On October 22, Moderna delivered news that should have been celebrated by patients, physicians, and the pharmaceutical industry. Its experimental personalized cancer vaccine, developed in partnership with Merck, demonstrated a 42% reduction in the relative risk of cancer recurrence or death among certain patients with melanoma. Yet instead of rewarding the company, Wall Street sent Moderna shares tumbling as much as 25% intraday. The disconnect between medical progress and investor reaction raises an important question: Have pharmaceutical investors become so obsessed with blockbuster expectations that even meaningful clinical breakthroughs are no longer good enough?

The Science Is More Important Than the Stock Price

Moderna’s experimental vaccine, known as intismeran autogene, represents a potentially transformative approach to cancer treatment. Unlike traditional vaccines designed to prevent infectious diseases, this treatment is personalized to the genetic characteristics of an individual patient’s tumor. Scientists analyze mutations within the tumor and develop an mRNA-based vaccine intended to teach the immune system to recognize and attack cancer cells carrying those mutations.

The Phase 3 clinical trial enrolled approximately 1,137 patients with high-risk melanoma whose tumors had been surgically removed. Patients received either Merck’s immunotherapy drug Keytruda alone or Keytruda combined with Moderna’s personalized vaccine. After two years, 82.2% of patients receiving the combination remained alive without cancer recurrence, compared with 70% receiving Keytruda alone. The combination also reduced the relative risk of distant metastasis or death by 38%. These are clinically meaningful results, although overall survival data remain immature and the treatment has not yet received regulatory approval.

For patients facing the possibility of melanoma returning after surgery, that difference matters enormously. Cancer recurrence is not simply another clinical endpoint on a pharmaceutical company’s investor presentation. It can mean additional surgeries, more aggressive treatment, mounting medical expenses, and profound uncertainty for patients and families. A therapy capable of reducing that risk could represent a significant advance in oncology.

Why Wall Street Wasn’t Impressed

The explanation for Moderna’s stock collapse appears to have less to do with the vaccine’s medical effectiveness than with investor expectations. Moderna shares had rallied dramatically following the company’s August announcement that its Phase 3 trial had succeeded. Investors were already anticipating exceptional results, and the detailed data, prematurely disclosed ahead of a major oncology conference, apparently failed to exceed those elevated expectations.

Analysts described the reaction as a classic case of investors selling after anticipated good news became public. Some also questioned whether the results provided enough evidence that Moderna’s technology could succeed across multiple cancer types. Melanoma is particularly responsive to immunotherapy, and success in this disease does not automatically establish that personalized mRNA vaccines will work equally well against lung, kidney, pancreatic, or other cancers.

That distinction is critical. Moderna isn’t simply developing another melanoma treatment. It is attempting to establish a platform that could eventually produce personalized therapies for numerous cancers. Investors are valuing the possibility of an entirely new oncology business, while clinical researchers are still working to establish which patients and tumors are most likely to benefit.

The Commercial Challenge Nobody Should Ignore

Even if Moderna’s cancer vaccine receives FDA approval, commercial success is far from guaranteed. Personalized medicine introduces operational and economic challenges that traditional pharmaceutical products rarely encounter. Each patient’s tumor must be analyzed, a unique vaccine designed, and individualized doses manufactured and delivered within a clinically appropriate timeframe. Moderna estimates that the process can take approximately six weeks, sometimes longer.

Then comes the uncomfortable question of cost. How much will a personalized cancer vaccine cost, particularly when administered alongside an already expensive immunotherapy such as Keytruda? Will insurers cover the treatment broadly? Will patients face substantial out-of-pocket expenses? And can hospitals and cancer centers integrate individualized vaccine production into routine clinical care without creating delays or widening disparities in access?

These questions deserve as much attention as the trial’s hazard ratios. A breakthrough therapy that patients cannot afford or healthcare systems cannot efficiently deliver will have a much smaller impact than its clinical potential suggests. The pharmaceutical industry has repeatedly demonstrated that scientific innovation and patient accessibility are two very different accomplishments.

A Bigger Test for mRNA Technology

Moderna’s results also carry implications beyond melanoma. Following the COVID-19 pandemic, mRNA technology became closely associated with infectious disease vaccines. Personalized cancer treatment could fundamentally change that perception by demonstrating that the technology can help the immune system target an established malignancy.

However, enthusiasm must be tempered by scientific discipline. One successful Phase 3 trial does not establish an entire therapeutic platform. Researchers still need to determine whether the approach improves overall survival, which other cancers respond, how durable the benefits are, and which patient populations are most likely to benefit. Regulatory approval, manufacturing scalability, reimbursement, and long-term safety monitoring remain important milestones.

The pharmaceutical industry also needs to resist turning promising scientific developments into exaggerated commercial narratives. Cancer patients have heard enough about miracle treatments and revolutionary breakthroughs that never quite deliver on their initial promise. Moderna’s results deserve serious attention precisely because they are supported by randomized clinical evidence, not because they offer another opportunity to promote a multibillion-dollar market forecast.

The Real Story Isn’t Moderna’s Stock Price

There is something troubling about a financial market that can punish a pharmaceutical company on the same day it reports evidence of a meaningful advance in cancer treatment. Investors have legitimate reasons to question valuations, future profitability, and the commercial potential of experimental therapies. But those concerns should not obscure the significance of what Moderna and Merck have demonstrated.

For years, researchers have pursued the possibility of training the immune system to recognize the unique genetic fingerprints of individual tumors. Moderna’s latest results suggest that this approach can produce meaningful clinical benefits in a large, late-stage trial. That does not mean cancer has been conquered, and it certainly does not guarantee that the technology will work across every tumor type. It does mean that personalized cancer vaccines have moved an important step closer to becoming a practical treatment option.

The next challenge is proving that the technology can deliver durable survival benefits, scale commercially, and reach the patients who need it.

Wall Street may have been disappointed by Moderna’s numbers. Cancer patients have considerably more reason to be encouraged.

And ultimately, the success of this technology should be measured not by how much Moderna’s stock rises or falls in a single trading session, but by how many patients live longer, healthier lives because of it.

The post Moderna’s Cancer Vaccine: A Medical Breakthrough, a Wall Street Meltdown, and a New Era in Cancer Treatment appeared first on World of DTC Marketing.

I had been on Mounjaro for a while, but the side effects were just too much. The nausea would come in waves and was so debilitating I would have to take an anti-nausea pill. When my wife wanted to go out to eat, I would decline because the idea of eating food made me even more nauseous. Even though I had lost weight, I decided to stop taking the medication. For me, it was a quality-of-life issue.

Headlines about Ozempic, Wegovy, Mounjaro, and Zepbound have focused overwhelmingly on weight loss. Celebrities look thinner, social media is filled with success stories, and pharmaceutical companies are investing billions in what has become one of healthcare’s most lucrative categories. These medications can produce remarkable results. But the GLP-1 story has another side that deserves just as much attention: patients who walk away because they simply don’t feel well.

Imagine losing 30 pounds but being afraid to eat dinner with friends. Imagine planning your workday around access to a bathroom, waking up nauseated, or feeling so bloated and constipated that even your favorite foods have become unappealing. For some patients, that’s the reality of taking these medications. While pharmaceutical advertising celebrates the pounds lost, patients increasingly talk about something that matters just as much: their quality of life.

The numbers tell a very different story from the advertising

In the landmark STEP 1 clinical trial of semaglutide 2.4 mg, published in the New England Journal of Medicine, gastrointestinal side effects were remarkably common. Nearly half of patients experienced nausea, and roughly one in four reported vomiting.

Gastrointestinal side effects reported with semaglutide 2.4 mg versus placebo

Source: STEP 1 randomized clinical trial, NEJM (2021). Percent of participants experiencing each symptom.

Those numbers deserve more attention. Nausea isn’t just a statistic when you’re trying to get through a business meeting. Diarrhea isn’t a minor inconvenience when you’re traveling. Constipation isn’t something to casually dismiss when it becomes painful and persistent.

Most gastrointestinal side effects in clinical trials were mild to moderate and tended to improve over time. That’s important context. But it doesn’t erase the experiences of patients whose symptoms are severe, persistent, or simply incompatible with the lives they want to lead.

In the large SELECT cardiovascular outcomes trial, 10% of semaglutide-treated participants permanently discontinued treatment because of gastrointestinal adverse events, compared with 2% receiving placebo. That’s a meaningful number for a medication that many patients may need to take for years. 

Patients are speaking out, and their stories are difficult to ignore

You don’t have to look far on Reddit or online medication-review communities to find patients struggling with these medications. Their accounts provide a human perspective that clinical trial tables cannot fully capture.

One Reddit user, posting in the r/Ozempic community under the title Too sick, don’t think I can keep this up, described losing 90 pounds in eight months while experiencing worsening gastrointestinal symptoms. The person reported persistent nausea, vomiting, and difficulty eating or drinking, even after reducing the dose.

“I can’t eat. I hate everything about life because I feel like crap.”

The same user acknowledged substantial weight loss and blood sugar improvements but questioned whether the physical toll was sustainable.

That contradiction is at the heart of the GLP-1 experience for some patients. The medication can be working exactly as intended from a metabolic standpoint while making the patient feel terrible.

A 2026 published analysis of 60 publicly posted Ozempic reviews on Drugs.com found that 62% of reviewers described gastrointestinal complaints. One patient reported:

“It started with huge belches and nausea.”

The reviewer went on to describe vomiting and being unable to get out of bed for three days. Another described severe constipation and worsening nausea, followed by daily vomiting at a higher dose. That patient ultimately felt the costs of treatment were outweighing the benefits. 

These are self-selected online accounts, not a representative sample of all patients. People with particularly positive or negative experiences may be more motivated to post. Nevertheless, their experiences help explain what percentages in a clinical trial can mean in everyday life.

And this isn’t merely a handful of isolated complaints. A research analysis of Reddit discussions about semaglutide identified thousands of drug–side effect relationships across posts collected through January 2025. Nausea was the most frequently identified side effect, while constipation, vomiting, and concerns about impaired gastric emptying also appeared repeatedly. 

The online conversation reveals something important: patients aren’t necessarily rejecting weight loss. They’re questioning how much discomfort they should have to tolerate to achieve it.

Why patients are really discontinuing GLP-1 drugs

One of the most revealing findings comes from a large real-world study published in JAMA Network Open. Researchers followed 125,474 adults with overweight or obesity who started GLP-1 medications.

64.8%

Without type 2 diabetes discontinued within one year

46.5%

With type 2 diabetes discontinued within one year

Moderate or severe gastrointestinal adverse events were significantly associated with a greater likelihood of discontinuation.

One in three former users cited side effects as a reason for stopping. Among respondents with type 2 diabetes, the figure was approximately 50%.

Another 2025 clinical-practice study examining 288 patients who discontinued semaglutide or tirzepatide found that 14.6% stopped because they could not tolerate the side effects, while 47.6% stopped because of cost or insurance issues. The findings reinforce an important distinction: side effects are a major obstacle, but they are not the only reason patients discontinue treatment. 

What the social media conversations reveal about quality of life

One of the most revealing Reddit posts appeared in r/Semaglutide under the title I’m giving up on Wegovy, and it’s ok if you do too. The patient described months of recurring vomiting, fear of eating, and missing enjoyable time with family because of feeling ill.

“My quality of life is suffering.”

The person had tried to make treatment work for six months but ultimately decided that continuing was no longer worthwhile. 

Another Reddit user, posting in r/WegovyWeightLoss after three months of treatment, described nausea, stomach pain, vomiting, and severe constipation. Despite losing 15 pounds, the person decided to stop:

“The way I feel is not worth losing the 15 pounds I’ve lost.”

A third user reported three weeks of severe stomach symptoms despite trying multiple remedies, including medications for nausea and acid-related discomfort. After an emergency department visit, the patient stopped Wegovy. The post made an important distinction: the medication might work well for others, but it was not tolerable for that individual.

These stories don’t prove that most patients experience severe symptoms. But they expose an uncomfortable truth about the weight-loss conversation: success cannot be measured solely by what happens on the scale.

For some patients, the side effects interfere with relationships, work, sleep, meals, travel, and emotional well-being. The medical definition of a tolerable adverse event doesn’t always capture its cumulative effect on someone’s life.

The problem with telling patients to just push through

One of the more troubling aspects of the GLP-1 conversation is the tendency to normalize persistent gastrointestinal distress as simply part of the process.

Online communities sometimes encourage patients to eat smaller meals, avoid fatty foods, stay hydrated, or wait for their bodies to adjust. Some of those strategies can genuinely help. Slower dose escalation, dietary adjustments, and individualized treatment can improve tolerability.

But there’s a difference between mild nausea that gradually resolves and persistent vomiting that interferes with normal functioning.

GLP-1-based medications slow gastric emptying, which can increase fullness but also cause uncomfortable gastrointestinal symptoms. Serious complications, including pancreatitis, gallbladder disease, and severe gastrointestinal reactions, require appropriate medical evaluation. Never dismiss persistent vomiting or an inability to keep fluids down as an ordinary inconvenience.

Patients should discuss intolerable symptoms with their prescribers rather than independently changing or stopping treatment, particularly when the medication is being used to manage diabetes.

The other uncomfortable truth: stopping often means regaining weight

The discontinuation story doesn’t end when the injections stop. Research consistently shows that weight regain is common after GLP-1 treatment ends.

A 2026 review in Nature Reviews Endocrinology described the problem clearly: gastrointestinal adverse effects, high costs, disappointing efficacy, and concerns about rare adverse events can all lead to discontinuation, while stopping treatment is frequently followed by weight regain and deterioration in cardiometabolic risk factors. 

That creates a difficult choice for patients who respond well to the medication but struggle with tolerability. Continue taking something that makes everyday life uncomfortable, or stop and risk regaining the weight they worked so hard to lose?

For a chronic treatment, this is more than a question of efficacy. It’s a question of sustainability.

The pharmaceutical industry needs to pay more attention to the patient experience

The GLP-1 market has been built around impressive clinical outcomes, and those outcomes deserve recognition. These medications have transformed obesity treatment and can offer benefits beyond weight loss, including improved glycemic control and, for certain products and populations, reduced cardiovascular risk.

But pharmaceutical companies and healthcare providers must recognize that clinical efficacy and real-world patient satisfaction are not the same.

A medication can produce impressive average weight loss in a randomized clinical trial and still be difficult for a meaningful segment of patients to tolerate over the long term. The disconnect matters most when treatment is expected to continue indefinitely.

Manufacturers should be investing not only in more effective drugs, but also in better tolerability, individualized dosing strategies, and systematic research into how side effects affect daily functioning. Physicians need to ask patients questions that go beyond pounds lost and laboratory results. Can they enjoy a meal? Are they missing work? Are they avoiding social activities? Are gastrointestinal symptoms affecting their relationships or emotional well-being?

Those questions matter because patients don’t experience their health as a collection of clinical endpoints. They experience it through their daily lives.

Weight loss shouldn’t come at the expense of living

GLP-1 drugs are an important medical breakthrough, and millions of patients may benefit. But the growing evidence around discontinuation makes one thing clear: long-term success depends on more than the ability to lose weight.

For patients who experience little or no gastrointestinal discomfort, these medications can be life-changing. For others, persistent nausea, vomiting, constipation, and diarrhea can turn an exciting weight-loss journey into a daily struggle.

The patients sharing their stories online are not necessarily questioning the science behind GLP-1 medications. They’re asking a more personal question: What good is losing weight if I feel too sick to enjoy my life?

The pharma industry, prescribers, and healthcare marketers need to take that question seriously.

The ultimate measure of a successful obesity treatment shouldn’t be how much weight a patient loses. It should be whether the treatment helps that patient live a healthier, happier, and more fulfilling life — and whether they can realistically stay on it.

The post The GLP-1 Reality Check: When Losing Weight Means Losing Your Quality of Life appeared first on World of DTC Marketing.

I’ve watched pharma marketing become increasingly obsessed with metrics that look impressive in PowerPoint presentations but often say very little about what patients actually need. We celebrate reach, engagement, click-through rates, and brand awareness while patients struggle to understand treatment options, navigate insurance coverage, manage side effects, and have meaningful conversations with their physicians.

I would build a DTC organization around a different philosophy: Patients first. Business results follow. And I would expect every member of my team to understand that putting patients first isn’t a slogan. It’s an operating principle that should influence how we spend money, develop campaigns, measure performance, and make difficult decisions.

1ne. I Would Spend More Time Listening to Patients Than Listening to Advertising Agencies

First, I would get my team out of conference rooms and into the real world. I would want them listening to patients, caregivers, physicians, pharmacists, and people who have stopped taking our medications.

Traditional market research has its place, but too much pharma research is designed to validate decisions already made. We test advertising concepts, measure message recall, and ask consumers whether they intend to speak with their doctors. What we don’t do nearly enough is understand the emotional and practical realities of living with a disease.

I would establish a continuous patient-listening program that combines qualitative interviews, online community research, social listening, patient advisory groups, and analysis of the questions people ask throughout their treatment journeys. I would conduct all of this with appropriate consent, privacy protections, and adverse-event reporting processes.

And I would pay particular attention to patients who discontinue therapy. They’re often more valuable sources of insight than patients who are satisfied with treatment. Why did they stop? Was it cost? Side effects? Unrealistic expectations? A lack of support? Did they feel their doctor adequately prepared them for what treatment would involve? These answers should shape our marketing strategy long before an agency starts developing creative concepts.

2wo. I Would Stop Treating Every Patient Like a Potential Prescription

One of the biggest problems with pharma DTC marketing is that it often treats awareness as the primary objective. The underlying assumption is that if enough consumers recognize a brand and ask their doctors about it, the campaign is successful.

I disagree. A successful DTC campaign should help the right patients understand whether a treatment might be appropriate for them. It should also help patients recognize when a medication may not be suitable.

That means communicating benefits and risks in language people can actually understand. It means setting realistic expectations about outcomes and side effects. It means being transparent about treatment limitations rather than burying them beneath emotional imagery and carefully crafted headlines.

I would rather have a smaller number of appropriately informed patients initiate treatment than a larger number start therapy with expectations that the medication cannot meet.

That may sound counterintuitive coming from someone responsible for marketing performance. But inappropriate expectations can drive dissatisfaction, discontinuation, and lost trust.

Good marketing doesn’t just create demand. It helps patients make informed decisions.

3hree. I Would Rebuild the Marketing Budget From Zero

One of my first major exercises would be a zero-based review of the DTC marketing budget. I wouldn’t automatically allocate millions of dollars to television simply because that’s what the brand did last year. Nor would I assume that digital advertising deserves more money just because it produces better attribution reports. But I would demand evidence that these investments are working together.

Every channel would have to justify its investment based on what it contributes to the patient journey and to measurable business outcomes. Television can still play an important role in building broad awareness. Search marketing can reach people actively seeking information. Educational content can address questions that traditional advertising cannot. Patient support programs can help people navigate barriers to treatment.

I would also challenge my media and agency partners to demonstrate incremental value, not just activity. A million impressions mean very little if they don’t lead to better-informed patients or meaningful commercial results.

I would establish rigorous experimentation, including geographic testing, holdout groups where appropriate, and independent measurement of incremental impact. I would want to know which investments genuinely influence outcomes and which simply take credit for behavior that would have occurred anyway.

4our. I Would Make Patient Experience a Core Marketing Responsibility

Pharma companies spend enormous amounts of money encouraging patients to start treatment, yet the experience after a prescription is written can be frustrating. Patients encounter prior authorization requirements, high out-of-pocket costs, pharmacy delays, confusing instructions, and side effects they may not have anticipated. Too often, marketing considers its job complete once the patient asks for the brand. I would reject that thinking.

My DTC team would work closely with patient services, market access, medical affairs, and other appropriate functions to identify where patients experience friction and how we can help address it. That doesn’t mean marketing should practice medicine or interfere with clinical decisions. It means marketing should understand the complete treatment experience.

If patients abandon prescriptions because they can’t navigate coverage, that matters. If they discontinue because the treatment experience differs from what they expected, that’s important too.

I would want our marketing to prepare patients for the realities of treatment, not just the possibilities.

5ive. I Would Demand Better Digital Experiences

Visit enough pharmaceutical brand websites, and you’ll see the same problems repeatedly: complicated navigation, excessive promotional language, difficult-to-find answers, and content organized around brand priorities rather than patient questions.

I would change that. We would design our website around the questions patients actually ask. What does this medication do? How effective is it? What side effects might I experience? How long does it take to work? What will it cost? What should I discuss with my physician? What happens if treatment isn’t working?

Those answers should be accessible, understandable, balanced, and easy to find. I would also insist on mobile-first design, accessibility, fast loading times, and search experiences that connect patients with reliable information.

And I would be cautious about adopting artificial intelligence simply because it’s fashionable. AI may help identify information gaps, improve content operations, and support approved educational experiences. But any patient-facing application must have appropriate safeguards for medical accuracy, privacy, regulatory compliance, and human oversight.

Technology should make healthcare information easier to understand, not create another layer of confusion.

6ix. I Would Change How We Work With Advertising Agencies

I wouldn’t want an agency relationship built around presenting three creative campaigns every six months and hoping one tests well. I would want strategic partners who understand healthcare, consumer behavior, patient experience, analytics, and the commercial realities of pharmaceutical marketing.

Agencies would be expected to challenge our assumptions, not simply agree with the brand team. I would also eliminate unnecessary approval layers and endless rounds of subjective creative feedback wherever possible, while preserving the rigorous medical, legal, and regulatory review pharmaceutical communications require.

And I would judge agencies on more than awards, production quality, and creative presentations. I would evaluate whether their work improves patient understanding, contributes to appropriate treatment conversations, and delivers measurable incremental value.

Great creative matters. But creative without strategic relevance is just expensive entertainment.

7even. I Would Build a Team That Isn’t Afraid to Challenge Conventional Thinking

I wouldn’t hire a team that always agrees with me. I would want marketers who understand data, consumer psychology, healthcare behavior, digital experiences, and the complexities of the pharmaceutical business. More importantly, I would want people who are curious, willing to challenge assumptions, and comfortable acknowledging when something isn’t working.

Our meetings wouldn’t revolve around reviewing dozens of slides filled with metrics. They would focus on decisions. What have we learned? What isn’t working? What should we stop doing? What are patients telling us? Where are we wasting money? What are we going to change?

I would encourage intelligent experimentation and make it acceptable to report disappointing results. If every campaign is described as a success, the organization probably isn’t learning very much.

I would also create a culture of accountability. Team members would understand their objectives, have the authority to make decisions within clear boundaries, and be expected to explain the business rationale behind their recommendations.

Leadership isn’t about having the final word in every meeting. It’s about building a team that can make excellent decisions without waiting for permission.

8ight. I Would Replace Vanity Metrics With Meaningful Performance Measures

This might be the most important operational change I would make. Pharma DTC marketing has no shortage of data. What it often lacks is a disciplined understanding of which data matters. I would still monitor reach, awareness, search activity, website engagement, and other traditional measures. But I would treat them as diagnostic indicators, not definitive proof of success.

My performance framework would focus on four areas:

• Patient understanding: Are patients better informed about the condition, treatment benefits, risks, and limitations?
• Appropriate treatment consideration: Are we helping relevant patients have more productive conversations with healthcare professionals?
• Patient experience: Are we reducing avoidable information gaps and helping patients navigate the treatment journey?
• Commercial effectiveness: Are our marketing investments generating incremental, sustainable business results?

I would also examine treatment persistence and discontinuation trends, recognizing that clinical decisions, tolerability, affordability, and many other factors influence these outcomes.

And I would be explicit that increasing persistence is not inherently a positive outcome. Sometimes stopping or changing a medication is the appropriate medical decision. The goal should be better patient experiences and appropriate use, not keeping people on a medication at any cost.

9ine. I Would Make Trust a Competitive Advantage

Pharma companies face a credibility problem that advertising alone cannot solve. Consumers are skeptical of drug pricing, concerned about side effects, and often uncertain about the motivations behind prescription drug advertising.

The answer isn’t to produce more emotionally compelling commercials. It’s to become more transparent.

I would push for communications that acknowledge uncertainty, clearly explain risks, and avoid overstating treatment benefits. I would want our brand to become a reliable source of information, even when that information includes something a patient may not want to hear.

I would also ensure that marketing works within a culture where regulatory compliance and ethical judgment are fundamental expectations, not obstacles to creativity.

Trust is difficult to earn and remarkably easy to lose. Once patients believe a company is minimizing risks or manipulating their concerns, even excellent advertising struggles to repair the damage.

10en. I Would Lead From the Front, Not From Behind a Dashboard

Finally, I would be a very hands-on leader. I would regularly review customer research, listen to patient interviews, examine website experiences, question media spending, and engage directly with the people responsible for executing our strategy.

I would make decisions quickly when the evidence supports them, and I would change direction when new information challenges our assumptions. I would protect my team from unnecessary bureaucracy while holding everyone accountable for results. And I would make sure that every person on the team understands the connection between their work and the patients who ultimately experience it.

A DTC marketing organization should never become so focused on internal processes, agency presentations, and quarterly performance reviews that it loses sight of the people it is supposed to serve.

I Would Build a Patient-Centered Business, Not an Advertising Machine

If I were leading a pharma DTC marketing team, my ambition wouldn’t be to create the industry’s most talked-about advertising campaign. It would be to build the most effective, disciplined, patient-focused marketing organization possible.

An organization that listens before it speaks. That values evidence over assumptions. That measures business impact rather than celebrating activity. That communicates risks as seriously as benefits. That understands the entire patient journey instead of focusing exclusively on prescription acquisition.

And one that recognizes a fundamental truth pharma marketing too often overlooks: The patient isn’t a target, a conversion, or a prescription opportunity. The patient is a person making an important healthcare decision. If we build our strategies around that reality, we’ll create better marketing, stronger brands, and a more sustainable business. That’s how I would lead a pharma DTC team.

Frankly, it’s how I believe pharma marketing should have operated all along. How many of you would join me?

The post Leading a Pharma DTC Marketing Team appeared first on World of DTC Marketing.

Some of the most successful pharma launches have rewritten the rules of medicine and marketing. Others show that understanding patients, physicians, payers, and the broader healthcare ecosystem matters as much as developing an effective molecule.

Consider Cialis, Lipitor, Humira, Keytruda, and Ozempic. Each achieved extraordinary commercial success, but for different reasons. Some created new opportunities within established markets. Others transformed treatment standards, built powerful clinical evidence, or became household names.

Their stories offer important lessons for pharmaceutical marketers, especially as patients are more informed, physicians are overwhelmed, insurers are increasingly restrictive, and social media can shape demand faster than traditional pharmaceutical advertising.

Cialis: How Understanding Patients Created a Competitive Advantage

When Eli Lilly and ICOS launched Cialis in 2003, they faced an enormous challenge. Pfizer had already established a dominant position in the erectile dysfunction market, and its treatment had become one of the most recognizable pharmaceutical brands in the world. Competing head-to-head against an established blockbuster wouldn’t be easy.

But Cialis had something that mattered to patients: a substantially longer duration of action.

While sildenafil generally provides an effective treatment window of approximately four hours, tadalafil, the active ingredient in Cialis, can remain effective for up to 36 hours. This difference created an opportunity to position Cialis around spontaneity, flexibility, and a less scheduled approach to intimacy.

That positioning was important because erectile dysfunction isn’t simply a clinical problem. It can affect confidence, relationships, and quality of life. Cialis recognized that patients weren’t necessarily looking for another erectile dysfunction pill. They wanted a treatment that fit more naturally into their lives.

The marketing strategy helped turn a pharmacological difference into a meaningful consumer benefit. Cialis became widely associated with a longer window of opportunity, while its advertising emphasized relationships and intimacy rather than the mechanics of treatment.

The brand eventually became a multibillion-dollar franchise, with worldwide annual sales exceeding $2 billion at its peak. Subsequent approval of once-daily dosing created another opportunity to differentiate the treatment, and an indication for symptoms of benign prostatic hyperplasia expanded its clinical relevance.

The lesson: Successful pharmaceutical launches don’t always require revolutionary science or first-to-market status. Sometimes the opportunity lies in identifying a product attribute that genuinely matters to patients and translating it into a compelling reason to choose the brand. Cialis showed that understanding patients’ lifestyles, emotional needs, and treatment preferences can matter as much as communicating clinical efficacy.

Lipitor: Winning Through Clinical Evidence and Sustained Execution

Lipitor is one of the greatest commercial success stories in pharmaceutical history. Warner-Lambert introduced it in 1997, and Pfizer later marketed it; it became a multibillion-dollar franchise and one of the best-selling prescription drugs ever.

What made Lipitor especially interesting was that it wasn’t the first statin. It entered a market where physicians already understood the importance of lowering cholesterol and where established competitors had a head start. Lipitor succeeded by demonstrating strong LDL-cholesterol reductions, building a substantial clinical evidence base, and supporting the brand with extensive physician education and consumer advertising.

The company didn’t simply promote the molecule. It reinforced the importance of cholesterol management, encouraged screening, and made treatment an ongoing conversation between patients and physicians. Importantly, the product’s potency gave physicians a meaningful reason to consider it rather than automatically prescribing an established competitor.

The lesson: Being first isn’t always necessary. A differentiated product, backed by convincing evidence, clear positioning, and consistent commercial execution, can outperform established competitors. But the differentiation has to matter to prescribers and patients. Marketing claims that sound impressive in a brand planning meeting don’t necessarily change prescribing behavior.

Humira: Building a Blockbuster Through Lifecycle Management

Humira offers a different lesson. Originally approved in 2002 for rheumatoid arthritis, AbbVie’s immunology treatment eventually became one of the world’s largest pharmaceutical franchises. Its success built over many years, not just at launch.

Humira expanded into additional inflammatory diseases, including psoriasis, Crohn’s disease, and ulcerative colitis. Each new indication opened another patient population, another group of specialists, and another opportunity to establish the brand within treatment pathways. AbbVie also invested heavily in patient support, physician relationships, and reimbursement infrastructure.

The strategy worked extraordinarily well, although Humira’s prolonged commercial dominance also reflected patent protections and legal strategies that delayed some biosimilar competition in the United States.

The lesson: View a successful launch as the beginning of a product’s commercial life, not its defining moment. Indication expansion, evidence generation, treatment experience, and patient services can create enormous long-term value. However, lifecycle management cannot be separated from the regulatory, patent, and competitive environment.

Keytruda: How Evidence Creates a Commercial Franchise

Merck’s Keytruda may be one of the most instructive examples of modern pharmaceutical commercialization. First approved in 2014, the cancer immunotherapy evolved into a treatment option across numerous cancer types and clinical settings. In 2025, Keytruda and Keytruda Qlex generated approximately $31.7 billion in worldwide sales.

Its growth reflects something pharmaceutical marketers sometimes underestimate: the commercial power of a disciplined clinical development strategy. Merck invested in trials across tumor types, treatment combinations, and earlier disease stages. Positive results and regulatory approvals progressively expanded the eligible patient population and strengthened the drug’s position in oncology.

Keytruda also illustrates the importance of thinking beyond the individual prescriber. Oncologists, hospital systems, treatment guidelines, biomarker testing, and reimbursement policies all influence adoption. Commercial organizations must understand how these pieces interact rather than treating a prescription as an isolated decision.

The lesson: In specialty medicine, evidence generation is a fundamental part of commercialization. The most effective strategy connects clinical development, medical affairs, market access, diagnostic pathways, and commercial execution. A compelling sales message cannot compensate for missing clinical evidence, and even strong evidence can be undermined by access or testing barriers.

Ozempic and Wegovy: When Patients Become the Engine of Demand

Few pharmaceutical franchises have changed public conversation as dramatically as Novo Nordisk’s Ozempic and Wegovy. Ozempic launched in the United States in 2018 for type 2 diabetes, while Wegovy arrived in 2021 for chronic weight management. By 2025, Ozempic alone generated more than DKK 127 billion in worldwide sales.

These products illustrate a fundamental change in pharmaceutical marketing: patients no longer wait for pharmaceutical companies to educate them about treatment options. They learn from social media, news coverage, celebrities, friends, and online communities, often before speaking with a healthcare professional.

The GLP-1 category benefited from powerful clinical results and substantial unmet medical need. But it also generated an extraordinary amount of organic conversation. Patients discussed weight loss, side effects, costs, insurance denials, and their personal experiences. Some of that conversation was informative; some was misleading. Either way, it shaped awareness and expectations.

The demand explosion also revealed the limits of commercial success. Manufacturing capacity, product availability, affordability, and insurance coverage became major obstacles. Even as the market expanded, competition intensified, and market leadership became less secure.

The lesson: In the social media era, companies don’t fully control their brands’ narratives. Patients and online communities actively shape perceptions. Pharmaceutical marketers need to listen to these conversations, identify misinformation, and understand the gap between clinical expectations and real-world experiences. Just as importantly, they must ensure that supply and access can support the demand they help create.

What the Numbers Tell Us

These products weren’t necessarily the fastest launches in their first year. They represent different forms of commercial success: competitive differentiation, category expansion, sustained market leadership, and new indications.

Note: Figures reflect different years and stages of the product lifecycle and are not a like-for-like comparison of first-year launch performance.

The Five Lessons Pharmaceutical Marketers Should Take Seriously

Looking across these success stories, five themes stand out.

First, understand what patients actually value. Cialis demonstrated that patients don’t necessarily evaluate treatments the same way pharmaceutical companies do. Clinical efficacy matters, but so do convenience, spontaneity, confidence, and quality of life. Ozempic and Wegovy showed how patients can drive treatment conversations. Yet many pharmaceutical companies still spend more time researching physician attitudes than understanding patients’ daily frustrations, fears, and financial realities.

Second, clinical differentiation has to be meaningful. Cialis, Lipitor, and Keytruda illustrate different ways differentiation can create commercial value. Cialis translated duration of action into a lifestyle benefit. Lipitor established a strong clinical position in cholesterol management. Keytruda built its franchise through an expanding evidence base. The strongest positioning connects measurable clinical or treatment-related benefits to specific decisions rather than relying on promotional language.

Third, market access is part of the product experience. A drug that patients cannot afford or obtain is not commercially successful simply because physicians want to prescribe it. Coverage restrictions, prior authorization, specialty pharmacy requirements, and out-of-pocket costs can destroy launch momentum. Market access should influence launch planning from the beginning, not become a problem commercial teams address after approval.

Fourth, the launch is only the beginning. Humira and Keytruda demonstrate how much value can be created after initial approval. Cialis also expanded its commercial opportunities through once-daily dosing and additional indications. New clinical data, treatment options, delivery innovations, and better patient support can extend a product’s relevance for years. The most effective organizations plan for a product’s entire lifecycle rather than treating the first twelve months as the ultimate measure of success.

Fifth, pharmaceutical marketing has become a conversation rather than a broadcast. Social media, patient communities, online physician discussions, and real-world treatment experiences now influence brand perceptions. Companies cannot control these conversations, but they can learn from them. The challenge is to translate those insights into accurate, compliant education, better patient support, and more relevant commercial strategies.

The Biggest Mistake Pharma Companies Make When Launching New Drugs

Perhaps the most important lesson is what these success stories tell us about the industry’s traditional launch model. Pharmaceutical companies often assume that strong clinical trial results, a large sales force, extensive physician targeting, and substantial promotional spending will produce commercial success.

That assumption is increasingly questionable.

Physicians are inundated with information. Patients are skeptical of pharmaceutical advertising. Payers exert enormous influence over prescribing decisions. Digital conversations can shape expectations before a company’s promotional campaign even begins.

Yet too many launch plans still revolve around the same questions: How many representatives do we need? How frequently should they call on physicians? What should our core message be? How much should we invest in advertising?

Those questions matter, but they aren’t enough.

The more important questions are whether patients recognize their need for treatment, whether physicians see a meaningful reason to change prescribing behavior, whether the evidence supports the intended positioning, whether insurers will cover the drug, and whether patients can actually start and remain on therapy.

Cialis provides a particularly useful example. Its commercial strategy wasn’t built simply around convincing physicians that tadalafil worked. It emphasized how its longer duration of action could meaningfully improve patients’ lives. That distinction helped the brand compete against a powerful incumbent. It was so successful it overtook Viagra sales.

There’s also an important distinction between generating a prescription and delivering a successful treatment experience. A launch team may celebrate prescription growth while patients are struggling with insurance denials, unexpected costs, side effects, or difficulty getting follow-up care. Those problems can eventually undermine the brand, regardless of how much money is spent on promotion.

Successful Launches Solve Problems, Not Just Promote Products

The pharmaceutical industry’s most successful products share one characteristic: they changed something meaningful about healthcare.

Cialis demonstrated that understanding patient preferences and translating product differentiation into real-life benefits can challenge an established market leader. Lipitor helped establish a powerful competitive position in cholesterol management. Humira expanded treatment options across multiple inflammatory diseases. Keytruda helped transform cancer treatment. Ozempic and Wegovy dramatically changed public awareness of metabolic disease and obesity treatment.

These outcomes depended on scientific innovation, clinical evidence, commercial investment, and favorable market conditions—not marketing alone. Still, each illustrates how understanding the broader treatment environment can turn a promising medicine into a major franchise.

The next generation of blockbuster launches will require more than compelling efficacy data and sophisticated omnichannel campaigns. Companies will need a much deeper understanding of patient behavior, physician decision-making, affordability, and the real-world treatment journey.

The question pharma executives should be asking isn’t simply, “How do we get physicians to prescribe our new drug?” It’s “What has to change in the healthcare system for the right patients to benefit from our drug—and how can we help make that happen?”

That shift in thinking may be the most important commercial lesson of all.

The post The Biggest Pharmaceutical Launches in History—and What They Teach Us About Winning in Today’s Market appeared first on World of DTC Marketing.

Mark Cuban has never been especially interested in befriending the pharma industry’s middlemen. And it’s easy to see why after reading his recent interview with Doctors on Social Media. Cuban believes the system of prescription drug pricing is intentionally complex, financially inefficient, and designed to benefit groups that provide dubious value to patient care. He raises some good points. But while his critique of pharmacy benefit managers (PBMs) is valid, the idea that eliminating the middlemen will somehow cure America’s prescription drug affordability crisis is far too simplistic.

Let’s start with something that most people outside of the pharmaceutical industry don’t understand. The price of a prescription drug isn’t necessarily what the manufacturer receives, what the insurance company pays, what the employer ultimately spends, or what the patient hands over at the pharmacy counter. They can be four very different numbers. And that alone should tell us something about how dysfunctional the system has become.

Cuban says PBMs have built a business model around this complexity. They negotiate rebates, steer formularies, arrange reimbursements, and collect all manner of fees. In theory, they are supposed to use their bargaining power to reduce the cost of drugs. In practice, some financial incentives may favor arrangements that aren’t necessarily the most economical for patients or employers.

He is right to question the system. When a patient finds out a drug costs less without insurance than it does through their prescription plan, something is clearly wrong. It’s wrong when doctors waste precious time fighting prior authorization rules for low-cost generic drugs. And when employers don’t have an easy way to know what percentage of their prescription drug spend goes to actual medications versus administrative fees and intermediary margins, something is very wrong.

But here is where I diverge from Cuban. PBMs are not solely responsible for the pricing issues in the pharmaceutical industry. Pharmaceutical companies helped to cultivate the climate in which these deals could thrive.

Pharma Companies Are Not Innocent Bystanders

For brand-name pharmaceutical manufacturers, operating in a pricing environment of high list prices, negotiated rebates, formulary position, and complex contracting arrangements has been the norm for years. Manufacturers want to reach patients, and PBMs control access to millions of covered lives. That gives PBM’s a big negotiating advantage. But manufacturers set their own prices, and some have profited from the very lack of transparency they now complain about.

Consider the economics of an expensive biologic. A manufacturer sets a list price, negotiates rebates with intermediaries, and may offer copay assistance that dramatically lowers out-of-pocket expenses for eligible commercially insured patients at the pharmacy. For the patient receiving assistance, the medication may appear affordable. But the basic costs don’t disappear. They’re spread out among employers, insurers, manufacturers, and ultimately the people paying for healthcare coverage.

Not all costly biologics are overpriced. Developing new medicines is costly and risky, producing complex biological products is costly, and many therapies have exceptional clinical value. But the industry has never been very good at explaining how a drug’s price, cost, and value are different. Too often, the response to criticism has been another carefully worded PR campaign, rather than meaningful transparency. And patients are fed up.

The most candid part of Cuban’s interview was about employers

One of the interview’s more provocative moments comes when Cuban is asked why employers still sign expensive PBM contracts. His answer is essentially that employers are not doing their homework. He argues that companies could use artificial intelligence to analyze their contracts and find expensive provisions.

That’s an oversimplification, but his point is worth being attentive to. Large self-funded employers are some of the largest buyers of prescription drug benefits in the United States. But many rely on consultants, benefits administrators, and PBMs to largely determine whether their plans deliver value. They may get a lot of reporting on rebates and discounts, but not a clear picture of whether they’re getting the lowest reasonable net price for medicines.”

A 40% rebate sounds wonderful until you realize that another drug with a smaller rebate would have been cheaper overall.

Here is where pharma marketing and market access professionals should take note. Employers are an increasingly important stakeholder in the pharmaceutical marketplace, and they ask different questions than physicians. A doctor wants to know whether a drug works, is safe, and which patients are most likely to benefit. An employer wants to know if the medicines improve employee health, reduce downstream medical expenses, and offer value for the total cost.

Pharma companies that can’t speak to both of those audiences are going to have harder and harder commercial conversations.”

Cost Plus Drugs Is a Wake-Up Call, Not a Full Solution

Cuban’s Cost Plus Drugs has pulled off something big. It has demonstrated to consumers that transparent pricing is possible and that some generic medications can be offered at a significant discount compared to what patients would pay through traditional channels. That’s an achievement.

But we should also know what the model does not solve. Many of America’s most expensive drugs are patented brand-name drugs—specialty therapies and biologics. Their prices are a blend of research and development economics, manufacturing costs, intellectual property protection, competitive conditions, contracting, and market power.

Removing PBMs from the transaction doesn’t magically make these products cheap.

There is also a real problem. Low prices are not enough for patients. They need reliable access, proper medication management, continuity of care, insurance coordination, and assistance when something goes wrong. A transparent pharmacy model can increase affordability without replacing every function of the current prescription benefit system.

Its real significance may not be replacing conventional pharmacies, but setting a benchmark. When patients and employers see a clear price, they start asking why other prices are so hard to explain.

The pharmaceutical industry should embrace that question, not shy away from it.

Prior Authorization is a Trust Issue

Cuban’s harshest criticism is on prior authorization. He believes some systems are set up to prevent patients from getting drugs, knowing some people will fall out of the process, because insurers and PBMs understand this.

Utilization management serves good purposes. Some drugs require careful patient selection, monitoring, or consideration of less expensive therapeutic alternatives. Insurers also have a responsibility to control costs. But when authorization requirements impose unnecessary burdens, they have effects that extend beyond administrative inconvenience.

If a patient cannot get their prescription filled, they may think the insurance company doesn’t care about their health. If a doctor has to fight over and over again to get coverage, he or she might get pretty pissed off with the whole system. And a pharmaceutical manufacturer with a hard-to-access product may find that clinical efficacy alone doesn’t translate into a positive treatment experience.

That should worry pharma marketers.

For decades, pharmaceutical marketing has been focused on awareness creation, physician education, brand differentiation, and appropriate prescribing promotion. Those things still count. But what good is a successful marketing campaign if a patient can’t afford the prescription or drops out of treatment because the approval process is too complicated?

The patient experience doesn’t stop when the doctor writes the prescription. In many ways, that’s when the most frustrating part begins.

Pharma marketing’s definition of value must change

So, here’s the bigger issue Cuban’s interview raises for the pharma industry. Drug companies spend billions talking about their products’ clinical benefits, but many patients still don’t know what they’ll cost or whether their insurance will cover them.

It’s getting harder and harder to defend that disconnect.

Pharma marketers have historically measured success by awareness, reach, prescribing behavior, market share, and sales growth. These are legitimate business metrics, but they don’t tell us whether patients start treatment and stay on it.

What if drug companies focused less on prescription abandonment and more on affordability, time to therapy, prior authorization burden, and treatment persistence? What if market access teams and brand teams were jointly accountable for reducing avoidable barriers to appropriate treatment? What if manufacturers made their pricing and patient assistance programs clearer, rather than forcing patients to navigate a maze of eligibility requirements?

This wouldn’t change the economic realities of pharmaceutical innovation. But it might help restore something that the industry has slowly lost: trust. There is a competitive opportunity here, too. Those that can show strong clinical results and make their products more accessible may have an advantage over competitors that depend mostly on traditional promotion. Access is no longer just a reimbursement issue. That’s part of the brand experience.

The industry must stop hunting for a lone wolf

It’s easy to blame PBMs for what’s wrong with prescription drug pricing. They are powerful, misunderstood by the public, and their business practices have come under legitimate fire. Cuban knows this, and his blunt style makes for compelling reading.

But if PBMs are to blame alone, too many other stakeholders are getting away with it. Manufacturers set price increases and launch prices. Insurers design benefits that dictate what patients pay. Employers decide how much scrutiny they want applied to their pharmacy contracts. Policymakers create competition, patents, reimbursement, and insurance rules. And middlemen strike deals that can either enhance or diminish market efficiency.

Each participant has incentives. Not all of those incentives serve patients’ interests. The real problem is not simply getting rid of the middlemen. “It’s creating a system where there’s a financial incentive for everyone involved to offer clinically appropriate medications at a reasonable total cost.”

That’s a much harder problem than Cuban sometimes acknowledges.

Mark Cuban deserves kudos for challenging an industry that has grown too comfortable with complexity. His willingness to challenge PBM practices, shine a light on price discrepancies, and offer an alternative purchasing model has brought much-needed attention to issues patients and physicians have long dealt with. But transparency alone will not solve the prescription drug affordability crisis, and a change of distribution model will not solve every reason medications are expensive.

The message to pharma executives should be clear. The industry’s future cannot rest on an approach that simply develops new medications and then expects patients, physicians, employers, and insurers to navigate an increasingly complicated system to get them.

Innovation is the key. Clinical outcomes are essential. But affordability, access and trust matter, too.

The drug industry has spent decades explaining why drugs are so expensive. Maybe it’s time to make a bit more effort to show patients they are getting value for money.

And that’s a conversation worth having long after Mark Cuban’s latest interview has dropped off the headlines.

The post Mark Cuban Is Correct About Prescription Drug Prices. But He’s Not Telling the Whole Truth appeared first on World of DTC Marketing.

If you ask a pharma marketer what the number one website is for healthcare professionals (HCPs), the answer is likely Medscape or Doximity. Both have built good businesses around physician engagement, and both provide opportunities for pharmaceutical companies to get their brands in front of prescribers.

But the truth is, being the biggest HCP website doesn’t make you the most effective pharmaceutical marketing channel.

That’s an important distinction to make in an industry where marketing budgets are increasingly under the microscope.

The Obsession With Reach

Large numbers are a drug marketer’s dream. HCPs registered by the millions. Impressive doctor penetration. Thousands of opportunities to convey brand messages. These metrics look good in PowerPoint presentations and make it easier to justify media investments.

Medscape reaches the vast majority of U.S. physicians on a monthly basis. Doximity has created a network with a significant percentage of practicing doctors. Both are now major players in pharma digital marketing.

But let’s ask a simple question: **What does it mean to reach a doctor?

Does that mean a doctor saw a branded banner ad while looking for clinical information? Does it mean a doctor scrolled past a sponsored message between seeing patients? Or does it mean the doctor stopped, thought about the information, and reconsidered a treatment option? Those three results are quite different.

But pharma marketing reports often treat them as interchangeable. Physician impression is not equal to physician attention. And physician attention doesn’t necessarily translate into prescribing influence.

Physicians don’t visit HCP Websites to see drug advertising

Pharma marketers need to know this. Physicians visit professional websites for a purpose. They might be researching a clinical question, reviewing the latest treatment guidelines, new research, or medical news. They’re not logging on hoping to find another pharma advertisement.

That doesn’t mean pharmaceutical advertising can’t be valuable. A physician may find useful relevant information about a new indication, meaningful clinical data, or an important safety update.

But context counts. Oncologists weighing treatment options will welcome information on a new therapy that addresses a particular clinical problem. The same oncologist may ignore an unrelated promotional message, no matter how sophisticated the targeting technology is.

The difference? The website, not necessarily. The question is whether the information meets the physician’s needs at that moment. Relevance matters more than reach when the goal is meaningful engagement.

Medscape vs Doximity: Different Value Propositions

Medscape and Doximity are often mentioned together as competitors, but doctors use them for different purposes.

Medscape is the leading online destination for physicians and healthcare professionals worldwide. This gives pharma marketers the opportunity to reach doctors while they are actively consuming medical content.

Doximity is more of a professional network that combines physician communications, networking, news, and workflow-based services. Its value to pharmaceutical advertisers is the ability to reach verified physicians with targeted messaging.

No model is inherently better.

Medscape may offer a favorable setting for communicating clinical information, especially if the content matches the physician’s specialty or information needs. If a brand has a specific physician audience to target on a professional platform, then doximity could be beneficial.

But the question shouldn’t be which company has the better sales presentation or the bigger membership database.

It should be about which platform can demonstrate that its advertising changes something that matters.

And that’s where the uncomfortable conversation begins.

The Problem of HCP Engagement Metrics

For years, the pharmaceutical digital marketing world has been obsessed with the usual metrics: impressions, clicks, open rates, time spent, and engagement. These measures aren’t wrong in themselves. “They can tell marketers if the content was delivered and if the physicians engaged with it.

What they can’t reliably tell us is if a doctor’s clinical thinking changed. A doctor might click an ad out of idle curiosity and never think of the product again. Another doctor may read a sponsored clinical article, find the evidence compelling, and recall the brand weeks later when treating a suitable patient.

That second interaction may be much more valuable, even if it results in fewer measurable digital actions. This is a nontrivial measurement challenge.

Pharma marketers need to move beyond activity reporting to measuring outcomes. This requires analyzing incremental new prescriptions, changes in prescribing by appropriately targeted physicians, and whether marketing increases awareness and understanding of clinically relevant product information.

Even a prescription lift needs careful interpretation. A correlation between advertising exposure and prescribing does not prove the advertising caused the change. Patient mix, formulary access, sales activity, and market trends drive prescribing.

Without credible control groups or other rigorous measurement methods, bold ROI claims risk being little more than costly assumptions.

The Physician Experience is Being Ignored

Another problem discussed far less is advertising fatigue. Physicians are immersed in information. Their inboxes are full, their schedules are packed, and medical research keeps growing.

Now add pharma advertising on professional websites, email newsletters, digital publications, social platforms, and point-of-care channels. When does another brand impression stop adding value and start adding noise?

Pharma marketers often treat frequency as if more exposure equals better brand recall. But repetition, when it isn’t relevant, can be irritating, especially if the message adds nothing new. Seeing the same promotional claim repeatedly doesn’t necessarily convince a physician who’s already seen it.

Maybe they’re just getting better at ignoring it.

The industry should spend less time patting itself on the back for delivering another million impressions and more time figuring out what physicians find useful.

What Should Drug Marketers Purchase?

Marketers shouldn’t be asking what the number one HCP website is, but rather a more challenging set of questions.

Does the platform reach the physicians who actually treat the patients eligible for the product? Does it put information in a context where those physicians are likely to find it useful? Are there any credible measures beyond clicks and impressions? And can it show incremental value over other marketing investments?

A brand targeting a smaller group of specialists may have little incentive to focus on the platform with the largest total number of doctors. A smaller, more focused channel may produce better results if it reliably gets the right information to the right clinicians.

And the same goes for primary care brands. Broad reach can be valuable, but only if the audience, message, timing, and treatment opportunity align. After all, pharma companies don’t buy doctor traffic. “They’re buying the opportunity to pass along information that may alter appropriate treatment decisions.”

That’s a much higher bar.”

The True #1 HCP Site

So is it Medscape, the #1 HCP website? Is that Doximity? ” Or is there another platform that pharma marketers are missing out on? That depends on what we are measuring.

For broad physician reach, Medscape is a serious contender. Doximity offers a compelling proposition for validated physician networking and targeted professional engagement. But if the question is which platform best influences prescribing behavior, the answer is less clear.

And perhaps that is the most important point. The #1 HCP site shouldn’t be the one that reaches the most physicians. It should be the one that has the greatest measurable impact among the physicians that matter to the brand.**

That means better targeting, more relevant content, more credible measurement, and the willingness to challenge the metrics that have ruled pharmaceutical digital marketing for years. The drug industry has become amazingly good at counting physician impressions.

We have to get much better at knowing if those impressions really matter. Because at the end of the day, a million impressions look good on a marketing report. But if they don’t change a single thing, what did the brand actually buy? Create a LinkedIn graphic for this article

The post The Number One HCP Website? Pharma Marketers May Be Asking the Wrong Question appeared first on World of DTC Marketing.

Physicians aren’t prescribing as fast as anticipated. Patients face unanticipated difficulties. Competitors change their tactics. Market access is more difficult than expected. The carefully laid-out launch plan is suddenly revised.

Could artificial intelligence help pharmaceutical marketers create better launch plans and avoid some of these costly mistakes? Totally. But the industry needs to understand some real limitations before it rushes to treat AI as the next great marketing solution.

## Why You Need AI: Better Brains, Faster Decisions. A major challenge in planning a pharmaceutical launch is that much of the research is already outdated by the time the product launches. Traditional market research can take months to conduct, and by the time results are delivered, physician attitudes, competitive dynamics, and patient expectations may have changed.

AI can change that.

Imagine a pharmaceutical company preparing to market a new obesity treatment. Instead of relying on physician surveys from six months ago, marketers could use AI to analyze new medical literature, physician conversations, patient conversations, and competitive and treatment trends.

This could lead to a much more up-to-date understanding of the market. Artificial intelligence can also pick up patterns traditional research may miss. For example, market research might excite physicians about a new therapy, but they might have concerns about reimbursement, patient adherence or treatment complexity elsewhere. Artificial intelligence can help connect those signals and find contradictions worth pursuing.

That’s potentially useful because what doctors say they plan to do often differs from what they actually do. Speed is another advantage. Pharmaceutical marketers spend weeks analyzing competitor messaging, strategic recommendations, and research reports. Artificial intelligence can cut that work down to hours.

But that doesn’t mean the recommendations will be any better. It does mean marketers can spend less time assembling information and more time asking what it means. ## AI Might Highlight Problems with Launch Strategies

The most interesting use case for AI, perhaps, is not building a launch plan. This one is a tough one.

Pharma launch teams can develop an emotional attachment to the strategies. Assumptions start to look like facts after months of development. Sales forecasts are expectations now. Teams selectively interpret market research results to fit the launch story.

AI could be a useful strategic challenger.

Consider a company that believes physicians will quickly adopt a new oncology therapy because it is clinically effective. AI could be used to test that assumption against competing treatments, treatment guidelines, payer restrictions, administration requirements and physician behavior.

It might find that the real problem isn’t clinical acceptance but the difficulty of integrating the therapy into existing treatment protocols.

Or maybe it’s a new diabetes medication. The marketing team might feel that pushing better clinical outcomes will increase prescriptions. AI-assisted analysis may show that affordability, formulary access, and patient persistence are bigger barriers to adoption.

These insights alone would not have invalidated the original strategy. They’d make marketers ask better questions before spending millions of dollars.

The real opportunity is to use AI to surface what launch teams may be missing, not just have it confirm what they already think.

The Problem: AI Does Not Understand the Market Like Humans

This is where we should temper the excitement.

AI is very good at finding patterns in available data. But human behavior, which isn’t always logical, consistent, or visible in data, shapes pharma markets. A physician might know a new drug has real clinical benefits but not prescribe it because of experience with an established treatment.

A patient may want a therapy but never fill the prescription because of cost, fear of side effects, or confusion about insurance coverage. A payer may impose restrictions that radically change the commercial opportunity.

AI can evaluate evidence around these behaviors, but it cannot reliably predict every decision made in an exam room, pharmacy, or payer organization.

And there’s another problem. Artificial intelligence can only be as good as the information it can find.

Most of the most valuable pharmaceutical market intelligence is proprietary. A general-purpose AI system may not have access to actual prescribing behavior, longitudinal patient data, payer contracting information, field sales observations or detailed physician research. Without those inputs, AI can produce a sexy-looking launch strategy based on incomplete information.

And because AI often speaks with great confidence, marketers may mistake a slick recommendation for a validated insight. That’s a dangerous combination.

Marketers May Be The Biggest Risk

One worry that deserves more attention is that AI could make pharmaceutical marketers intellectually lazy.

Launch teams can easily use AI to write positioning statements, identify target physicians, recommend communication channels, and develop promotional strategies. They could have a presentation that looks remarkably sophisticated in minutes. But did anyone question the assumptions behind it?

Would the team understand why doctors resist changing their long-established prescribing habits? Would they know which patient concerns really affect treatment decisions? Could they see when AI-generated recommendations conflict with what veteran field reps are hearing?

But the risk is not just that AI will get it wrong. They may no longer see them as marketers. Good pharma marketing needs curiosity, skepticism, and an understanding of human behavior. It means asking why a doctor doesn’t prescribe, why a patient goes off treatment or why a convincing clinical message doesn’t get traction. Artificial intelligence can help marketers explore those questions. It cannot substitute the judgment needed to interpret the answers.

Then There Is the Regulatory Problem

Pharmaceutical marketing is not like selling cars, cell phones or breakfast cereal.

Promotional claims must comply with the applicable regulatory requirements and be substantiated by sufficient evidence. In the United States, the FDA regulates prescription drug promotion, including requirements for truthful, nonmisleading communication and fair balance.

Using AI for messaging adds an extra layer of complexity. An AI system might generate a catchy positioning statement that exaggerates effectiveness, downplays safety issues, makes an unapproved comparison, or exceeds approved labeling.

It may also include information from patient conversations or external sources without clearly separating verified clinical evidence from anecdotal opinion. This is where pharmaceutical companies need clear guardrails around the data AI can access, how outputs are validated, and when medical, legal, and regulatory teams must review recommendations.

Patient privacy, proprietary commercial information, data provenance, and decision documentation also become critical. Artificial intelligence can speed up the creation of marketing ideas. It must not be permitted to accelerate the spread of unsupported claims.

Top Areas Where Artificial Intelligence Can Deliver the Most Value

I think the best use of AI in pharmaceutical launch marketing will be to improve strategies, not create them from scratch.

Say you have a launch team that has already done physician research, mapped the patient journey, assessed market access, and defined a positioning strategy.

The AI could take those inputs and help answer questions such as: Are we targeting the right physicians? Are we too focused on clinical differentiation and not enough on barriers to treatment? Is there a mismatch between what patients want and what physicians think they want? What are our most aggressive forecast assumptions? What if a competitor gets there ahead of us? What happens to our strategy?

These questions can drive performance.

AI could be particularly useful post-launch as real prescribing, access, and engagement data replace assumptions. It might help identify nascent performance gaps, generate hypotheses about their causes, and recommend areas for further investigation.

But these applications require more than simply hooking a chatbot up to a pile of research reports. They need governed data, the right analytical techniques, human verification, and measurable business objectives.

Without those elements, AI risks becoming yet another expensive technology that produces more presentations but not better decisions.

The Pros and Cons of AI in Pharma Launch Planning

AI has to work for the pharma marketer, not take over their thinking

The pharmaceutical industry has long supported new technologies that promise to revolutionize marketing effectiveness. Breakthroughs include customer relationship management systems, predictive analytics, digital engagement platforms, and omnichannel marketing.

Some have made meaningful improvements. Some have added complexity and failed to deliver the expected returns.

AI could go either way.

Its greatest contribution may be not helping pharmaceutical companies develop launch plans faster. It might help them identify flawed assumptions, spot missed market barriers, and adapt when the market behaves differently than expected.

But a fundamental difference exists between generating information and understanding what drives prescribing behavior.

AI can analyze thousands of data points. It can condense research and scenarios and uncover potential strategic weaknesses. It cannot guarantee that a physician will change prescribing habits, a patient will initiate treatment, or a payer will make favorable access available.

These outcomes are a complex mix of clinical evidence, experience, economics, trust and human behavior.

The pharma companies that stand to benefit the most from AI may not be the most AI-enabled. The ones that use it to ask better questions, challenge conventional thinking, and make better-informed decisions will benefit most. And that’s possibly the most important point of all: pharma marketers don’t need AI to tell them what they want to hear. They need it to help them see what they might be getting wrong.

The post Can AI Actually Improve Pharma Launch Marketing Plans? These are the pros and cons. appeared first on World of DTC Marketing.

Marketing brands will keep putting together annual plans. Agencies will keep making media plans. Research companies will keep running research studies. Media partners will keep selling impressions, and analysts will keep pulling up dashboards that tell us what happened. We will all have jobs and budgets. But we’ll keep asking the same question we have always asked. Did we make a difference?

That question will be harder to dodge in the coming years.

I believe we will see huge changes in pharma marketing organizations over the next 3-5 years. AI, commercial pressures, changes in HCP behavior, more empowered patients, and increased scrutiny of promotional spend will force these organizations to think differently not only about how we market our products, but also about how they are built and measured.

It may even mean some marketers discover their skill set no longer matches what their company needs.

Is the brand team dead?

Many pharma marketing organizations today have structures very similar to what they had 15-20 years ago. They include Brand Directors, Product Managers, Digital Marketers, Research Analysts, Agencies, and a variety of functional experts. They will all continue to do many of the same tasks they do today.

These people aren’t bad at what they do. Some of these folks are incredibly smart. The issue is that these organizations are built for a type of marketing that no longer exists.

We will likely have fewer people doing these activities, and more people focused on driving outcomes. Brand teams will still exist, but they’ll focus more on driving customer experience and making business decisions.

As AI becomes more prevalent, these capabilities will take over many tasks that currently take up a significant portion of marketing’s time. These include writing content, pulling research studies, segmenting customers, monitoring prescriber behavior, and executing media plans. These capabilities will allow marketers to focus on higher-value decisions.

A Brand Manager may begin their week with a summary of what occurred in their market. Which customers showed a behavior change, where are patients facing access hurdles, what messaging resonated with customers, what are competitors doing, and, most importantly,y what can we do this week to change our business trajectory? This is a different position.

AI will not replace pharma marketers. It will make bad marketers more obvious.

A narrative is emerging around AI as a productivity enhancer in pharma. That’s true, but I think the bigger conversation around AI will be which assumptions we no longer accept as “the way we do things.”

Why does it take months to launch a media campaign when AI can speed up the process? Why do we keep running similar research studies when we already have data that may provide answers? Why are we still using annual plans to make marketing decisions when we can monitor our customers much more frequently?

Obviously, there will be caveats to all of these statements. We live in a world of medical-legal, regulatory, and Privacy. So AI will not be able to write promotional content for us and push it out to customers. We also won’t be able to input patient-level data into our commercial engines and expect to leverage everything we learn in our marketing programs.

But that does not mean we cannot use these capabilities to improve how we do marketing. I think more organizations will incorporate AI into their day-to-day marketing operations, rather than building an “AI team” that spends most of its time showing off its tech.

What will give organizations an edge is their ability to use these capabilities to make better business decisions.

Customer experience will become a bigger part of the pharma marketing organization.

As these marketing organizations continue to evolve, we will see fewer silos across marketing functions. Currently, teams focus on HCP marketing, patient marketing, digital, research, field, and access. All of which can play a significant role in driving customer behavior.

Customers do not think about pharma marketing that way.

A physician may see a piece of content, look up information about a disease, speak to a sales rep, and research access to a therapy. A patient may see an ad, navigate to our website, speak to their provider, learn they have no access to a therapy,y and never start their treatment.

All of these touch points can impact behavior.

Marketing organizations need to think about how to drive the full customer experience and address issues that prevent target customers from making informed decisions.

“How can we improve our physician email open rate?” may no longer be a question marketing should ask. Instead, marketing will focus on questions like, “How can we get the right HCP to consider our therapy for our target patient population?”

“How many people visited our patient website?” will become “Did our patient learn valuable information that allowed them to have a better conversation with their HCP?”

Access will also become a bigger focus for marketing. We will continue to have Market Access teams that focus on this area. But marketing will need to partner with these teams to identify access hurdles each function can address.

Obviously there will need to be some separation of these functions. But I think we will see them work together in a more meaningful way.

What will this new organization look like?

There will not be one cookie-cutter organization that fits every pharma company. Companies that focus on specialty diseases will have different needs than companies that sell to primary care.

However, we can start to picture what this new organization may look like.

There will be fewer roles focused on certain areas and more that require being a jack-of-all-trades. Someone who knows how to work with an agency will be more valuable than someone who can analyze data and challenge how we do marketing. The best marketers will not be the ones that can create the most campaigns. They will be the ones that know what campaigns we should NOT be running.

How Marketing Will Be Measured is the Biggest Change

This is where it gets a little uncomfortable. We have been measuring all sorts of marketing metrics that are easy to quantify but don’t drive business impact.

Impressions. Clicks. Web Traffic. Email opens. Video views. Number of detail aids handed out. Awareness of campaign. These are not useless metrics. They can help you diagnose whether something is working. But they don’t tell us whether our marketing is making a difference.

Just because a physician opened your email does not mean they will consider your therapy. Just because a patient visited your website doesn’t mean they received the care they needed. You can spend millions of dollars on an ad campaign and not see any incremental business impact.

Marketing will be forced to drive more incremental business in the future. Here are some examples of how we may start to measure performance in the future:

The key word here is incremental. If your Rx grew by 8%, how much of that can be attributed to your marketing efforts? Did we see more coverage? Did your competitor have a shortage? Did guidelines change? Did your sales team work harder? Did we just see growth in our market?

We will continue trying to attribute our efforts to business growth. But attribution will not be the end-all, be-all answer. We need to get better at experimenting with our customers and proving our efforts drove business impact. Sometimes we can’t prove our efforts. Good marketers will know when to stop trying to make data say what we want it to say.

Marketing Will Have To Do More Than Drive Prescriptions

Pharma marketing is not the same as marketing a brand at the grocery store. We cannot measure our success simply by driving more prescription volumes. We need to ensure we provide the right information to the right patients and HCPs. If we increase Rx volume but our patients are not taking the therapy they are prescribed,d then we have failed.

We should also measure our marketing teams on how well they drive customer experience and the patient journey. Do we know that we are targeting the right HCP population? Are our patients receiving information that helps them make informed decisions with their HCP? Are we removing access hurdles that are preventing patients from starting and staying on therapy?

We will not be able to measure everything that our marketing does. But we can hold ourselves accountable to certain actions that drive these outcomes.

The Role Of The CMO Will Continue To Evolve

The CMO will need to become a better steward of their marketing dollars. They will need to know not only why we are investing in certain activities but also when to pull back. They will need to tell Finance where their dollars are going and why.

This will require marketing to work more closely with finance. They will need to show Finance that investing more dollars will yield higher returns. What would you do with an extra $5M? Educate patients? Run more ads? Invest in better content capabilities? Or not spend that dollar?

Good CMOs will know the answer. They will also need to hire better. We need to find people who can think beyond what we are currently doing. Someone who can be creative and make smart business decisions.

Agencies Will Have To Adapt As Well

Agency teams will also have to change how they operate.

We will continue to see agencies provide value to pharma marketing organizations. But how they are paid and how many people are on these teams will change.

Pharma companies will start to ask why we need to pay these high fees for something that AI can help us with. Agencies that can bring unique value to the table will continue to thrive. But agencies that rely on producing more assets faster may see their business decline.

The agency of the future may have fewer people and focus on specific areas of expertise. Similar to marketing teams. Agencies will have to prove that they are making a difference.

Technology Will Not Be The Biggest Roadblock. Mindset Will.

Pharma has abundant data, vendors, and consultants that can help it transform its marketing organizations.

What we lack is the desire to change how we operate.

Annual plans. Functional teams that work in silos. Too many levels of approval. Rewarding activity over outcomes. And people who have built their careers around how we operate today. AI will not fix these issues. Nor will implementing a new martech solution. Or creating a new org chart.

Companies that embrace change will keep growing. They will challenge the status quo and make better business decisions. They will also fail at some things. Instead of covering those failures with vanity metrics,s they will learn from them.

I think we will continue to see changes in pharma marketing organizations over the next few years. By 2030, we will likely have leaner organizations that use AI to make better decisions and deliver a better customer experience. This does not mean that we will spend less money on marketing. Or have fewer people. Some companies may take the money they save by streamlining their organizations and invest it in expanding access or customer support.

But we will use those dollars better.

We will have organizations that are more focused on driving business impact. They will better understand their customers and find ways to improve access to care. The biggest change may be that we will stop telling people what we did.

And start proving that we made a difference.

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The thieves aren’t the patients

Start with the biggest enforcement action of the year. In June, DOJ announced charges against 455 defendants tied to more than $6.5 billion in alleged false claims. Ninety were doctors or other licensed medical professionals. The schemes were wound care, skin substitutes, durable medical equipment, opioid distribution, and unnecessary diagnostic testing.

One case shows the scale. In a single alleged allograft scheme, providers billed Medicare over $4 billion and collected over $2 billion. One scheme, run through billing, kickbacks, and a supply chain.

Now compare that to Medicaid’s slice of the takedown: 295 defendants and more than $518 million in false claims. A record for Medicaid enforcement, and still a fraction of the total.

Consider what that tells you about where the money is stolen. People who bill the system steal it. People in the waiting room don’t steal it. Policy experts say most Medicaid fraud comes from a small number of providers engaging in criminal conduct. Aim your policy at enrollees, and you’ve aimed at the wrong end of the transaction.

“Improper payments” is the most misused phrase in this debate

Here’s the number you’ll hear: CMS estimates Medicaid improper payments for fiscal 2025 at 6.12%, or $37.39 billion. Politicians say it like it’s a heist total.

It isn’t. Open the number up:

• More than 77% of Medicaid improper payments stemmed from insufficient documentation, which CMS says generally isn’t indicative of fraud or abuse.
• About 43% were “technically improper,” meaning the right recipient got the right amount, but a procedural step wasn’t met.
• CMS itself says the measurement is designed to protect program integrity, not to serve as a fraud metric.
• The Congressional Research Service says the true total of Medicaid fraud is unknown.

An improper payment can be an underpayment. It can be a missing signature, a form filed in the wrong place, a reviewer who couldn’t confirm a step. Calling that “fraud” is like calling every typo in your tax return tax evasion.

This matters because policy built on the wrong diagnosis gives you the wrong cure.

The cure can make the disease worse

Here’s the twist that rarely makes the talking points. Piling on eligibility documentation tends to increase errors, not reduce them.

Analysts at the Center on Budget and Policy Priorities argue that new work requirements add complex rules on exemptions, countable hours, and qualifying activities, raising the likelihood of more errors as states roll out new procedures and documentation demands. Georgetown’s Center for Children and Families made the same point earlier: documentation requirements create documentation errors, and documentation errors count as improper payments. The same analysts note that the Congressional Budget Office concluded a Medicaid work requirement would leave employment and hours worked unchanged, and that most adult enrollees under 65 already work.

So you can end up with a double failure. Eligible people lose coverage over paperwork. And the paperwork-driven error rate goes up, which then gets cited as proof that the program is riddled with fraud.

Then there’s the human side. Picture a hypothetical home health aide working two part-time jobs with irregular hours. She qualifies. She misses a reporting deadline because the notice went to an old address. She’s disenrolled. Three months later she’s in an emergency room with an untreated condition that now costs ten times as much. The state saved nothing. The fraudster who billed for catheters nobody received kept right on billing.

What actually works

Here’s the policy playbook. None of it requires taking coverage away from a single patient.

1ne. Stop the payment before it goes out

The 2026 takedown marks a shift toward analytics-led detection, pre-payment suspensions, and integrated federal and state data sharing. That’s the right direction. Pay-and-chase has always been a losing game. Flagging an abnormal billing pattern, say a sudden explosion in skin-substitute claims, before the check clears beats trying to claw money back from a shell company later.

Policy to push: expand pre-payment review for high-risk categories, and require states to feed claims data into shared federal analytics in near real time.

2wo. Screen and revalidate providers

CMS suspended 1,079 providers and revoked billing privileges for another 1,403 as part of the takedown, and HHS-OIG reported more than 1,400 exclusions. CMS has also announced it will require all states to revalidate their Medicaid providers. Good. Researchers have argued for years that a large share of improper payments traces back to states failing to follow provider screening and enrollment requirements, and that better compliance could cut the rate substantially.

Policy to push: enforce provider enrollment rules, add site visits and fingerprint-based screening for high-risk provider types, and tie federal match dollars to state compliance.

3hree. Fund the people who catch fraud

State Medicaid Fraud Control Units reported recovering $2 billion from criminal and civil cases in fiscal 2025. Earlier reporting put the return around $3.46 for every dollar spent. Show me another government line item with that yield.

Fraud units were partners in this year’s takedown in all fifty states, the most in DOJ history. Cutting them loose with flat budgets while demanding more enforcement is not a serious strategy.

Policy to push: protect and expand MFCU funding, and treat investigators as revenue generators, because they are.

4our. Fix the oversight gaps GAO keeps flagging

The Government Accountability Office has long called on CMS to conduct a Medicaid fraud risk assessment and has flagged duplicate coverage (people enrolled in more than one program) and weak oversight of supplemental payments and managed care as vulnerabilities. GAO has continued to strengthen Medicaid program integrity on its High Risk List.

Policy to push: complete the fraud risk assessment, run automated duplicate-enrollment checks, and tighten reporting on supplemental payments.

5ive. Use data matching instead of paperwork demands

Here’s the smartest fix for the “payments after death” problem. Federal auditors found more than 450,000 managed-care payments made after enrollees had died, around $318 million across 14 states over a decade. That’s a real gap. It’s also a data problem, solvable with automated matching against death records, not with making living, eligible people re-prove they exist.

Policy to push: automate eligibility checks against trusted data sources, use ex parte renewals so states verify from records they already hold, and reserve manual paperwork for the exceptions. CMS’s 2024 rules on eligibility documentation were aimed squarely at cutting the paperwork errors behind most eligibility-related improper payments.

6ix. Check your own work

Even the agency leading this crackdown had to admit an error in the fraud analysis of New York’s Medicaid program that it used to justify scrutiny. If your fraud numbers are wrong, your enforcement is wrong, and honest providers and patients get caught in the net.

Policy to push: publish methodology, separate fraud, error, and underpayment in every report, and stop using “improper payments” as a stand-in for “stolen.” “Cut coverage” and “cut fraud” are not the same goal. One removes patients. The other removes criminals. Right now we’re being sold the first as if it were the second.

The tools that work are on the table: pre-payment analytics, provider screening, funded investigators, GAO’s recommendations, and smarter data matching. They go after the people who actually take the money.

Fight fraud like you mean it. Just don’t confuse the patient with the perpetrator.

Sources:

• DOJ’s 2026 Health Care Fraud Takedown (Sidley)
• DOJ Announces 2026 National Health Care Fraud Takedown (Mondaq)
• Major Healthcare Fraud Takedown Unveils $6.5B False Claims (HomeCare)
• The 2026 National Health Care Fraud Takedown (Health Capital Topics)
• CMS Reports Billions in Improper Payments, But Says Most Are Paperwork Errors
• 77% of Medicaid improper payments tied to paperwork, not fraud (Becker’s)
• CBPP: Claims of fraud are a pretext for Medicaid cuts
• CBPP testimony on improper payments
• Georgetown CCF: Measuring Medicaid’s Mistakes
• GAO: Medicaid program integrity statement
• Agencies doled out $186B in improper payments (Nextgov)
• Fact Check: Payments for deceased Medicaid recipients (WJLA)
• Senate Budget Committee testimony (Aug. 2026)
• KFF brief summary (Greene Barrett)

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Looking For That Magic Bullet

Many pharma and medical device startups need someone who can take the company to the next level. We need that magic bullet to hit our clinical milestones, gain market access, and drive our bottom line. Most of the time, we look for people who have worked at these large pharmaceutical or medical device companies and hope they can transfer those skills to our startup.

Sure, they’ve been a VP or SVP at J&J, Pfizer, or Medtronic. They know how to sell a product, navigate the FDA, and manage a P&L. Great! But can they do that at a start-up? Not necessarily.

Some executives know how to survive in big companies. But they don’t know how to make hard decisions when no one will save you. They may know how to sell to a board of directors but don’t know how to help their employees.

You need leaders who can build a company.

You Know When You Have One

Usually it starts with the new hire coming in with a grand plan. They bring on consultants, restructure the org chart, and have a new plan to reach our goals. Employees who know the product and customers may not be consulted on these decisions. Money is being spent, and you can see movement but not results.

The board wants to think they made the right decision by hiring this individual. They signed off on the contract and told their investors that we found the person to lead us to the finish line.

After a few months, the results aren’t there. Commercial plans aren’t being met and expenses continue to climb. We let our executive go with a golden handshake and tell our employees we have to let them go.

How ridiculous is that? You can let go of a scientist who has spent years on a product and give them a small payout. Let go of your regulatory affairs department who stayed late to submit an NDA. Let go of your sales and marketing dept that took a chance on your product and now they’re out of work.

Of course, not all bad executives deserve punishment for their actions. Maybe the drug didn’t work, or we couldn’t find reimbursement. There are many scenarios where you may have to let your executive go. But if their poor decision-making put the company in a bad spot, you should rethink letting them walk away with a golden handshake.

This isn’t just hypothetical.

Consider Axovant Sciences, where CEO David Hung left after roughly ten months with about $2.56 million in severance and bonus payments as the struggling biotech cut jobs.

Biogen, where former CEO Michel Vounatsos received approximately $26.6 million in reported compensation in 2022, including nearly $8.8 million in severance, as the company faced declining revenue and commercial setbacks.

Then there’s Valeant Pharmaceuticals, where former CEO Michael Pearson received a reported $72.5 million in stock compensation, severance, and benefits in 2016 amid a corporate crisis. These situations weren’t identical, and not every setback was attributable to one executive. But they raise the same uncomfortable question: Why do boards negotiate extensive financial protection for executives while the employees who carry out the company’s strategy often have far less security when that strategy fails?

Biotech start-ups aren’t immune either. Consider Geron Corporation. After years of development, the biotechnology company finally achieved FDA approval for Rytelo in 2024. It was a milestone worth celebrating. But commercializing a breakthrough therapy is a different challenge from getting it approved.

In 2025, Geron parted ways with several senior executives, including its CEO, chief operating officer, and chief commercial officer. According to the company’s SEC disclosures, those three executives received approximately $3.36 million in combined severance, healthcare benefits, and certain bonus payments.

Then, in December, Geron announced it would eliminate approximately one-third of its workforce. Think about that. Executives had contractual financial protections, while dozens of employees lost their jobs. That doesn’t prove those executives caused the company’s problems, but it raises a legitimate question: Why do pharma companies build such substantial financial safety nets for their leaders while the people responsible for developing and commercializing their products face the greatest employment uncertainty? And where is the board’s accountability for the leadership decisions that preceded those outcomes?

Are we Desperate?

Yes. In some cases, we are so desperate to look credible that we hire based on where someone worked, not what they did. We want someone who has launched a product, knows how to deal with the FDA and run a commercial operation. But what about their personality? Do they know how to work with their employees? Do they have good fiscal management? Can they tell when a plan isn’t working? Can they build rapport with their employees?

We should dig deeper into what they did in past roles. How much did they contribute to those successes? Did they have great employees working under them? Maybe they were just lucky and had great people around them.

Also look into what went wrong at their past jobs. Don’t just take what they tell you and dig deeper. Ask their past colleagues what they thought of them as a leader. What decisions did they make when things got tough?

Find people who can get things done for your company.

Another Issue With Letting Them Walk Away With Nothing

I also think there should be some repercussions for employees who don’t perform as well. If they aren’t hitting their goals, maybe you should put them on a PIP. But if your executive isn’t hitting their goals, why are they getting a golden handshake?

Maybe it’s because their contracts say they get that if they don’t meet certain benchmarks. Then why can’t we help our employees a little more?

When you let go of key employees, you lose that knowledge. You may also lose key relationships they built. Your current employees will question why you let them go. Why wasn’t I fired if I’m not doing my best?

This is one reason it’s hard to recruit good employees for these types of positions. Word gets out, and you’ll have a hard time finding quality employees.

Hold Your Board Of Directors Accountable

Who hired this person? Why did they sign off on this contract? What were their expectations? When did they know something was wrong?

Your board should be holding these people accountable. They should have set goals for your executive and evaluated performance against them. Contracts shouldn’t let them walk away with nothing if they didn’t meet their goals.

Employees are just as important to your company’s success. If you have to let them go, maybe you should also reconsider your executives’ payout.

The Employees Will Remember

Your employees will remember when you let them go. They will remember who got bonuses and who didn’t. They will remember that their leader never came to their office when they let people go. They will remember that you told them you were a family until you let them go. These are people that can become your customers in the future. Or maybe your next employee. Or maybe they know someone who could become your next customer.

Build your company by helping others.

Stop Hiring People That Can Manage Themselves

We need to stop hiring people who can manage themselves. We need leaders who can help us grow the company, not focus on managing their own careers. Help your employees, and they will help your company. Help your board, and they will help your company. Don’t focus only on the money you can make in your next position. Focus on the money you can help your current company make.

I’m sure you’ll get there eventually, but why not help your current company get there first?

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