The pharmaceutical industry creates some of the most valuable products in human history: Medicines that can extend, save and better our lives. The product is rarely up for question, but the industry itself can struggle to be recognized for its contribution.
Until this year, pure-play pharma companies struggled to make an impact at their own awards category at Cannes Lions, the premier creativity event for every industry around the globe.
For years it was tech-based products that kept taking the gongs, with medicines left out in the cold. That changed this year with several pharmas taking the top prizes, but it remains to be seen whether this becomes a trend or a blip.
In this latest feature of the inside agency view series, Fierce spoke with Frank Mazzola, Managing Founder of 21GRAMS and Chief Creative Officer of Real Chemistry, about how creativity around drug messaging can be better recognized, and the challenges inherent in this sector.
“From our perspective, medicine is one of the greatest products that was ever invented,” Mazzola said. “When you really kind of get into it, the creativity that goes into to making medicine is off the charts. Then there’s a whole other half which is communicating it.
“So, people have to know medicine can't work in isolation. People have to know to take it, understand it, be able to have some sort of connection or relationship to it.”
This is a key part of the communication, but this relationship can missed, Mazzola said. “I have to take this medicine every day, or every week, or every month; that’s the relationship, and really the responsibility of communicating that is on the pharmaceutical companies and the agencies that support them.”
Because of pharma’s relatively low reputation (it often scores as one of the lowest industries in terms of reputation, with the federal government typically coming in last), it can be hard to communicate the good it does to a broadly skeptical audience.
The industry also sits within a highly regulated space, meaning the creativity not just to create medicines but the messaging behind them requires a unique mixture of risk and reward.
Because of this, “medicine tends to be very inward facing,” Mazzola said. He said the focus tends to fall on telling the story of what the medicine does, as well as the numbers behind it.
“All that stuff is important, but what gets left out of the equation is the audience, and really understanding who they are,” he said.
“How do we relate to them on their level? We can have this very serious medicine-making company, but it's more about the audience. At the end of the day, they're going to make the decision. They have to take it. They have to talk to their doctor about it. So, I think the idea is really: How do you understand the audience more in a nuanced way?”
Making patient experiences matter
Mazzola said, however, that the way this story is told to an audience tends to become “genericized.”
“A medicine can extend somebody's life or makes somebody's life better, so as a patient you go through the things like all right, well, what would I do with that time? And how is that represented? Maybe I garden; maybe I walk on the beach. This ends up being really genericized,” he said.
Instead, Mazzola said that people “want to see a reflection of themselves more than what they see on TV, because pharma does tend to be very polished. People are smiling and in situations that they shouldn't be smiling and pointing at things,” he said—something that can be seen in the broad spectrum of TV ads or images associated with branded medicine websites.
Pharma ad agencies are also now having to vie for attention like never before. “People have a million things on their phone in their pocket that they could do other than sit through [pharma campaigns],” Mazzola said.
“How you how do you beat that? You know, if they're gamers, how do we gamify this method of action? And it's not passive learning anymore. It’s that the authenticity of really understanding: what is this audience going to respond to, and what do they need from us?”
Mazzola said his agency has shown how that can work, with one of its campaigns for Jazz Pharmaceuticals, “See A Seizure,” winning Bronze at the 2026 Cannes Lions.
This campaign uses an interactive digital site where HCPs and others can click on motion captured videos that show the signs of a number of seizures which could otherwise be dismissed as other issues.
“I’m not just calling this out because we won,” he said. “What I love about it is that it was for severe epilepsy, so it's mostly kids who are having up to 400 seizures a day, but there’s never been a tool for people to understand these [types of] seizures.
“Not even doctors know all the different signs of when somebody's having a seizure. There wasn't a tool for it, so we essentially created a tool that shows the subtlety of seizures and used motion capture to kind of get that across. This specific rare kind of epilepsy usually takes up to 15 years to diagnose.
“And within the first week of the campaign being out, six people got diagnosed just in one facility.”
DTC crackdown
Naturally, drug commercials remain a mainstay for many Big Pharmas that spend billions of dollars every year on traditional linear TV ads in the U.S. For all of 2025, the top 10 spenders alone shelled out a combined total of $2.67 billion to air their TV ads, well above the previous year’s $2.13 billion.
There is, however, a major government crackdown coming for these ads. The Trump administration is seeking to create new rules that aim to make pharma companies spell out each specific side effect and contraindication contained in the drug’s label. For some drugs, this can be several pages long.
Both the HHS and FDA have said this would make ads “prohibitively long and expensive.” Indeed, the administration has signaled that the rulemaking is intended, in significant part, to deter companies from DTC advertising by making compliance impractical.
These rules are open for public comment in December, but the challenges they would pose if enacted are being discussed right now. In the meantime, the government is not simply waiting around. It has already ramped up warning letters, known as untitled letters, to pharma companies censuring them for promotional drug claims ahead of these rules.
There’s been more than 80 untitled letters published by the FDA since last September. Before that, the agency had issued only 35 untitled letters in 12 years, with the biggest year of letters before this being just nine in 2015.
Mazzola said: “I think it's always something that we've had in mind. The way we've always approached it is integrating the safety [of a drug] into the story. You know we don't try to skip over it. Make it sort of interesting enough, or a continuation where it doesn't feel like we're seeing just a montage of things and trying to move through it really fast.”
Creativity, he said, can help move with these rules, just as pharma marketers have always done. He said the challenge will be to ask how to make that part of the overall experience.
“On a personal level, I feel if we really wanted people to understand the safety information, are they going to sit by a TV and write down all these notes from the commercial? Probably not. There are probably better ways that we could do it.
“But I mean, I'm a strong believer in that people do need to understand all the risks of anything they're taking.”
He pointed out that the untitled letters are mostly about overpromises. “And I think most of us, and on the agency side especially, we don't want to overpromise anything. I've never really seen the regulations as a barrier.”
Challenges remain, but Mazzola says the future is bright for pharma marketing. “More people are coming from consumer into health and I’m seeing more and more marketers growing up through the organization.
“They have a great arena to work in: it's life and death, it's sickness and health, heartbreak, redemption, all of those things. I do think it's going to be one of the most creative categories within the next 10 years, and we're going to see that. So, I think it's very much on the way up.”