Google’s “Messy Middle” and How Pharma Brands Can Win in It

Introduction: The Launch Dilemma

You’re a product manager and you’ve just launched a new Dapagliflozin/Metformin combination. Your MRs have already visited the target physicians several times. Yet, prescriptions haven’t started. The campaign has entered its second quarter, but the brand still hasn’t gained the traction you expected.

What next? Beyond the usual deep-dive like manager discussions, fieldwork, and data analysis, is there any other way to change gears?

The answer may come from Google. Not Google Search, but Google’s groundbreaking marketing research project: Decoding Decisions -Making Sense of the Messy Middle.

Understanding the “Messy Middle”

Google’s research, published in 2020, revealed a profound insight: the traditional linear marketing funnel is dead. Today’s customer journey is non-linear, chaotic, and best represented as an infinity loop.

Key Concepts from the Study

• The Infinity Loop:
  Consumers no longer move step-by-step through Awareness → Interest → Desire → Action (AIDA). Instead, they bounce between Exploration (broad research, expanding options) and Evaluation (narrowing choices, filtering options). This back-and-forth continues until they feel confident enough to decide.

• Fluid Brand Preference:
  In experiments, even fictional brands with zero awareness could win up to 28% of preference share from loyal consumers by applying behavioral science principles.

• Three Strategic Imperatives:

  1. Be Present and Accessible: Just being visible at key exploration moments can win preference.

  2. Be Compelling with Behavioral Science: Load your brand with cues like social proof, authority, and clear value signals.

  3. Make Consumers Feel Confident: The winning brand is the one that closes the “confidence gap” with clear, credible, and easy-to-digest information.

Applying “Messy Middle” to Pharma Marketing

Pharma brands don’t win just by being the first name doctors hear. They win by being the most confidence-inspiring choice during the exploration and evaluation loop.

Let us attempt how to adapt this to pharma marketing. Let's take the above mentioned example. Here’s how to dislodge competitors by leveraging behavioral science biases from the study.

1. 🧠 Category Heuristics - Make Decisions Easy

Bias: People rely on simple shortcuts like “Sugar-Free,” “Clinically Proven,” or “Visible Results in 2 Weeks.”

Pharma Application:

• Create a clear patient category portrait. Narrow targeting works, e.g., “For CKD patients with diabetes.”

• Use easy-to-process claims, eg.,:
  “Cardio-safe even in high-risk patients.”
  “Reduces risk of hospitalization for heart failure.”

• Visualize dosing, titration, and evidence to simplify information processing.

• Other heuristics that can be used:

  • Pricing: “Most economical choice.”

  • Access: “Available at 200 chemists in the city.”

  • Quality: “Manufactured in USFDA/EU-approved facility.”

2. 🏛 Authority Bias - Earn Trust with Credibility

Bias: People trust experts, guidelines, and reputable sources.

Pharma Application:

• Quote clinical guidelines (ADA, EASD, RSSDI) prominently.

• Use only peer-reviewed journal references.

• Build an online evidence hub summarizing studies from only reputed journals for your indication.

• Share the microsite link on email, WhatsApp, or Telegram with clear subject lines like:
  “Peer-Reviewed Evidence Hub: Dapagliflozin + Metformin in CKD.”

3. 👥 Social Proof - Show Peers Prescribe It

Bias: People follow others’ behavior when uncertain.

Pharma Application:

• Compile real-life case studies (anonymous) of patients on your brand, ideally supported by KOLs.

• Use testimonial-style quotes from study authors and early adopters.

• Highlight availability at top hospitals or institutions as a signal of trust.

4. 🎁 Power of Now - Show Immediate Wins

Bias: People prefer instant gratification or clear, near-term benefits.

Pharma Application:

• Communicate specific timelines:
  “Visible reduction in post-meal spikes from first dose.”
  “FPG reduction by Day 7.”

• Provide starter packs so doctors can initiate therapy immediately and see patient feedback sooner.

• Collapse the “waiting horizon” by showing first milestones clearly and ethically.

• It’s about making the benefit feel immediate, actionable, and emotionally rewarding, even if the full clinical outcome takes time.

5. 🎀 Scarcity Bias - Make It Feel Exclusive

Bias: Scarce or limited opportunities feel more valuable.

Pharma Application:

• Run small real-world evidence studies with early adopters.

• Host invitation-only roundtables (7-8 specialists) to discuss results.

• Position access to these insights as exclusive and valuable.

6. 🎁 Power of Free - Give Valuable Freebies

Bias: People overvalue freebies, even if small.

Pharma Application:

• Provide customized patient education materials — ideally with QR codes for clinic use.

• Offer unbranded disease-awareness portals for caregivers/patients/families.

• Run Patient Support Programs: free HbA1c checks, starter samples, or periodic follow-up calls.

• Build personalized education websites for HCPs or clinics with their names.

The Bottom Line

Winning in the messy middle is about more than brand awareness. It’s about building confidence, simplifying decisions, and ethically influencing choice. For pharma marketers, this means combining behavioral science insights, evidence-based messaging, and digital delivery to stay top-of-mind during every exploration-evaluation loop.

And remember - the messy middle isn’t a one-time challenge. It’s an iterative and continuous process, just like the infinity loop itself. The brands that monitor, learn, adapt, and keep showing up with credibility and clarity will be the ones that win, again and again.

How Curafto Can Help:
Backed by over 25 years of collective pharma sales, marketing, and behavioral science expertise, Curafto helps brands win in the messy middle with confidence. We design behavioral-science-driven messaging, create digital eDetailers and evidence hubs, and build patient engagement programs that make doctors’ decision-making easier and faster.

📩 Talk to Curafto about your next launch and let’s craft campaigns that earn attention, build trust, and keep winning in this infinite loop.

If your brand needs to earn attention, build trust, and win consistently in this infinite loop, Curafto can help you make it happen.