of Kassel of different specialization. The average age is 25 years. All participants are informed that they are contributing to a research about energy drinks and are not informed in any way regarding the true research purpose of the study so that their expectations are not affected. Participants are randomly divided into four groups: three treatment groups and one control group. Participants were asked to confirm their good health state by admitting not having heart problems. Female participants were asked to confirm that they are not pregnant. Participants were asked to abstain from caffeine consumption earlier that day. Procedure Each group is tested during four separate sessions during two days in one of the classrooms at University of Kassel campus. All four groups are asked to consume a beverage and then to solve a series of puzzles. There are three types of beverages consumed in the experiment: three treatment groups consume either Red Bull® or another energy drink that has similar amount of active components but doesn’t have a well-established brand name and the control group consumes water. The second energy drink is supposed to produce the same effect due to the similar components. Moreover the taste of two energy drinks is similar so that the participants could not distinguish between two energy drinks only by tasting them. The first treatment group consumes Red Bull® from an original bottle. I chose Red Bull® since it is the leading brand of energy drinks in Germany accounting for 44% of market share in 2011. (Euromonitor). Thus it has the strongest brand awareness. The second treatment group consumes another energy drink that is put into a Red Bull® bottle. The third treatment 12 group consumes the second energy drink from an original bottle. Finally, the control group consumes water. In order to measure the physical effectiveness of energy drink, all four groups are asked to solve a series of puzzles that measure mental alertness, concentration, memory and reasoning. The puzzles include letter cancelation task, a task that involves remembering a number of numbers and two negotiation tasks adapted to be conducted on one participant only. After solving the puzzles all three treatment groups are asked to fill in a questionnaire regarding their feelings after the consumption of the energy drink. The answers will help to evaluate subjective experience of participants after consuming an energy drink. Before consuming the beverage the first two treatment groups are asked to fill in a questionnaire that contains questions regarding the brand awareness and the expectations of participants for their performance and feelings after consumption of a given energy drink. By doing this, participants’ expectations are being enhanced. Moreover in order to encourage expectations, before the consumption of the drink, the first two groups are shown a number of videos regarding the extreme sports competitions that Red Bull is sponsoring. Before the main experiment a pre-test is run in order to assess possible pitfalls and limitations. Pre-test presents the same experiment design and procedures with reduced number of participants. 13 Overview of Chapters Topic: Placebo effect in marketing: unexplored influence of brand name. Title page Abstract Table of contents List of figures List of tables List of abbreviations 1. Introduction to the research 1.1. Introduction 1.2. Problem statement 1.3 Research question 2. Theoretical background of placebo 2.1. Classical conditioning and its contribution to placebo process 2.2.Exectancy theory in shaping placebo effect 2.3.Other theories contributiong to placebo effect 2.4.Possible models of placebo effect process 3. Placebo effect in marketing 3.1. Overview of the previous research conducted in the given area 3.2. Various marketing actions and its effect on product perception and efficacy 4. Influence of brand name on consumer’s perception of a product 4.1. Marketing theories of brand perception 4.2. The influence of brand name on various product 5. Experiment 5.1. Experimental design 5.2. Experimental procedure 5.3. Results 5.4. Discussion 6. Conclusion 6.1 Conclusion 6.2 Managerial implication 6.3 Limitations and future research 14 Bibliography Appendices 15 Schedule May 2012 – 3 Sep 2012 Developing topic proposals 3 Sep 2012 - DEADLINE FOR SENDING TOPIC PROPOSAL 3 Sep 2012 – 17 Sep 2012 Time lag 17 Sep 2012 – 21 Sep 2012 Choosing the topic 21 Sep 2012 – 17 Oct 2012 Reading related literature 17 Oct 2012 – 31 Oct 2012 Writing expose 31 Oct 2012 – DEADLINE FOR SUBMITTING THE EXPOSE 31 Oct 2012 – 11 Nov 2012 Time lag for improving the expose 11 Nov 2012 – 1 Dec 2012 Writing the draft of theoretical background 1 Dec 2012 – 11 Dec 2012 Preparing for the experiment 11- 13 Dec 2012 Conducting the experiment 13 Dec 2012 – 16 Dec 2012 Analyzing the results of the experiment 16 Dec 2012 – 18 Dec 2012 Preparing a draft of intermediate report 18 Dec 2012 – 20 Dec 2012 Time lag for finishing up the draft of intermediate report 20 Dec 2012 – DEADLINE FOR SUBMITTING THE DRAFT OF INTERMEDIATE REPORT 20 Dec 2012 – 8 Jan 2012 Writing Chapters 1-4 8 Jan 2012 Feedback on the draft of intermediate report 8 Jan 2013 – 18 Jan 2013 Improving the intermediate report + finishing up the draft of chapters (1+2+3+4) 18 Jan 2013– 22 Jan 2013 Time lag + making of Intermediate presentation 22 Jan 2013 –DEADLINE FOR SUBMITTING INTERMEDIATE REPORT 23,24,25 Jan 2013 Intermediate presentations 25 Jan 2013- 18 Feb 2013 Analyzing the results of the experiment/Writing Chapter 5 18 Feb 2013 – 18 Mar 2013 Writing Conclusion 18 Mar 2103 – 8 Apr 2013 Finishing up the thesis 8 Apr 2013 – 6 May 2013 Time lag 6 May 2013 – 13 May 2013 Proofreading 13 May 2013 – 27 May 2013 Working on the final presentation of the thesis 27 May 2013 – 31 May 2013 Final presentations 16 Bibliography Alford, C., Cox, H., & Wescott, R. (2001). The effects of Red Bull Energy Drink on human performance and mood. Amino Acids, 21, 139–150. Allison, R. I., & Uhl, K. P. (1964). Influence of Beer Brand Identification on Taste Perception. Journal of Marketing Research, 1(3), 36–39. doi:10.2307/3150054 Becerra, L., & Borsook, D. (2005). Plaœbo : From Pain and Analgesia to Preferenœs and Products. Journal of Marketing Research, XLII(November), 394–398. Beecher, H. K. L. C. (1946). Pain in men wounded in battle. Annals of surgery, 123(1), 96–105. Beecher, H. K. (1955). The Powerful Placebo. J.A.M.A., 159(17), 1602–1606. Berns, G. S. (2005). Price, Placebo, and the Brain. Journal of Marketing Research, XLII(November), 399–400. Fillmore, M., & Vogel-Sprott, M. (1992). Effect of caffeine on motor performance predicts the type of response to placebo *. Psychopharmacology, 106(2), 209–214. Hróbjartsson, A., & Gøtzsche, P. C. (2001). Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. The New England journal of medicine, 344(21), 1594–602. doi:10.1056/NEJM200105243442106 Irmak, C., Block, L. G., & Fitzsimons, G. J. (2005). The Placebo Effect in Marketing : Sometimes You Just Have to Want It to Work. Journal of Marketing Research, XLII(November), 406–409. Lane, V. R. (2000). The Impact of Ad Repetition and Ad Content on Consumer Perceptions of Incongruent Extensions. Journal of Marketing, 64(April), 80–91. Montgomery, G. H., & Kirsch, I. (1996). Mechanisms of placebo pain reduction: An Empirical Investigation. Psychological science, 7(3), 174–176. Montgomery, G. H., & Kirsch, I. (1997). Classical conditioning and the placebo effect. Pain, 72(October 1996), 107–113. Rao, A. R. (2005). The Quality of Price as a Quality Cue. Journal of Marketing Research, 42(4), 401–405. Rao, A. R., & Monroe, K. B. (1989). The Effect of Price, Brand Name, and Store Name on Buyers’ Perception of Product Quality: an Integrative Review. Journal of Marketing, 26(3), 351–357. Seidl, R., Peyrl, A., Nicham, R., & Hauser, E. (2000). A taurine and caffeine-containing drink stimulates cognitive performance and well-being. Amino Acids, 19, 635–642. 17 Shiv, B., Carmon, Z., & Ariely, D. (2005). Placebo Effects of Marketing Actions : Consumers May Get What They Pay For. Journal of Marketing Research, XLII(November), 383–393. Shiv, B., Carmon, Z., & Ariely, D. (2005). Ruminating About Placebo Effects of Marketing Actions. Journal of Marketing Research, 42(4), 410–414. Stewart-Williams, S. (2004). The placebo puzzle: putting together the pieces. Health psychology, 23(2), 198–206. doi:10.1037/0278-6133.23.2.198 Stewart-Williams, S., & Podd, J. (2004). The placebo effect: dissolving the expectancy versus conditioning debate. Psychological bulletin, 130(2), 324–340. doi:10.1037/00332909.130.2.324 Turner, J. A., Deyo, R. A., Loeser, J. D., Von Korff, M., & Fordyce, W. E. (1994). The importance of placebo effects in pain treatment and research. J.A.M.A., 271(20), 1609– 1614. Rao, A. R., & Monroe, K. B. (1989). The Effect of Price, Brand Name, and Store Name on Buyers’ Perception of Product Quality: an Integrative Review. Journal of Marketing, 26(3), 351–357. Voudouris, N. J., Peck, C. L., & Coleman, C. (1990). The role of conditioning and verbal expectancy in the placebo response. Pain, 43, 121–128. Zhu, M., Billeter, D. M., & Inman, J. J. (2012). The Double-Edged Sword of Signaling Effectiveness : When Salient Cues Curb Postpurchase Consumption. Journal of Marketing Research, XLIX(February), 26–38. 18