Perhaps the most iconic scene from sci-fi thriller "The Matrix" comes when Neo is told to pick one of two pills: the blue would return him to the illusionary comforts of the dream world he's always known, while the red would release him into the harsh but freeing real world.

If Neo was a pharmaceutical marketer he may have appreciated just how much thought likely went into those color choices. In the U.S., blue is associated with peace and trustworthiness, red with action and stimulation. Both colors align with the effect of their respective pill.

In a pharma world, the commercial team behind Neo's choice would have correctly identified their target customer.

The industry has seen that color can help propel a tiny pill into a billion-dollar franchise. Those success stories have in turn nudged manufacturers and marketers to consider how color, whether in a logo, a campaign, or the drug itself, may best serve a patient's needs and elicit the emotions brand developers want to connect to the product.

Straying outside the lines

The most famous blue pill isn't found on the big screen, but rather at local pharmacies. Pfizer's Viagra (sildenafil citrate), first approved in 1998 for erectile dysfunction, quickly achieved blockbuster status and held onto it through 2017. For many pharma marketers, it's a preeminent example of color building a brand.

AstraZeneca's stomach medications Nexium (esomeprazole magnesium) and Prilosec (omeprazole magnesium) are also widely recognizable by their purple shades.

Despite how lucrative these drugs became, some marketers have found that color doesn't come up in many client conversations, but some are trying to change that.

Jeanne Ryan, principal at life sciences advertising firm ZS, said this has been especially true when the point-person for a new drug isn't in a commercialization role.

In one instance, Ryan noted a client with a clinical asset who was looking into color options. The agency researched patient and pharmacist preferences, potential storage and handling issues, and regulatory and manufacturing requirements before offering a color recommendation, but the client ended up keeping to white.

"One of the stated reasons why they stuck with white was that it wasn't their job to commercialize this drug, it wasn't their job to decide how to position it," she told BioPharma Dive. "They literally said they didn't want to take away any of the degrees of freedom from the ultimate brand team that would be responsible for those things."

For drugmakers who do pursue color, the decision-making process is far more complicated than throwing a dart at a color wheel — as Ryan's anecdote suggests.

Competition alone can greatly shape the selection.

"If you have a big competitor in your category that is the orange brand, you're not going to go out and have orange be your primary color," Dave Traini, creative director at healthcare advertising agency Sentrix Health, said in an interview with BioPharma Dive. "So you do want to be mindful of what else has already been taken in that therapeutic category."

With Viagra, Pfizer's adoption of blue pushed other erectile dysfunction brands to use a different color, such as the orange branding seen with Eli Lilly's Cialis (tadalafil). Lilly declined request for comment about Cialis branding.

"Blue also connotes sort of a feeling of calm," Ryan said. "Then their competitor that came out afterwards took advantage of that and said: we don't want to be calm, we're about virility and so we want to be the anti-blue pill."

More recently, three similar migraine prevention treatments came to market within the span of a few months. The lettering used for each of their logos employ soothing cool tones of blue and purple, outfitted too with a multi-colored symbol of sorts.

"As a company, we typically select a brand’s colors palette and logo years before launch, based on deep customer insights," Lilly, which makes one of those drugs, Emgality (galcanezumab), wrote in an email to BioPharma Dive.

"We consider many variables when determining the color palette and logo," the company added. "The right combination of brand elements can evoke emotion from customers while helping to differentiate from other brands in the disease state and drug class. While consideration is given to other brands in the therapeutic area, ultimately we made our branding decisions based on customer insights."

Color me a campaign

Lilly's not alone in its rationale, as drugmakers make most commercialization decisions based on what they think will resonate with patients and physicians. Studies have shown color can bring forth strong, wide-ranging reactions from consumers.

Though not extensive, research suggests patients are more inclined to take a drug when its color symbolizes the type of effect they're hoping to get. Warm-colored pills appear stimulating, cool-colored capsules imply sedation. The connotation with darkness or death across multiple cultures explains why black is a rare find among medicines.

"If you have a product for, let's just say a dermatology product for psoriasis, you're not going to make the color red because that reminds people of inflammation. You're not going to use the color yellow for something treating an infection because that reminds you of puss," Sentrix's Traini said.

The selection process becomes trickier still when a product is hitting multiple geographies or patient groups. In Japan and the U.S., which happen to be two of the biggest pharmaceutical markets in the world, white can symbolize very different things. Offering a unique color is also advantageous when the target population, such as elderly patients, is likely to be taking multiple medications and at risk of accidentally taking the wrong pill.

Traini notes, however, that in his work the color of the actual pharmaceutical is less a point of conversation than the promotional materials which go along with it.

That's partially because many of the drugs hitting the market right now are large-molecule biologics that come as injections rather than pills. But it's also because color decisions need to be made early on in drug development, sometimes before an advertising agency is even tapped to help commercialization.

Ryan's noticed a similar trend, in that color conversations tend to happen in advance, "when a company is able to connect that pill color to their advertising and to their DTC campaign."

"You know, the 'little purple pill.' I mean that was the entire sort of crux of that product when it came out," she said of Nexium, "and they really leveraged it."

Yet even with Nexium and Viagra, their advertisements aren't just a single color, but rather a small assortment of complementary hues.

"It's really about how the colors work together. I'd say you definitely need to work from a palette," Traini said, adding that color gradients have been trending across digital marketing, and are starting to gain traction specifically in pharma.

Pfizer and AstraZeneca declined requests for comment.

Pigments in production

Contrary to marketers, ​Nicolas Madit, business development manager at Lonza Pharma & Biotech, said he has conversations about color with pretty much every client he deals with.

If the client wants color, it's a decision needed to be made early on, Madit said, because validating a new color takes between nine months and a year, due to a long list of production and regulatory tests that must be redone.

Regulatory requirements sometimes also force a drugmaker's hand to choose a new pigment. Certain colors can be restricted for pharmaceutical use in one country but not the next, creating problems particularly for multinational companies. In the U.S., for example, there's a limit on how much synthetic iron oxide is allowed to go into ingested drugs.

Madit said clients have described to Lonza the issues they're having staying compliant with color.

"You don't know yet the color you want to develop; marketing did not say, 'Okay, I want the blue and the green or a yellow and red,'" he explained.

To that end, the contract services provider recently rolled out its Colorista technology. The platform uses special capsules that contain between 50 and 150 colorants, from which a specific color or specific colors can be selected later in the drug development process.

Lonza sees a substantial customer base for the product, and argues its new system allows clients to still meet regulatory guidelines while also proving flexibility to pharma companies and marketers.