Several years ago, a casting director working on a commercial for the NovoLog FlexPen, a dial-a-dose insulin injector from Novo Nordisk, called a friend and urged her to try out.
The friend, Vivicca Whitsett, a compliance administrator at a brokerage firm in Los Angeles and a stand-up comic, was game. Her audition went well, but Ms. Whitsett also filled an essential requirement: She has Type 2 diabetes.
She was chosen to spearhead the campaign, which included a national TV spot (she was identified on screen with her name misspelled, as “Vivica, actual FlexPen user”) and her likeness on a billboard in Times Square.
“I didn’t mind telling my story if it helped other people,” said Ms. Whitsett, who is in her early 40s. “And I think it comes across better in a commercial if the person hawking the stuff actually uses it.”
Drug commercials have long been populated by very healthy-looking actors or celebrities — among them Blythe Danner, Phil Mickelson and Ray Liotta — who swear by the efficacy of the pills they’re pitching.
Now, many in the industry say there’s an increased desire to use real people in ads for over-the-counter and prescription medications. Examples include the allergy nasal spray Flonase; Excedrin Migraine; Cosentyx, an injection for psoriasis; and Keytruda, an immunotherapy drug that treats certain types of cancer.
“In our culture, the whole trust thing is under fire on every level, and consumers tend to trust real people, people who are going through something similar to what they’re going through and who can guide them and inspire them,” said Jill Strickman, the founder and president of Genuine: The Real People Company. Genuine, a New York casting agency, has found patients to appear in commercials for conditions including asthma, allergies, incontinence, H.I.V., Alzheimer’s disease and depression.
The approach is particularly effective when the medication is for a serious illness, said Howard Courtemanche, president of the global health care practice at the ad agency Young & Rubicam.
“It’s the power of a peer,” he said. “If you’re not sick and you say, ‘I empathize,’ the reaction from the sick person is: ‘You don’t have my disease, so you don’t know.’
“If someone has been through it and has taken a drug and had a positive outcome and you’re out there in TV land or digital land, you want to hear that story,” Mr. Courtemanche added. “‘I have what you have, and I took my doctor’s advice and the medication and I got through it. It worked for me, and it might work for you.’ That’s very potent.”
The presence of real people can also be an effective counterweight to the government-mandated recitation of a drug’s side effects.
“If you have the resonance of someone’s real experience, it will overcome the robotics of compliance information,” Ms. Strickman said.
The casting director Jodi Kipperman routinely asks doctors’ offices, clinics and pharmacies to display fliers; contacts support groups for a given ailment; and posts notices online.
“Social media has made the process a bit easier,” said Ms. Kipperman, who has cast real people in ads for medicines that treat conditions like irritable bowel syndrome and attention deficit hyperactivity disorder.
Instagram brought Andy Dodge, an allergy sufferer who works in financial services, to the attention of GlaxoSmithKline when it was scouting for “real people” for an online campaign for Flonase that began this year.
Mr. Dodge, 35, said his wife was “always posting things about our family and our love of baseball,” a love that was being hindered by his nasal congestion.
“I had tried everything, and, honestly, Flonase was the only thing that ever worked for me,” said Mr. Dodge, who was selected to appear after several interviews conducted over Skype.
The audition sessions for nonprofessionals do run longer than those with actors.
“You have to be more patient during the casting process,” said Paul Bernstein, the executive producer at Donna Grossman Casting. “You have to give them more leeway and more direction.”
There are often questionnaires and special documents to fill out, including release forms so a patient’s medical information can be shared with the ad agency or the drug company involved in the commercial. In certain instances, casting directors will ask for proof that patients are on the medication and have the condition they say they have.
“We go through a very extensive authentication process,” Jill DeSimone, a senior vice president at Merck Oncology, said of selecting patients to appear in commercials for the company’s Keytruda. “We make sure it’s verified through a physician. It has to be a true story.”
Compensation rates vary.
“If a drug company or an ad agency is a signatory of the Screen Actors Guild, it has to pay the regular S.A.G. rate in these instances,” Ms. Kipperman said. “Otherwise, the fee is negotiable.”
Sometimes, things don’t progress that far. After all, the patient can be struggling with a serious condition.
“If you cast them on Day 1 and you’re shooting 10 days later, there’s some percentage chance that the person will not be healthy enough to work with you,” said Jeff Rothstein, the chief executive of CultHealth, an ad agency that specializes in health care. “It’s happened to us. Everybody on the set feels terrible about it. You want them to feel well. And you’re spending a lot of money waiting for the talent to feel better. That’s the business reality.”
And, Mr. Rothstein said, casting patients means relying on people with no experience on camera.
“Just because people are experiencing something doesn’t mean they’re great communicators,” he said. “We would use teleprompters to help the real people in the ads, and it limited what we could do in terms of storytelling. Talking and walking and dealing with props at the same time is super challenging. It’s a lot to lay on real people.”
Nonetheless, ad agencies and their pharmaceutical clients intend to keep real patients front and center.
“We heard from advocacy groups that patients wanted to tell their stories,” Ms. DeSimone said. “And we got the message loud and clear.”
