Medical Marketing: Bridging the Gap

The current study provides valuable insights into the determinants of brand loyalty in the healthcare sector, highlighting the significant roles of perceived risk, marketing strategy, and trust in shaping consumer loyalty. These findings align with and extend the existing body of research on brand loyalty, consumer behaviour, and healthcare marketing. Firstly, the gender distribution of the sample, with a slightly higher representation of females (58.9%) compared to males (41.1%), is consistent with previous studies that report women often engage more with healthcare services and health-related decisions than men. This demographic characteristic may influence the overall attitudes and perceptions toward healthcare brands, as women tend to exhibit different trust and risk assessment patterns compared to men. Frequency analysis indicated that consumers generally express moderate trust in healthcare brands endorsed by public organisations such as the NHS or MHRA. This aligns with extant literature emphasising the importance of institutional trust in healthcare (Iliffe & Manthorpe, 2021; Kerasidou & Kerasidou, 2023). Trust in public endorsements acts as a heuristic that reduces complexity and uncertainty for consumers when selecting healthcare products or services (Mathur, 2021). However, despite this moderate trust, participants reported a notable caution toward new or unknown healthcare brands and digital health services, which scored the highest in perceived risk. This finding corroborates earlier research that highlights consumer skepticism and risk aversion toward digital health solutions due to privacy concerns, lack of face-to-face interaction, and perceived reliability issues (Ezeudoka & Fan, 2024).

The cautious attitude toward digital healthcare brands indicated a need for healthcare organisations to address perceived risks to improve adoption and loyalty. The strong positive correlations found between perceived risk and brand loyalty (r = .803), as well as between marketing strategy type and brand loyalty (r = .760), reveal critical dynamics in healthcare branding. The role of perceived risk in consumer loyalty is extensively supported by prior studies (Bernarto et al., 2022), which show that risk perception negatively impacts purchasing behaviour unless mitigated by trust and effective marketing communications. In healthcare, the stakes are higher due to the sensitive nature of services and potential health consequences. Therefore, healthcare consumers are particularly sensitive to risk and require reassurance through credible information, quality assurance, and safety guarantees. Marketing strategy emerges as another key determinant of brand loyalty in this study. The significant correlation between marketing strategy type and loyalty aligns with Keller’s brand equity theory, which underscores that well-crafted marketing programs that build brand associations, enhance perceived quality, and foster emotional connections drive consumer loyalty. In healthcare, marketing strategies that emphasise patient-centred communication, transparency, and education have been found to build trust and loyalty effectively (Tran, 2021). Regression analysis highlights marketing strategy as a significant predictor of loyalty (β = .370), reinforcing the importance of tailored and strategic marketing efforts in the healthcare context.

Interestingly, trust in healthcare brands did not significantly predict brand loyalty in the regression model once perceived risk and marketing strategy were accounted for. This result suggests a complex interplay where trust alone is insufficient to foster loyalty if consumers perceive high risk or if marketing strategies are ineffective. This finding is somewhat contrary to the broad consensus that trust is a cornerstone of brand loyalty. However, it can be interpreted through the lens of multidimensional brand loyalty models that consider trust as necessary but not sufficient without addressing risk and communication. For healthcare brands, this implies that building trust must be complemented by risk mitigation strategies and effective marketing communications to convert trust into loyalty (Birkhäuer et al., 2017). The dominance of perceived risk as a predictor (β = .536) underscores its pivotal role in healthcare consumer decision-making. Literature in health psychology and marketing consistently highlights perceived risk as a barrier to adopting new healthcare products or services. Specifically, in the context of digital health services, risk factors such as data security, misinformation, and uncertainty about effectiveness reduce consumer confidence (Agarwal et al., 2020). Addressing these concerns through robust privacy policies, transparent communication, and endorsements from trusted public bodies may reduce perceived risk and thereby enhance loyalty.

Moreover, the study’s findings emphasise the importance of endorsements from recognised public organisations such as the NHS or MHRA. The moderate mean score reflecting trust in these endorsements aligns with research demonstrating that institutional legitimacy enhances brand credibility and consumer confidence (Iliffe & Manthorpe, 2021). Public endorsements act as external cues signalling quality and reliability, which are important in healthcare, where consumers often lack the technical expertise to evaluate product efficacy independently. The absence of significant gender differences in perceptions and attitudes, despite observable mean trends, suggests a shared baseline of healthcare brand attitudes among men and women in this sample. This is in line with findings by (Alkire et al., 2023), who found that while gender influences certain health behaviours, brand perceptions and loyalty drivers may converge in healthcare contexts due to universal concerns about health and safety. Nevertheless, nuanced gender-based marketing approaches might still be beneficial, given the observed differences in mean scores, as gender can influence communication preferences and health service usage patterns.

However, hypothesis H1 (Trust in healthcare brands has a positive and significant effect on brand loyalty) was not supported, as regression analysis revealed the relationship to be statistically non-significant (β = -0.008, p = .903). In contrast, H2 (Perceived risk has a negative and significant effect on brand loyalty) and H3 (Marketing strategy type significantly affects brand loyalty) were supported, with both predictors showing strong statistical significance in influencing brand loyalty (p < .001). Additionally, H4 (Perceived risk mediates the relationship between trust in healthcare brands and brand loyalty) was supported through a significant indirect effect, indicating full mediation. These results suggest that while consumers express general trust in familiar and institutionally endorsed healthcare brands, it is the perception of risk and the nature of marketing strategies that play more central roles in determining actual loyalty behaviours. In particular, perceived risk emerged as a pivotal factor, both as a direct influence and as a mediator, indicating that managing consumers’ risk perceptions may be more critical than building trust alone.

From a practical standpoint, these findings offer several implications for healthcare marketers and organisations. First, reducing perceived risk should be a priority. This can be achieved through clear communication of safety measures, transparent data handling, patient testimonials, and third-party certifications. Second, marketing strategies should be designed to build emotional connections, educate consumers, and reinforce brand reputation. Approaches such as storytelling, patient engagement campaigns, and personalised communication can enhance brand loyalty. Third, leveraging public endorsements and partnerships can strengthen brand trust and credibility. Future research could expand on these findings by exploring the specific dimensions of perceived risk in healthcare, such as financial, privacy, and health risks and how different demographic groups perceive and react to these risks. Additionally, longitudinal studies could examine how trust, risk perception, and marketing strategies interact over time to influence brand loyalty, particularly as digital health services become more prevalent. Thus, the present study contributes to understanding healthcare brand loyalty by highlighting the dominant influence of perceived risk and marketing strategy over trust alone. These findings align with and extend prior research, underscoring the need for integrated approaches that combine trust-building with risk mitigation and strategic marketing to cultivate loyal healthcare consumers. Healthcare organisations that effectively address these dimensions are better positioned to foster long-term brand loyalty, which is essential for competitive advantage and sustained patient engagement in an evolving healthcare landscape.