#FierceMadness, DTC Edition: Grab a bracket and get ready to vote for your favorite pharma ads!

Fierce DTC March Madness. (ioanmasay/iStock/FierceMarkets)

UPDATE: Voting has begun! Select your favorite ads in the finals here. Polls close at midnight ET on Tuesday.

#FierceMadness is back—this time with DTC advertising. We've created our first-ever DTC March Madness tournament where drugmakers and their brands square off in search of the national title for best pharma ad of 2016.

Get ready for a battle. Pharma advertising can be polarizing, to say the least. For every ad watcher who wanted a Xifaxan "Gut Guy" squishy ball, five others were grossed out by the walking, talking intestinal tract that consistently interrupted their Sunday afternoon football. For every person who switched channels when the ladies in blue dresses started talking about erectile dysfunction, there were men who tuned in to the messages for info about Viagra single packs and text-in discount coupons.

But what is it that makes a "good" pharma ad? Is it edgy creative or serious messaging? Scary warnings or humorous characters?

In the spirit of March Madness basketball-bracket mania, we’d like our readers to help us figure that out. We've set up a Fierce bracket of matchups with ads that ran in 2016, and we want you to vote for your favorites and tell us why. For each round, cheer the champs and dis the duds in the comments section on the poll form.

To get started, the FiercePharmaMarketing staff has selected 40 of the best, most interesting or most controversial DTC advertising campaigns from 2016.

FierceMadness bracket
Click here to download the bracket

Click here to download the bracket

These are the ads that sparked anger, laughter, scorn, kudos—and maybe even some head-scratching.

Official voting starts Wednesday with play-ins. We’ll update here twice weekly with each round of advancing winners, so check back in every Monday and Wednesday through April 3 to vote on the next round.

We'll also feature the smartest, funniest and most insightful comments in a companion article on each individual round. You'll find links to them all right here as they're published.

Here are the contenders. Click through the links to learn more about the campaigns and watch videos.


Ad: “Flooded Room” heart failure disease awareness
Company: Novartis
Launched around the same time as its heart failure drug Entresto, Novartis’ “horrifying” ad, according to cardiologists, depicted a man in an armchair reading a newspaper, unaware as the room fills with water. The TV ad ran only two months.

Ad: Entresto “Tomorrow”
Company: Novartis
The DTC launch for Entresto began just after “Flood” ended, and it portrayed older people crooning the “Annie” Broadway show tune “Tomorrow” as an analogy for the drug’s possibility to make more tomorrows possible.

Ad: Pradaxa “Red Fish”
Company: Boehringer Ingelheim
Boehringer Ingelheim’s swimming red fish as representative of red blood cells illustrated how those cells move and sometimes clot when traveling between the heart and brain.

Ad: MegaRed fish oil “Dancers”
Company: Reckitt Benckiser
Dozens of synchronized dancers in matching-colored unitards moved together to form a pink heart, then a yellow fish and finally a red arrow in work from McCann Humancare to create a visually appealing message about the OTC drug’s ease of absorption.

Ad: Opdivo “Most prescribed immunotherapy”
Company: Bristol-Myers Squibb
BMS pioneered TV ads for cancer treatments with Opdivo in 2015, then followed it up with a new campaign in spring 2016 touting both the fact that a PD-L1 biomarker isn’t needed for Opdivo patients and that its drug was the most-prescribed in the field.

Ad: “Ready. Raise. Rise” immuno-oncology awareness
Company: Bristol-Myers Squibb
BMS snagged “Modern Family” TV star Eric Stonestreet to raise awareness for cancer immunotherapies in an online effort that encouraged people to honor a friend or loved one by raising virtual flags in their names.

Ad: “Queen Latifah Live” heart disease awareness
Company: Novartis
Actress Queen Latifah, Novartis’ “Rise About It” spokeswoman, took her dedication to heart disease awareness, inspired by her mother, to social media with a Facebook Live session on World Heart Day and follow-up appearances to draw attention to early intervention.

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Ad: “Breakaway from Cancer” disease awareness with Patrick Dempsey
Company: Amgen
Actor Patrick Dempsey, who played a fictional doctor on TV’s “Grey’s Anatomy,” starred in the latest Breakaway disease awareness TV spot to drive support for a team effort from Amgen that benefits four leading cancer organizations.

Ad: “Stand Up to Cancer” PSA with Morgan Freeman
Company: Roche’s Genentech
Actor Morgan Freeman stood up with a cancer patient in this public service campaign sponsored by Genentech to drive people to get screened and get involved in prevention and clinical trials.

Corporate/Disease Awareness

Ad: “Before it Became a Medicine” corporate campaign
Company: Pfizer
Pfizer scientists took center stage in a corporate reputation effort that depicted the long and arduous process from idea to lifesaving drug, all through the eyes of a grateful patient.

Ad: “Innovation Saves” industry campaign
Company: BIO trade organization
The Biotechnology Innovation Organization (BIO) tackled the sticky drug-pricing issue in an industry campaign featuring patients and families whose lifesaving treatments also saved healthcare system costs.

Ad: “Face Your Risk” food allergy awareness
Company: Mylan
Months before Mylan’s EpiPen pricing scandal, it bowed an ultrarealistic TV campaign around peanut allergies that shows the panic and life-threatening progression of anaphylaxis after a young woman accidentally eats peanut butter at a party.

Ad: “PBA Facts” disease awareness with Danny Glover
Company: Avanir
Avanir tapped actor Danny Glover as spokesman for an unbranded campaign to shed light on the little-known condition called pseudobulbar affect (PBA), which can cause uncontrolled laughter or crying jags.

Ad: Trumenba “How Did We Get Here?”
Company: Pfizer 
Pfizer’s first effort for meningococcal group B vaccine Trumenba laid out the scary repercussions of the disease as a mom watches over her son in a hospital bed—and then flashes back to his night at a party sharing food and drinks, and kissing a girl.

Ad: “Big Bad Wolf” whooping cough vaccination
Company: GlaxoSmithKline
A grandma who morphed into a scary wolf grabbed attention in GSK’s push to encourage grandparents to get vaccinated for whooping cough lest they become a “big bad wolf” to infant grandchildren.

Ad: “Actually She Can” female health awareness
Company: Allergan
Girl power stars in Allergan’s unbranded multimedia campaign with purple-haired spokes-character Violet, hashtags and emojis, all in support of women sharing information about healthcare, including contraceptive options.

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Ad: “New Day” non-24 disease awareness
Company: Vanda Pharmaceutical
Vanda's ads explained non-24, a circadian rhythm sleep disorder that affects blind people, causing them to confuse day and night.

Ad: “Breakaway From Heart Disease” awareness with Joe Montana
Company: Amgen
Former quarterback Joe Montana and his wife Jennifer spoke out in a Breakaway campaign for heart disease that mirrored Amgen’s Breakaway from cancer campaign (see East bracket).


Ad: Linzess “Tell Me Something I Don’t Know”
Company: Allergan and Ironwood Pharmaceuticals
In its third campaign for Linzess, Allergan and Ironwood took a more arresting creative approach, using stop-motion techniques to draw attention to its message of possible relief for people who have tried “everything” for IBS with constipation.

Ad: Viberzi “Irritabelle”
Company: Allergan
Quirky redhead Irritabelle plays the role of irritating symptoms of IBS-D in a young woman’s life, distracting her and interfering with her plans, in Allergan’s first TV marketing for Viberzi.

Ad: “Superhero Comic Books” for IBD disease awareness
Company: Takeda 
Partnering with Marvel comics, Takeda created a new superhero and cast of characters to fight the good fight against inflammatory bowel disease in both digital and custom-published comic books.

Ad: “Envy” OIC disease awareness
Company: AstraZeneca and Daiichi Sankyo
Debuting during the 2016 Super Bowl, AstraZeneca and Daiichi's TV spot drew attention to the problem of opioid-induced constipation via a man who envied “everyone who can go.” The ad drew fierce backlash from media pundits and even the White House.

Ad: Xifaxan “Gut Guy”
Company: Valeant
The now-familiar happy, walking pink bundle of intestines marked the debut of Valeant’s Xifaxan IBS-D treatment with TV ads that triggered love and hate on social media.

Ad: Entyvio “Bathroom Doors”
Company: Takeda
Takeda took a different view for its new biologic IBD treatment Entyvio, with ads that showed what sufferers see most often—the inside of bathroom doors—while they’re missing out on fun or important life events.

Ad: Cosentyx “See Me”
Company: Novartis
While most ads feature actors, Novartis tapped real plaque psoriasis patients talking to the camera and asking that people see past their condition in its ads for new biological treatment Cosentyx.

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Ad: Harvoni “I Am Ready”

Company: Gilead
Promising the very real possibility of a cure for people with hepatitis C, Gilead launched an anthemic bid to grab attention and market share for its then-rising star Harvoni.

Ad: Farxiga “For Athletes”
Company: AstraZeneca
AZ hit the gym with sport-and-sweat advertising for diabetes treatment Farxiga, using gritty black-and-white shots. The ads departed from standard diabetes fare, including its own former "Everyday People" upbeat jam.


Ad: “Eyelove” dry eye awareness
Company: Shire
Well-known actress Jennifer Aniston confesses to her eye drop addiction in Shire's unbranded campaign that targeted women who use drops several times a day.

Ad: Xiidra “ii’s word”
Company: Shire
Following up on its successful unbranded dry eye awareness ads, Shire launched branded treatment Xiidra with clever word-play on the double-i in the name, as in "Hii" and "Niice to meet you."

Ad: Excedrin “Migraine Simulator”
Company: GlaxoSmithKline
GSK took empathy to a new level in a powerful set of virtual reality demonstrations that gave simulated migraine headaches to sufferers' loved ones using VR headsets.

Ad: Zostavax “Lurking Inside”
Company: Merck
Tapping older people's fear of shingles, Merck added to its already-running humor campaign—with athlete Terry Bradshaw—with new ads using a darker scenario and a snarky voice warning of the potential disease lurking inside.

Ad: Kybella “Ancestors”
Company: Allergan
Using heredity instead of weight or aging, Allergan cleverly depicts, with turtlenecks and high collars, the potential need for its double-chin treatment Kybella, thanks to the dear old family tree.

Ad: Botox “Don’t take it lying down”
Company: Allergan
Botox is better known as an aesthetic treatment for aging lines and wrinkles, but Allergan added advertising this year that reminded consumers of its approved therapeutic use to treat chronic migraines.

Ad: Prezcobix “Wisdom”
Company: Johnson & Johnson Janssen
Janssen took real patients' words of wisdom and empowerment and, with the help of artist Sean Williams, transformed those words into stylized purple images of people.

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Ad: Jublia “Super Bowl Spa” with Deion Sanders and Howie Long
Company: Valeant
Valeant seems to know no bounds when it comes to the places its purple-clad big toe fungus spokescharacter will show up. In this case, it went to the spa with former pro footballers in an ad that ran during the Super Bowl.

Ad: Viagra “Straight Talk-Single Packs"
Company: Pfizer
The women in dark blue dresses started talking directly to men about Viagra and erectile dysfunction almost three years ago but this year added marketing around new single-pack dosing to the mix.