With moderator JOE KUCHTA, Agency Principal The Sandbox Agency


Our panel of experts:


SVP, Group Creative Director




Design Director

Rx EDGE Pharmacy Networks



Chief Creative Officer




Founder and President

Good Apple



Senior Vice President, Executive Creative Director

AbelsonTaylor It’s an age-old question: “How creative can an agency really be if they ply their trade in the healthcare space?” The stigma against creativity is certainly there in the broader marketing and agency world when it comes to the regulated business of drug and device advertising. It is a constant challenge from clients, a pervasive concern among the talent we all need in our industry as they consider the limitations of this space. But is it really true?


Times have changed for all marketers, healthcare or not. Between the new media, unlimited channels and instant responses, the overload of messaging and data that is now constantly at our fingertips, creativity has taken on new shapes and forms that were unfathomable just 10 years ago. But is it more difficult to be creative now vs. then? And is it true that is even more difficult to be creative in healthcare now vs. then? We asked four renowned creative experts who have been faced with all of these issues in the world of healthcare marketing and advertising to share their opinions and experiences on this subject.

Let’s begin with a broad question about big ideas. Is “creative thinking” and the generation of ideas more valued or less valued than it was a generation ago?

Stephen Neale: I think “creative thinking” and idea generation are just as valued as they were a generation ago. I think the question continues to get asked because the definition of creative thinking and idea generation changes from generation to generation. For the new generations, “idea” applies to the medium or object. For the older generations, it applies more to the story, the images and words. It’s incredibly powerful when you bring them all together.

Sam Cannizzaro: “Creative thinking” is definitely more valued today—and it’s justifiable. In healthcare creativity is pushed to the limits every day, perfectly fusing science, strategy, creative and technology. Research has suggested that creativity involves the unique intersection of a variety of characteristics, behaviors, and rituals but is greatly influenced by experiences and context. The world’s leading scientists still don’t fully understand how the imaginative mind works. What we do know is creativity involves a number of cognitive processes, neural pathways, and emotions. In today’s “always on,” 24/7 connected world, the best ideas have staying power. The idea must be focused on keeping the audience engaged in a story or memorable experience. In the past, everyone was focused on stopping power and how a particular idea could stop a person immediately in their tracks for a moment in time. That is not enough today.

Norbert de Laclos: I do believe that our end creative product has devolved over the years. Even in pharma, I look at creative as an art form and not simply marketing. And while it’s easy to point to a client, market research, or regulatory as the reason for diluted creative, I see that our best work is often being killed internally, within the agencies themselves—by lack of imagination, vision or general knowledge. Today, there seems to be less finesse and knowhow about how to take an idea to its highest level. Design is more illustrative than it is conceptual. Language has lost its rules, its moods (in pharma, the conditional mood has replaced the indicative one), and is being simplified to the extreme. It’s not necessarily “creative thinking” that is less valued today—it is “thinking.” Indeed, why use concepts and complicated ideas when you can share an emoticon?

Julie Hogrefe: People tend to think about healthcare when they are in need of it. Then they will take notice. So our communications need to stand out when people are in that right “mindset moment.” There are thousands of channels competing for people’s time and attention spans. Current and prospective patients use multiple sources to find out about conditions and symptoms. Plus, they are less apt to spend a lot of time on any one ad or medium. No one has to sit there and watch a television ad any more. We need to keep our messages shorter and to the point so that they are understood quickly when people are paying attention.

So presuming ideas are still of high value, what are the main challenges to creative people at agencies today?

Norbert de Laclos: Pick up any People magazine while waiting in your doctor’s office and take a closer look at the first page of pharma advertising. What do you see? An improbable group of friends, ethnically too representative of a specific target audience, walking on a beach at sunset and laughing—or maybe biking on a sunny road in the middle of some fields, still laughing. Why are these people laughing? They may have just been diagnosed with a last stage colon cancer. But you don’t feel bad, because there may be hope. MAYBE. What follows is a complicated series of incomprehensible sentences, all using conditional mood, even for facts and phone numbers, and that is clearly the result of automated copy-and-paste. This page of advertising summarizes quite well the challenges of a creative team.

Al Muzaurieta: I would think that today we are valuing data more than creative and this is dangerous ground because while algorithms may drive a successful day-trading strategy they don’t build a great business. In the same way, data may suggest that all creative with a smiling image produces a .04% higher CTR it won’t build a great campaign that drives shifts in culture and product adoption.

Stephen Neale: I’ll mention one that doesn’t seem to get discussed enough: graphic designers being able to design with “white” or “negative” space. I saw a piece that was going into the Medical Advertising Hall of Fame a year ago, and the agency was required to produce a video about the work. They shot someone walking the ad around their agency for feedback, and one creative after another said admiringly, “Wow, look at that white space!” Negative space is important to have because it helps the viewer focus attention where you want it, establishing a visual hierarchy.

Sam Cannizzaro: We are constantly balancing creative perfection vs speed of current marketing. People own more screens and devices than ever; recent research shows ~70% say they use three or more devices and prefer engaging with content across screens regularly. It takes a new type of creative that we are breeding to adapt and thrive while ensuring the brand story, advertising, and experiences seamlessly engage at a moment’s notice. Another challenge is driving real innovation in healthcare and overcoming the question creatives dread: “How do we know this is going to work?” I believe marketers have a desire to innovate; however, they are in a constant tug-of-war between real innovation and how to predict success. The definition of innovation is in direct conflict with the comfort of predictable success because it has never been done before. The best creatives understand the future of our advertising industry must breed real innovation or be ready to be disrupted by tech startups and smaller idea shops.

How does the necessity of clinical data in our space affect the ability to craft messagesand execute good creative?

Sam Cannizzaro: What it actually did is challenge creatives to find new ways to tell these complex stories more effectively. A good example of how it evolved our industry is the explosion in data visualization techniques. When done right, these beautifully crafted visuals with accompanying numbers and words have provided creatives with a new way to present data in a pictorial or graphical format. Some of my favorite executions have married history, art, science, and technology in magical ways to captivate and tantalize audience participation.

Norbert de Laclos: All of the sciences have become part of the marketing mix. Today’s treatments involve a variety of fields—nuclear physics, genetics, bioprocessing, etc. The amount of data associated with each discipline makes it harder to digest and identify the overarching idea. But however fastidious the process may be, it should not have an effect on the quality of execution of the creative work. To develop strong, credible messaging and thought-provoking creative, we simply need people who understand and can convey these high-science principles. Besides, “cross-creation” is something creative minds should be used to—we all look for ideas in other fields or industries.


Al Muzaurieta: After all these years we continue to avoid presenting clinical data to our patients. As a community we believe they aren’t equipped to manage the data and so we build our communication to deliver very simplistic messages. We need to build CVAs for our patients that deliver clinical data in patient friendly ways.

Stephen Neale: I often wonder if packing regulatory language into every available space, whether broadcast, digital or print, is having the exact opposite effect of attracting attention to fair balance information. Instead, maybe no one is paying attention to it. Is it too much for people to process too quickly and thus easier to overlook and forget? In an attempt to make everything important and stand out, nothing does. Someday someone will do a study and find a better way for fair balance and marketing messages to coexist.

How has the preponderance of digital and social media channels changed the way you approach campaigns or programs?

Julie Hogrefe: Integration is the key thing to keep in mind. We always strive to connect the messages we create for the pharmacy channel with other creative that the consumer may be seeing elsewhere, whether it’s digital, social, TV, or print. My goal is to be consistent with the positioning, tone, and look of other brand elements so that key messages are reinforced across channels.

Stephen Neale: On many projects, we’re now trying to do more “trans-media” concepting where we consider all aspects of the interaction we want the physician to have with a brand and use that interaction as a springboard for creating the campaign or story. I’d like to see more of this, but many times our clients are under pressure to get concepts into research quickly, and thus we have to ideate around a traditional campaign, keeping in mind how it will translate into other channels. We’ve created an Experience Design group staffed with talented creative digital experts who partner with teams across the agency to add their digital expertise to any assignment. So while the brand group creatives are doing their thing for the product campaign, they can also be planning ahead with the ExD group to create work that takes full advantage of the channels available to us and ensures that technology, analytics and digital trends support the campaign idea in the most effective way.

Al Muzaurieta: Social for pharma is like taking your anti-social friend to a party and asking them to sing and dance for the group. They simply aren’t well equipped to be the life of the party. The FDA does not want pharma to be social, and as a result we need to partner with health publishers, advocacy groups who have strong relationships with patient groups and publish FDA-compliant messaging alongside very high quality editorial. I also think that most pharma companies should actively buy media inventory on user-generated content. I see very little regulatory risk here and believe that these platforms will grow if they can attract more meaningful ad dollars. For example, if you check out the message boards on WebMD you will see a great opportunity to place your message alongside very meaningful content. I also think that digital can enhance the CRM stream and allow us to deliver very targeted messages along the patient pathway.

Norbert de Laclos: New media, new technologies, and social media do add dimension to the creative equation, but in the end, it’s still about finding a great idea that can promote behavior changes.

Sam Cannizzaro: It definitely has changed the way we approach creative as a whole, but that shift happened years ago. Our campaigns are conceived of and presented as customer experiences at their outset vs. as an afterthought. We decided a long time ago we needed to go beyond advertising to create personalized brand experiences that involve, inspire, educate, and activate people through ongoing brand journeys.

Everyone believes regulatory concerns, cautious clients and competitive campaigns tend to constrain creativity. Do you agree, or does this merely challenge you to do better in spite of those?

Sam Cannizzaro: There are a lot of things out of our control just like any regulated industry, but we don’t dwell on what we can’t do because it can stifle creativity. We intentionally focus our efforts on leading change and constantly evolving the status quo. In most cases, these “brand journeys” are someone’s “health journey” and it’s a privilege to help people find the information and get treatment they need.

Norbert de Laclos: Regulatory and legal teams can be roadblocks, but in my experience they do not limit creativity. We still share what we feel is our best, most compelling work, not our “safest” work. Besides, some additional challenge in the language can be fun. I have found that vetting concepts earlywe’re talking pencil sketches and headlines—with a medical, legal, and regulatory team, even inviting them to attend market research meetings, can go a long way toward developing trust.

Al Muzaurieta: In the last 20 years shops have specialized in pharma and it takes a brave pharma company to hire a traditional general ad agency to create messages and campaigns. This has led to many copycat campaigns and a sort of stagnation. I think every major pharma company should actively hire one non-pharma specialist to support a brand team and challenge itself to create something unusual. The best work in the future will come from healthcare agencies who also engage in other verticals.

Julie Hogrefe: I don’t feel that regulatory concerns and “cautious clients” are a constraint to creativity. It is just part of doing business in pharma. The longer you’ve worked in the industry the more you understand what the regulatory requirements are, and what can and can’t be done and what can or can’t be said. Guidelines for branded or unbranded communications, ISI placement, and fair balance can differ from brand to brand. The more you understand up-front about guidelines, the faster it will be to get a program approved through the medical/legal/regulatory process.

Stephen Neale: Interestingly, more and more clients are saying they want to do something different in the market. I’ve heard the term “disruptive” countless times, from a variety of clients. When we hear this, we try to communicate very quickly that if they want to do something truly “disruptive” or different, success is just as dependent on them as on the agency. There needs to be a client commitment — by the brand director, senior leadership, and regulatory — that agency and client marketing together are going to attempt to approach the market differently. I like it.

What creative avenues have you explored to communicate messages to clinicians now that sales rep access is becoming more limited?

Stephen Neale: We created something called “Detail at a Distance” for customizable remote presentations that increase the footprint of a small field force. As an example, for an oncology product, a very small MSL force was often urgently summoned to an office to educate the staff on how to administer the product before a patient succumbed to relapsing cancer. Hours mattered and there was no budget for travel, so an online presentation was made available to address the urgency of the need and overcome the access issue. When clinicians simply refuse to allow access, however, we provide patient education materials of high quality to gain access.

Sam Cannizzaro: When access to a group of clinicians is limited, we predominantly rely on precision targeting strategies. Our first step is identifying where the low-see/no-see clinicians congregate online. Are they active in any online communities like Doximity or Skipta, and what content are they viewing? Then we dig deeper to better understand their geolocation and if they are influenced by online or offline KOLs. Lastly, we take an inventory of the professional congresses they attended in the past 12 to 24 months and assess the upcoming congress schedule. Once we have captured all this intelligence, we generate a custom communications plan and regularly monitor the frequency and reach to gauge success.


Norbert de Laclos: I’m a believer in the power of “surround sound” communications—not just to HCPs, but to patients, spouses, and caregivers—using every channel available. For a consumer video, I used a little dog as a catalyst to provoke a reaction in patients with bipolar disorder. A survey on the ranking of the major U.S. hospitals was used to push CXOs to check out the latest surgery materials on the market. A gaming site for schizophrenic patients and their doctors, nurses, parents, and friends used badges and SMS to help change the daily routine. Reaching physicians when they are out of the office, such as cardiologists when they are on the golf course and don’t have their usual defenses up, can be a powerful opportunity for engagement.

Al Muzaurieta: We also actively target MDs in traditional consumer environments. If a call plan doctor reads the WSJ we want to be in his digital and print edition. Data is allowing us to get down to this level of targeting and while the individual impression is costly, it is very effective in driving sales and building brand awareness.

What about the growing role of activist patient and advocacy organizations? Do they influence your creative thinking, and if so, in a positive or negative way?

Norbert de Laclos: We lean toward working with activist and advocacy groups for networking (network of people, e-networks, and GPS), targeted toward children, elderly, and long-term care patients. I have worked with or helped create local communities built around diabetes, asthma, bipolar disorder and schizophrenia, where being connected to someone—even on the other side of the planet—can change a life. For people with cancer and AIDS, activists and communities are a very effective and even fearless way for market shaping and communicating. For some patients, these groups represent the only resource for getting access to information and support services.

Sam Cannizzaro: Strong advocacy organizations and having more patients engaged in their own health is great thing. We inject healthcare with human care by turning have-to-do’s into want-to-do’s, which drive healthier outcomes. According to a study of nearly 25,000 patients at Fairview Health Services in Minnesota, engaged patients are more likely to comply with their treatment. As creative, we have the ability to lead this shift and move from lecture to dialogue – from complex to simple – and helping people understand their health, their disease, and their treatment while motivating them to take an active role in their care plan.

Stephen Neale: They really influence our thinking for orphan drugs or diseases. The public is so desperate to have any help for the rare disease they or their loved ones are facing. So there are many very well-informed individuals in the advocacy community who are very vocal and helpful to therapies that are fast tracked and have had some success.

Are there situations or types of products even in healthcare that allow you to be either more lighthearted or edgier

Norbert de Laclos: Medical devices and technologies allow us to move away from the constraints of the drug market. I was thrilled to work on a device that has revolutionized cardiac care and on a new software program that allows remote surgery in New York on a patient in China. For me, creating global campaigns with customized messaging sequences about these new, groundbreaking, and cutting-edge technologies was fascinating and definitely exciting.

Stephen Neale: Greater creative freedom is one of the reasons agencies are always looking for a device account. Usually no one’s life is hanging in the balance, there are fewer restrictions on what you can say, and you have more freedom to explore work that runs a wider range of emotions and tonality.

Julie Hogrefe: Since our focus is on the pharmacy channel, we need to tailor messages to the needs of the target audience found there. They are in the pharmacy; they are looking for solutions and thinking about their health and healthy outcomes. Sometimes a lighter approach is appropriate. In any case, we are also required to gain approval of retailers (such as chain drug stores). They may have their own set of conditions and opinions about acceptable creative, so that needs to be taken into account as well.

Sam Cannizzaro: Some conditions like erectile dysfunction and low testosterone naturally enable a more lighthearted approach compared to life-threatening diseases. In addition, unbranded communication generally translates very nicely toward a more edgy approach because it’s used ahead of product approval to help support condition awareness, lead generation and market preparation. In my past experience, medical device advertising can offer creatives the ability to be edgier because these organizations were built with innovation at the core, so they generally are more open to ideas that have never been done before.

Finally, what’s on the horizon for creative in our industry? Will the emergence of more Biopharmaceuticals change things? Will mergers and acquisitions give you more complicated administrative cultures to deal with?

Al Muzaurieta: We are seeing a large number of RFPs from small pharmas who in ten years will be fantastic mid-size companies who are inventing great new products to treat a number of serious conditions. We hope that as they grow they elect to grow organically and remain independent.

Stephen Neale: I think the new generation of physicians, who’ve grown up as consumer users of digital and social media, will have high expectations of how pharma approaches them as doctors. They’ll want the same level of customization in how they get content from brands, they’ll expect value-added objects/apps to help them in their practices, and they’ll demand that drug manufacturers have causes aimed at diseases beyond their product offerings. We’re already seeing it. I think pharma products that are campaigning around a cause or disease in addition to their products, and somehow connecting the two, will be standard in any new marketing plans. I think new physicians are expecting it.

Julie Hogrefe: Intriguing people with strong, memorable creative will be important whether you’re talking about a vaccine, a specialty drug, or a traditional drug. And we have already dealt with many mergers and acquisitions over the 15+ years we have been doing business. You just have to keep up with the changes as best you can, and be up for anything!

Norbert de Laclos: As someone who has lived through four mergers, I can definitely say that they do complicate work, and more importantly, they can mess up your life! My advice to anyone who learns that their organization is part of a merger or acquisition is the following. First, look at each merger as a new job. Be prepared to rebuild trust levels with your teams, and to prove yourself, your skills, and abilities. Pay careful attention to the new lexicon and vocabulary being used by your “new” company, because the incoming managing team will have “redefined” marketing and communication, renamed the various departments, and added the “words of the moment” to the company’s vision, mission, and value propositions.

On the creative horizon, I see continued diversification of products and brands: more devices, more cross-science and medical fields, more digital, and more real working apps for mobile platforms. I also see more industrialization: companies will produce the app and the device themselves. As creative leaders, our challenge will be to find writers who have the skills to work across channels. And of course, we need to educate and train our employees, both young and experienced, on mastering their cross channels.

Sam Cannizzaro: Building experiences while blurring the lines further between the real and digital worlds—this new breed of creative will be referred to as a “fusionist.” They will act as the “fusion” between research, art, engineering, and science. The ad agency of the future will continue to evolve and construct more physical open spaces outfitted with more touch screens (fewer laptops); moveable walls; an electronics workshop for building devices, generating virtual reality experiences on demand, and replacing color printers we use today with 3D printers. We will prototype and build things in real-time in an effort to get the involvement of our consumers and clients to experience, research, and buy in to these innovative ideas we create.


JOE KUCHTA, Agency Principal, The Sandbox Agency [until recently known as GA Healthcare Communication] Joe believes that creative is not a department or a label. It is neither limited to creative types within agencies or limited to only coming from agencies themselves. Having spent 30 years in the healthcare space, both on the client and agency side, Joe has a real passion for creative thinking across the board—from how strategy and foundational brand positioning is established to how campaigns, messaging and tactical plans are executed. Delivering creative is a challenge, always has been and always will be. That’s why Joe believes that both agencies and clients should place a high value on people who bring a creative mindset to the table any chance they get.  


Sandbox is an entirely new integrated marketing agency built on the foundation of four remarkable firms who believe that, together, they can deliver much more for their clients. GA Healthcare Communications is one of those founding agencies and has been a full-service agency with more than 30 years of pharmaceutical and healthcare advertising experience. Headquartered in Chicago, Sandbox operates from seven locations across the U.S. and Canada. Its roster of clients includes some of the most respected names in human and animal healthcare, agriculture, biotechnology, financial services, travel, and consumer products.


SAM CANNIZZARO, SVP, Group Creative Director at GSW

Sam is all about going beyond communication to tell better stories. As an SVP Group Creative Director at GSW, Sam is an inspiring and creative problem-solver with a proven track record of conceptualizing and orchestrating memorable brand experiences. As an avid listener, Sam is genuinely driven by human insights, creativity, teamwork, and a passion for storytelling. From US to global, traditional to interactive media, small clients to giants, Sam brings more than 15 years of experience helping companies overcome marketing and business challenges by building valuable relationships and creating brands with staying power. His category expertise spans neurology, pain, urology, respiratory, pediatrics, dermatology, diabetes, infectious disease, cardiovascular, vaccines, and devices. Speaking the language of people and healthcare is something that has profound meaning to Sam. His motivation is to impact people’s lives in a positive way is something he knows he can’t get anywhere else. For Sam, that’s the true meaning of Speak People.


GSW, an inVentiv Health company based in Columbus, Ohio, with offices in New York, Pennsylvania, and Canada, is one of the largest health and wellness advertising agencies in the world and was awarded 2015 Most Admired Agency by MedAdNews and 2014 Agency of the Year by both MedAdNews and MM&M. The company provides a full range of client resources, including research, analytics, marketing and brand consultancy, advertising, promotion, public re lations, advocacy, medical education, meetings and events, interactive communications, and more. 

JULIE HOGREFE, Design Director, Rx EDGE Pharmacy Networks

Julie combines her knowledge and skills to deliver visual concepts that inspire, motivate, and get results. She leads design and creative services for all Rx EDGE Pharmacy Networks programs, developing graphics for client initiatives as well as internal marketing materials for the company. With experience in all facets of design and a background in both the CPG and pharmaceutical industries, Julie brings a fresh perspective to every project, whether it is brand identify design, logo development, digital media, interactive, or print.


Rx EDGE assists pharmaceutical brands in educating and acquiring new patients through consumer marketing programs delivered in the retail pharmacy channel. To date, the company has worked with over 150 pharmaceutical brands in 74 different therapeutic categories encompassing more than 62 manufacturers.

NORBERT DE LACLOS, Chief Creative Officer, Natrel

Norbert is responsible for ensuring Natrel’s creative vision, high standards and overall creative excellence. With more than 15 years at healthcare agencies in the U.S. and diverse consumer experience in Europe, he has extensive cross-channel expertise in global and domestic communication solutions for all audiences, as well as a solid background in branding design. Norbert has launched or rebranded some of the biggest blockbusters in the healthcare industry, including Nexium, Seroquel, Crestor and Enbrel. He has also produced best-in-class websites, e-details and mobile apps for such high-profile brands as Gardasil, Zetia, Vytorin and Viagra.


Natrel is an independent, full-service healthcare communications agency founded in 1999 and headquartered in Parsippany, N.J. Using proprietary strategies called Persona IDSM and Bilateral BrandingSM, the agency combines the emotional power of brand personality with the intellectual power of traditional positioning to ensure the differentiation of client brands beyond what can be achieved by regulated product claims and messaging alone. The firm combines world-class branding capabilities with a wide range of other advertising, marketing and education services.

ALBERT MUZAURIETA, Founder and President, Good Apple

Al Muzaurieta founded Good Apple in June 2006 as an online media consulting practice. In 2008, with the help of Nedim Aruz, he converted the consulting practice into a full service media planning and buying agency. Prior to creating Good Apple, Al served as an Account Director at Razorfish where he led the AstraZeneca account. He was also a Media Director at MediaCom, where he managed the Pharmacia business. Since, 1999 Al has created groundbreaking digital marketing programs for blockbuster products like Celebrex, Detrol LA, Crestor, Seroquel, Vyvanse and Intuniv.


Good Apple started in response to the rapidly changing digital industry. With the democratization of data, technology and creative leading to a fundamental shift in how companies managed their media, smaller brands and start-ups were in need of focused campaigns that didn’t fit into the slow, bureaucratic chains of the big agencies. Good Apple is a nimble, boutique media agency focused on clients seeking data-driven results with their unique audiences. Its launched the first Facebook campaign for Starbucks, its first client, and generated over 650K fans and 1.2M virtual drinks sent by users. Good Apple’s client partners include Shire Pharmaceuticals, Birchbox, Moda Operandi, Hologic, Zola and Endo Pharmaceuticals. It also does complete nonprofit work Smile Train, Inc.

STEPHEN NEALE Senior Vice President, Executive Creative Director, AbelsonTaylor

Stephen’s philosophy for a great creative campaign is simple – make a human connection. Stephen joined AbelsonTaylor as a young designer seeking to make a difference and he did just that with the Hytrin Balloon Ad in 1993. The campaign changed the face of medical advertising, lifting creativity out of its sameness and connecting with physicians. It was recently inducted into the Medical Advertising Hall of Fame. Connecting with customers is a common theme at AbelsonTaylor as Stephen continually encourages and mentors teams to push the creative envelope. Not surprisingly, he is frequently invited to judge awards competitions. His perspectives are cited in industry publications and he occasionally pens articles on creativity.


AbelsonTaylor is the largest independent medical agency-of-record in the world. Established in 1981, AbelsonTaylor serves pharmaceutical, biotech and health-and-wellness companies, creating award-winning brand experiences in broadcast, print and digital.

Getting Engaged with HCPs

Getting Engaged with HCPs