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Quoting this article Efficacy, effectiveness, efficiency, 1  efficacy is the extent to which a drug has the ability to bring about its intended effect under ideal circumstances, such as in a randomised clinical trial. 2  effectiveness is the extent to which a drug achieves its intended effect in the usual clinical setting.
However, neither effectiveness, nor effectively, inform about the direction (positive or negative) and the comparison to a standard of the given effect. Efficacy, on the other hand, is the extent to which a desired effect is achieved; the ability to produce a desired amount of the desired effect, or the success in achieving a given goal.