The HUMIRA TV Commercial, “Not Always Where I Needed to Be,” follows the story of a young female bandleader struggling with Crohn’s Disease who achieves remission because of choosing HUMIRA as her new medical treatment. Narrating her own story throughout the advertisement in the first-person voice, this Crohn’s patient gains credibility and wins the audience’s trust early on. Kairos—the contingencies of time and place—shape the rhetorical purpose of this direct-to-consumer ad by addressing the urgency for treatment. According to the CDC, about three million adults reported an inflammatory bowel disease (IBD) diagnosis in 2015, a significant increase from two million in 1999. With no cure for Crohn’s, it is critical to connect patients with different drugs that may support their unique health journeys.
Given that Crohn’s Disease is not a widely discussed illness, impacting only 1.3% of American adults, the pharmaceutical company must make a wide-reaching and exciting case for why Crohn’s is worth treating with HUMIRA. The commercial faces a significant rhetorical challenge: to appeal equally to existing Crohn’s patients and members of the general public, distinct groups that can both act on the pharmaceutical company’s exigence—to sell more HUMIRA. By constructing a memorable narrative arc that accurately represents the experiences of both a Crohn’s patient and the general public, with an emphasis on social dynamics, the ad satisfies both constituencies. With a clear opening and end resolution, the commercial’s story arc is hierarchically structured to convey a message of hope and optimism to all its viewers, thereby expanding its potential reach. By emphasizing the relevance of HUMIRA’s potential for those who suffer with IBD and those who do not, the commercial convinces Crohn’s patients to take agency over their health by switching to HUMIRA while also urging relatives or friends of the patient to help them make this choice.
The ad’s opening portrayal of the social repercussions of a Crohn’s flare successfully appeals to both IBD patients and the public by sensitively showcasing the patient’s pain while framing the scene within a community context familiar to any viewer. The ad begins by following the protagonist’s sudden departure from three group settings associated with her role as the lead singer in her band: a recording booth, band lunch event, and stage performance. Each shot contains similar elements (e.g., woman clutching her abdominal region, wincing in pain, and inhaling sharply) that suggest her flare-up is inhibiting her participation in social activities. Although every Crohn’s patient experiences different symptoms, abdominal pain is common. Therefore, a Crohn’s patient watching this ad could relate to the protagonist’s physical experience. Moreover, each shot showcases her emotional isolation from her group as well as a tinge of guilt she feels for letting her group down, consequences of flares most patients can directly relate to. Blurring out her peers, the shot focuses on how the woman’s pain makes her feel isolated. This sensitive representation of IBD, which holistically considers both the physical and emotional consequences of a flare-up, allows a Crohn’s patient viewing this ad to feel empathized with, thereby contributing to the pharmaceutical company’s ethos.
A different quality of this opening sequence appeals to the general audience: the fact that the protagonist plays a key role within a larger group setting. Any member of the public understands the pivotal role of a bandleader within a band—she holds her group together. The ad’s audience can therefore reach the logical conclusion that in her absence, the band falls apart and cannot create new artistic work. While a non-Crohn’s patient may not be able to empathize with severe intestinal pain, the individual can relate to themes of community, teamwork, and collaboration. Thus, when the ad reveals how concerned the group members appear each time the woman’s health forces her to step out of the room, the general audience understands this feeling. As a result, the commercial successfully appeals to relatives, friends, and colleagues of a Crohn’s patient who are impacted by the individual's ability to contribute their healthy self to their lives. By centering the ad’s narrative around a group experience stunted by the symptoms of the one member with Crohn’s, the ad answers the implicit audience question “why should I care about HUMIRA if I don’t have Crohn’s myself?” and paves the way for the central question: “How can I, a Crohn’s patient, get to where I want or need to be in life?” (as well as the parallel question: “How can I, someone in the Crohn’s patient’s life, help them reach this point?”). HUMIRA, the ad goes on to reveal, is the answer. As the protagonist states, HUMIRA successfully targets patients whose symptoms have not been relieved by other medications. HUMIRA, this claim suggests, can be a patient’s new solution—a success story amidst a history of failed treatments.
Despite FDA requirements that drug ads address all deleterious risks, this commercial’s multifaceted conclusion successfully reaches both Crohn’s patients and the general public by layering optimistic visual elements over the serious voiceover listing of side effects to persuade both parties that HUMIRA’s benefits outweigh any risks. In selecting an older, monotone voice to rapidly list HUMIRA’s side effects as opposed to the airy voice of the protagonist, the ad’s creators encourage viewers to tune out. While the side effects are listed, the visual narrative of the young woman continues, now focused on her HUMIRA-granted remission and triumphant return to normal life, full of invigorating music, young, smiley people, bright clothing, and positive vibes. In the world of this ad, the standard of “normalcy” is represented by the protagonist’s ability to participate in her band, which in turn serves as a metaphor for an IBD patient being able to contribute to society. Healthy enough to actively engage in music again, the woman begins singing with her band, a scene engaging enough to distract the viewer from the side effects. Layered over the robotic voiceover, the band’s upbeat rock music crescendos, nearly drowning out the voiceover. The ad’s cyclic narrative also helps meet the challenge of a Crohn’s patient reconciling the opposing elements of HUMIRA’s negative side effects with the display of positive and vibrant experiences made possible through HUMIRA. While the beginning twenty seconds of the ad showcased how the protagonist’s active Crohn’s Disease negatively impacted both her life and the people around her, the commercial’s last scenes offer positive resolutions to each of the situations the ad initially introduced. For example, the woman reenters the sound booth where her band was practicing, steps back onto the stage where her band had been performing, and rejoins her band for lunch. This circular storytelling ties up the strings of the commercial’s plot while establishing a direct cause-and-effect relationship, which, when simplified, implies: “if you take HUMIRA, your life can be normal again.” This optimistic conclusion, enhanced by the engaging acoustics, relieves a Crohn’s patient’s concern over the health risks of switching to a new biologic treatment such as HUMIRA. In the last five seconds, the protagonist’s voiceover reemerges to urge Crohn’s patients to ask their gastroenterologists about HUMIRA, galvanizing audience members struggling with Crohn’s Disease to take initiative over their own health. Now that the protagonist has gained the audience’s trust, when she claims that the “majority of people on HUMIRA saw significant symptom relief and many achieved remission in as little as four weeks,” adding great emphasis to the word “significant,” the audience’s natural reaction is to believe her. This statement appeals to logos because it presents the possibility of (long-term and sustainable) remission: a logical reason to at least give HUMIRA a try. Unlike other illnesses that are associated with only one or two standard treatments, there exists a wide variety of treatment options for IBD, each of which work differently depending on a patient’s demographics, clinical history, genetic makeup, and overall health. Therefore, a patient would not feel as though they were challenging the status quo if they were to bring up HUMIRA to their doctor but would instead feel empowered (by the ad) as they take initiative over their own treatment process. Given how little agency and control individuals with IBD typically feel over their health, this level of active encouragement would likely appeal to a Crohn’s patient and counteract any initial hesitation they may feel around spearheading a conversation with their healthcare provider about a new treatment path.
By structuring the ad to let the protagonist both begin and conclude the message, the commercial’s creators ensure that the Crohn’s patient’s personalized story—one of hope and success—is what any viewer is left remembering. The ad’s strong and streamlined narrative urges any audience member, no matter whether they have Crohn’s or not, to leave this commercial knowing they have witnessed a human story, and to feel touched by it. Maintaining a focused narrative through the ad allows the pharmaceutical company to shield their exigence to sell more drugs within a compassionate effort to improve the lives of Crohn’s patients.
“With HUMIRA, remission is possible,” the protagonist announces at the end of the ad, seemingly speaking from experience. The protagonist also urges her fellow Crohn’s patients to “be there for you and them” in the final five seconds. This statement once again reminds viewers that HUMIRA has the potential to not only relieve a Crohn’s patient’s IBD symptoms, but to also allow the patient to participate fully in the lives of those around them.
This advertisement is not just the story of a Crohn’s patient, but also the story of the non-Crohn’s people around her. This narrative, while narrowly defined and following the specific experience of a protagonist with a distinct health condition, serves to showcase the broader implications of an individual’s health problems on society. By the end of the ad, the protagonist’s early claim that “with moderate to severe Crohn’s Disease, I was there, just not always where I needed to be” becomes, from the lens of an enlightened viewer, “...just not always where we needed to be.” The viewer, even if they do not have Crohn’s, now feels part of this ongoing dialogue around IBD treatment and the societal repercussions of one individual’s poor health. Thus, this ad ultimately unites viewers—both Crohn’s Disease patients and the public—over the ultimate goal of helping IBD patients achieve remission through HUMIRA, not only for their personal health journeys but for the overall benefit of society.
References
Centers for Disease Control and Prevention. (2021, July 9). IBD: Data and Statistics. Centers for Disease Control and Prevention. Retrieved October 2, 2021, from https://www.cdc.gov/ibd/data-statistics.htm.
Belluz, J. (2015, September 29). Why prescription drug ads always have that absurd list of side effects at the end. Vox. Retrieved October 2, 2021, from https://www.vox.com/2015/9/29/9414145/direct-consumer-advertising-pharmaceutical-regulation.