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April 13, 2026 0

Getting a patient diagnosed and prescribed is hard. Keeping them on therapy long enough to see real benefit? That's often even harder — and the stakes couldn't be higher.

Most medications don't deliver their full effect after a single fill. Antidepressants require weeks of consistent use before therapeutic stabilization sets in. Biologics for chronic skin conditions need time to modulate the immune response. Long-term maintenance therapies only work if patients actually maintain them. When patients drop off early, they don't just generate less revenue for the brand — they frequently don't get better.

For pharma and life sciences brands, the gap between prescription and persistence is therefore one of the most costly — and underaddressed — challenges in the business. Patients discontinue therapy for a wide range of reasons: they forget refills, lose touch with their specialist, or simply don't feel the urgency to continue a medication when symptoms aren't immediately visible. The result is a cycle of drop-off that undermines both patient outcomes and brand performance.

Nimble, the platform modernizing independent and regional pharmacy operations, has developed a data-driven approach to solving this problem — and the results across multiple therapeutic areas are compelling.

The Core Idea: Meeting Patients at the Moment That Matters

Nimble's patient engagement programs work through the pharmacy layer — a touchpoint that's often overlooked in DTC and patient support strategies but sits at the critical junction between prescription and actual medication use. By leveraging precise digital outreach, Nimble can identify targeted patient populations and deliver timely, relevant interventions that keep them connected to their care plans.

The approach isn't one-size-fits-all. Nimble tailors its programs to the specific clinical and behavioral challenges of each therapy area — whether that's addressing the high discontinuation rates common in mental health, re-engaging patients who've drifted away from specialist care, or sustaining adherence for long-term maintenance medications.

What the Data Shows

Nimble recently published a new case study documenting outcomes across three distinct therapeutic programs: a mental health indication, a dermatology program targeting chronic skin conditions, and a women's health maintenance therapy.

Across all three, the results point in the same direction: patients who receive Nimble's digital support are meaningfully more likely to stay on therapy, refill their prescriptions, and remain engaged with their care providers.

A few highlights from the data:

  • Adherence improvements were consistent and significant across all three programs — not marginal gains, but the kind of lift that moves the needle on persistence curves and lifetime patient value.
  • Specialist engagement increased substantially in the dermatology program, with targeted outreach driving patients back to their physicians at rates well above the control group.
  • New-to-brand starts surged when Nimble identified and activated treatment-naive patients who had previously been managing their condition on inadequate therapies.
  • Long-term adherence continued to climb month over month in the women's health program, with dispensed quantities also increasing — a strong indicator that patients weren't just refilling, but actually taking their medication.

Why This Matters for Pharma Brand Teams

For brand managers and patient support leads, the commercial implications of improved persistence are straightforward: more refills, longer treatment duration, and prescriptions that convert into realized, ongoing therapy.

But the most important story here may be the patient outcome one. Medications only work when patients take them — and for most chronic conditions, the clinical benefit compounds over time. A patient with atopic dermatitis who stays on a biologic long enough experiences sustained skin clearance. A depression patient who remains on their antidepressant through the critical stabilization window is far more likely to achieve remission than one who discontinues after a few weeks. A woman who consistently fills her maintenance therapy reduces her long-term health risk in ways a single fill never could. Persistence isn't just a commercial metric — it's a proxy for whether the treatment actually worked. Nimble's programs address both dimensions simultaneously, turning better adherence into better outcomes for patients and better performance for brands.

The case study also speaks to the value of the pharmacy network as a patient engagement channel. Independent and regional pharmacies serve millions of patients who may have less access to the robust support infrastructure that surrounds large health systems. Nimble's technology brings a level of proactive, data-driven outreach to those patients that was previously difficult to achieve at scale.

Read the Full Case Study

The full case study includes detailed program data, outcome charts, and a breakdown of results by therapeutic area — giving brand and marketing teams a clear picture of what Nimble's interventions look like in practice and the kind of impact they can deliver.

Download the Case Study

To learn more about Nimble's patient engagement programs, visit nimblerx.com.

 

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April 9, 2026 0

Pharma’s next growth market isn’t a new drug. It’s an underserved audience.

For decades, pharmaceutical marketing has prioritized scale over specificity, relying on broad campaigns designed to reach the “general market.” But as the United States becomes more diverse and patient expectations evolve, that definition no longer reflects reality.

Today, growth in healthcare is being driven by audiences that have historically been overlooked, particularly Black and multicultural consumers. These communities are disproportionately impacted by many chronic conditions, highly engaged in health decision-making, and increasingly influential in shaping cultural and consumer trends.

Yet, they are still not being reached in ways that feel meaningful or culturally sensitive.

This gap is not just a health equity issue. It’s a missed business opportunity.

The Business Case Has Changed

The U.S. is rapidly becoming more diverse, and with that shift comes a change in where growth will come from.

Black Americans represent more than $1.6 trillion in buying power, according to Nielsen, and account for an estimated $135 billion or more in annual healthcare spending. They also over-index in several high-priority therapeutic areas, including those associated with hypertension, diabetes, and asthma. These are conditions that require long-term management and ongoing engagement with care.

At the same time, multicultural consumers are shaping how health information is consumed, shared, and trusted.

For pharmaceutical companies operating in increasingly competitive categories, growth is no longer just about innovation. It depends on reach, engagement, and ongoing adherence.

And, all of that depends on trust.

The Data: Diverse Audiences Are an Economic Opportunity

Industry data tells a clear story. Diverse audiences are not difficult to reach; they are misunderstood.

Citing research from CMI Media Group, a recent report in MM+M suggests that Black and Hispanic consumers may be more receptive to pharmaceutical advertising than many marketers assume, especially when messaging feels relevant and credible.

Nielsen insights reinforce this. Black consumers demonstrate strong brand loyalty when trust is established and show high engagement across mobile, video, and culturally relevant media environments.

Industry data points to the size of the opportunity. Audience-level insights show what it takes to actually earn it.

The Trust Gap Is the Revenue Gap

Despite the opportunity, trust remains one of the most significant barriers and one of the clearest drivers of growth.

Historical inequities and lived experiences have created both mistrust and distrust in healthcare among Black patients. Mistrust can often be addressed with information. Distrust requires something more dedicated and intentional – consistent, credible engagement over time.

BlackDoctor audience-level insights reinforce this dynamic. They show that  trust does not start with messaging. It starts with meeting real needs.

In a 2024 survey of nearly 500 respondents, BlackDoctor found that:

  • 74% said lowering the cost of treatment would make pharmaceutical companies more helpful
  • More than 55% want tools like doctor visit checklists
  • 54% want health information made easier to understand
  • Over 40% want ways to track and better understand their symptoms

These are not just feature requests. They are early signs of trust. When patients feel supported and equipped to navigate their care, they are more open to engagement.

Still, meeting needs alone is not enough.

When asked what pharmaceutical companies should do to build trust:

  • Nearly 47% said invest more in communities
  • 40% called for more Black representation in pharma leadership
  • More than 38% want greater visibility in the Black community
  • Over 32% said communication should happen through Black-owned media platforms

The message is clear. Trust is built with presence, representation, and helping people in real ways. Messaging alone will not get you there.

You see this even more clearly when trust is broken.

In a separate BlackDoctor audience poll, more than 73% of respondents said they felt troubled or insulted when brands used Black representation in mainstream channels while failing to invest in Black-owned platforms. Many said it reduced their trust.

People are not just listening to what brands say. They are watching where and how they show up.

This is where business impact becomes clear.

If patients do not trust the message, they are less likely to seek care, start treatment, and/or stick to their treatment plan.

That directly influences ongoing-adherence and, ultimately, revenue. Medication non-adherence alone is estimated to cost the U.S. healthcare system more than $300 billion annually.

If trust drives adherence, and adherence drives revenue, then trust directly impacts the bottom line.

Why Pharma Has Missed the Mark

Despite growing awareness around diversity, equity, and inclusion, many pharmaceutical marketing strategies have yet to fully evolve.

Analysis from Pharmaceutical Executive points to a familiar pattern. There is strong intent, but inconsistent execution, especially when it comes to embedding cultural nuance into marketing and engagement strategies.

Too often, Black and Brown audiences are treated as secondary segments or campaign extensions, rather than core drivers of growth.

At the same time, many brands continue to rely on broad “general market” approaches, even as the market becomes more culturally defined.

In many cases, the gap is not awareness. It is execution.

Pharma has scaled its messaging. It has not scaled its credibility.

What Winning Looks Like

For pharmaceutical companies looking to unlock this opportunity, success requires a shift in mindset and strategy.

1. Invest in Trusted Platforms

Trust cannot be manufactured. It has to be built or strengthened through the right partnerships. More brands are recognizing the value of culturally rooted platforms, like BlackDoctor which has spent over 20 years earning credibility through consistent, community-centered engagement with both audiences and the healthcare professionals (HCPs) who serve them.

These environments operate differently than traditional media. They do more than deliver impressions. They help shape and influence real decisions over time.

2. Move Beyond Awareness to Education

Patients are not just looking for messaging. They are looking for guidance.

Content that is practical, culturally relevant, and easy to understand – whether it is checklists, explainers, or real patient stories – creates a clear path from awareness to action. Platforms are also beginning to use tools like AI to make that guidance more accessible, delivering information in ways that reflect the audience and the healthcare professionals they trust. When done well, these tools can help people better navigate complex conversations and feel more confident in their decisions.

3. Reflect the Audience Authentically

Representation matters, but relatability is what makes it stick. Messaging needs to reflect lived experiences, cultural context, and real-world concerns to truly resonate. People want to see themselves in the story and feel understood, not marketed to. That means creating content that is not only accurate, but culturally relevant, grounded in real experiences and delivered in environments where people feel safe learning about their health. When this happens the message doesn’t just land. It builds trust and encourages action.

4. Measure What Matters

Traditional metrics like impressions and reach only tell part of the story.

Leading organizations are focusing on indicators that reflect real impact:

  • Engagement
  • Treatment initiation
  • Ongoing-Adherence
  • Long-term trust

The Competitive Advantage

The pharmaceutical companies that lead in the next decade will not simply be those with the most innovative pipelines.

They will be the ones who understand how to build trust and sustain it.

When engagement is rooted in trust, the impact goes further. It influences decision-making, strengthens relationships, and drives long-term value.

The future of pharmaceutical marketing is not broader. It is more precise, more culturally sensitive, and more human.

And for the companies willing to embrace that shift, the opportunity is not just to reach more patients by spending marketing dollars on general market platforms.

It is to meet them where they are, where trust already exists with the brands who know and can reach these diverse audiences better and where action is far more likely to follow.

Sources include: Nielsen Diverse Intelligence Series; MM+M (CMI Media Group research); Pharmaceutical Executive; Annals of Internal Medicine; WHO; CDC; CMS; KFF; and proprietary audience insights from BlackDoctor.com.

Jade Curtis

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April 6, 2026 0

Pharmaceutical direct-to-consumer (DTC) marketing has grown increasingly complex. Today’s patients and caregivers don’t engage with brands in a straight line; they move seamlessly between streaming platforms, social media, search engines, display ads, and even offline channels. From their perspective, it’s one continuous experience—not a collection of separate campaigns.

Yet many pharma marketers still build and execute campaigns in channel silos: programmatic, social, digital, broadcast, streaming, etc. While there’s value in this specialization, it often comes at a cost. When audiences are fragmented across channels, omnichannel execution is nearly impossible.

The Problem with Channel Silos: Fragmented Audiences

Many omnichannel strategies fall short because they are built on disconnected audience segments. Each channel often operates with its own targeting logic, datasets, and measurement frameworks. While campaigns may appear coordinated on the surface, the underlying audiences are fragmented. This leads to:

  • Inconsistent messaging: Patients may receive disjointed or repetitive communications
  • Poor sequencing: Campaigns fail to build on prior interactions
  • Limited visibility: Marketers struggle to understand true performance across channels

True omnichannel activation starts with a shift in perspective—from channel-centric planning to audience-centric execution.

Defining an Omnichannel Audience

An omnichannel DTC audience is one that can be activated across multiple channels without losing its integrity. It maintains consistent identity and targeting logic regardless of where engagement happens.

  • Cross-Channel Reach: The same audience can be engaged across TV, digital, social, and point-of-care environments without rebuilding segments from scratch.
  • Consistent Identity Resolution: Individuals are recognized accurately across platforms using privacy-safe methods, ensuring continuity in messaging.
  • Seamless Measurement: Performance can be tracked holistically, allowing marketers to understand how different touchpoints contribute to outcomes.

In other words, an omnichannel audience is a portable audience—one that can move seamlessly across channels without losing identity, context, or continuity. Without this portability, even the most sophisticated campaigns become fragmented and inefficient.

The Benefits of Audience Portability

Portable audiences allow marketers to define a group once and activate it across multiple channels without losing consistency. Instead of rebuilding segments for each platform, you maintain a unified view of who you’re trying to reach.

This approach unlocks several advantages:

  • Consistent Messaging Across Touchpoints: Messaging can be coordinated and reinforced across every channel, creating a more coherent narrative that improves understanding and recall
  • Smarter Sequencing and Timing: Greater control over the order and timing of exposures allows messaging to evolve logically—from awareness to action
  • Better Frequency Management: A unified strategy helps ensure the right level of engagement without redundancy or wasted spend
  • Clearer Measurement and Attribution: Portable audiences provide a more accurate view of performance across the full journey, making optimization more effective

The Other Cost of Fragmentation: Collaboration

One of the most overlooked drawbacks of fragmented audiences is how they affect collaboration. Silos create friction, duplicate work, and make it difficult to align on performance. Success is often defined differently depending on the channel or team.

Portable, omnichannel audiences give teams a shared foundation—a single view of brand-eligible patients. This alignment makes execution more seamless and optimization more effective. For leaders, it also provides clarity and confidence that every effort is moving in the same direction.

Moving Toward a Unified, Omnichannel Approach

Today’s channel-based DTC audiences may reflect how media teams are commonly structured, but they don’t align with demand for omnichannel strategies.

For life science marketers and media teams navigating rising costs, increased scrutiny, and higher expectations, audience portability isn’t a nice-to-have. It’s a performance advantage. By prioritizing portability, marketers can reach patients more effectively, deliver more relevant experiences, and increase marketing impact.

Omnichannel success doesn’t come from being everywhere—it happens when marketers create a unified journey that advances patients towards a better heath outcome. That means performance isn’t driven by any single tactic, but by how well your channels work together. And that coordination can’t be built on fragmented audiences.

About OptimizeRx

OptimizeRx is redefining how life science brands connect with patients and healthcare providers. By bridging the gap between HCP and DTC strategies, we empower brands to create synchronized marketing solutions that drive faster treatment decisions and improved patient outcomes.

Our privacy-safe, patented Micro-Neighborhood® technology combines brand-specific precision with channel-ready flexibility, using HIPAA-compliant medical, demographic, geographic, and media behavior data to find patients at or near brand eligibility, the create audiences that can be easily activated on all major media channels and onboarding platforms. It’s seamless, precise, and compliant—for omnichannel marketing that outperforms the competition. Learn more.

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March 16, 2026 0

Changes in Patient Behaviors and Expectations Are Driving Shifts in Go-to-Market Strategies

The post-COVID era has normalized virtual healthcare, with telemedicine and home delivery now seen as standard expectations. Since 2022, most sources say that more than 30% of people used telemedicine services in the prior year, signaling a lasting shift toward digital-first care.

At the same time, there has been record-breaking e-commerce activity—such as Black Friday and Cyber Monday in 2024, where sales through Shopify hit a record $11.5B—reshaping consumer behavior. Trends like mobile and social shopping, along with buy-online-pickup-in-store (BOPIS) models, are influencing how patients expect to access medications. Compounding pharmacies and generic manufacturers have embraced these expectations, allowing patients to obtain many prescriptions through e-commerce-style experiences. Companies like Hims have demonstrated the power of this model, growing into a $7.5B business.

With the healthcare system stretched to capacity—especially in specialty care—virtual fulfillment offers a way to relieve pressure by streamlining access for patients who don’t require an in-person visit with a healthcare provider, allowing them to engage with a doctor via video or asynchronously via messaging. In response, over the past few years, many pharmaceutical brands have been launching white-labeled telemedicine and fulfillment platforms within brand.com to make treatment access faster and more convenient.

Larger manufacturers are scaling these efforts enterprise-wide: Eli Lilly introduced Lilly Direct in January 2024, and Pfizer launched PfizerForAll in August 2024; both platforms are designed to centralize patient education, support, and treatment information while giving patients greater control and clarity in how they obtain their medications.

While the initial DTP solutions have focused on lifestyle medications, driven by the GLP-1s, these solutions are poised to support treatments in areas that are low touch, and don’t really need specialist intervention. We’re starting to see that come to fruition, with solutions rolling out to support drugs in the asthma, lipid management, and migraine spaces.

Government and FDA Policy Shifts Are Accelerating the Rollout of Discounts and Direct-to-Patient (DTP) Solutions with Large Manufacturers

On May 12, 2025, the White House announced the Most-Favored-Nation Prescription Drug Price Presidential Action (MFN). MFN aims to reduce prescription drug prices and calls on the large pharmaceutical manufacturers to offer new ways for patients to access medications more affordably.

In June 2025, the FDA announced the Commissioner’s National Priority Voucher (CNPV) pilot program. This initiative, much like the existing FDA voucher program, grants accelerated approval for new drug launches. However, this new CNPV is only accessible to manufacturers “aligned with critical US national health priorities”—essentially incentivizing manufacturers to participate in MFN. This could change plans for in-market brands, as competitors may now launch sooner than originally planned—and at lower costs.

On September 29, 2025, PhRMA announced that it will support the White House’s programs, launching three actions that will deliver additional investments to the industry, provide further financial assistance to patients, and launch americasmedicines.com as a way to help patients access medications by consolidating DTP purchasing options for all medications and manufacturers. Shortly after, on September 30, the White House announced TrumpRx.gov, a website launching in January 2026, which allows patients to purchase medications as part of MFN directly.

From September through October 2025, the first partnerships under MFN have started to be announced, and it’s likely more will follow as the year continues:

  • Partnership 1: Pfizer
    • This partnership, announced on September 30, 2025, aims to bring Pfizer drugs to all state Medicaid programs at discounts of up to 80% when purchased directly
  • Partnership 2: AstraZeneca (AZ)
    • This partnership, announced on October 10, 2025, aims to bring AZ’s respiratory portfolio to all state Medicaid programs at discounts of up to 98% when purchased directly via AZPatientDirect.
  • Partnership 3: EMD Serono
    • This partnership, announced on October 16, 2025, aims to expand access to IVF and fertility treatments, and will bring EMD Serono’s fertility portfolio (Gonal-F, Ovidrel, and Certrotide) at deep discounts to those purchasing directly from TrumpRx.gov, starting in January 2026. Low- or middle-income women will be able to access further discounts.

While not announced by the White House, on September 25, BMS announced the launch of BMS Patient Connect, which will allow cash patients to receive Sotyktu at an 80% discount beginning in January 2026. This was a follow-up to their announcement of Eliquis 360 Support in July. On October 6, Amgen introduced AmgenNow, offering Repatha at a 60% discount off the list price to all patients.

On October 16, the FDA also communicated the recipients of the first wave of accelerated approvals under CNPV, which also included Pergoveris, EMD Serono’s fertility medication (currently approved in the EU and Canada), which will likely launch in January 2026.

We’re also starting to see the first partnerships that are connecting these online DTP platforms with traditional retail pharmacy—leveraging the trend toward BOPIS in consumer commerce. On October 29, Lilly announced a partnership with Walmart pharmacy, which is the first retail partnership that enables a pick-up option with direct-to-consumer pricing for Zepbound.

While these partnerships and announcements seem positive on the surface for lowering prices and enabling greater access to needed medications, they likely aren’t bringing price relief too broadly, and patients may have to jump through hoops to receive the discounted prices:

  • Only available for cash-paying patients
  • Only available for select government-insured patients with specific income requirements
  • A requirement to bundle multiple medications together from the same manufacturer
  • A requirement to purchase the medication from a specific third-party pharmacy

Additionally, there are clear underlying incentives for pharmaceutical companies to participate in MFN beyond driving greater access to medications. Partnering with the administration can:

  • Get pipeline drugs considered for the CNPV program for accelerated drug approvals in 1–2 months
  • Reduce or waive tariffs on pharmaceutical imports

Confusingly, many of these announcements around DTP pharmaceutical sales coincided with the tightening of the rules and regulations around DTC pharmaceutical advertising, with the wave of FDA Untitled Letters issued to manufacturers on September 9. This tightening of DTC promotion is somewhat incongruent with driving patients to obtain medications directly.

A Timeline of Key Events

Examples of Manufacturer DTP Portals

 

What Does This Mean for Patients and Providers?

These changes have the potential to significantly improve how patients access their medications—making the process more convenient, flexible, and personalized. However, they also reshape the traditional role of the healthcare provider, introducing new dynamics in how care and fulfillment intersect.

Patients

For patients, these shifts can offer greater autonomy and control over their treatment experience. They may have more choices in how they pay for, receive, and manage their medications, which can enhance satisfaction and adherence. At the same time, the growing number of fulfillment options and support models may also create confusion. Patients may struggle to understand which programs apply to them, which are supported by their provider or insurer, and which option ultimately best serves their needs.

Additionally, as many of the discounted medications are only available under specific circumstances (e.g., for patients paying cash, those with specific government insurance, through a specific pharmacy, or bundled with other medications from that manufacturer), this could cause disappointment if patients don’t fully understand the offers.

Providers

For providers, these changes can bring both efficiency and complexity. On the positive side, a streamlined fulfillment process may free up time to focus on the patients who most need their expertise. However, as more manufacturers adopt unique DTP or hybrid distribution models, providers will need to adapt their workflows to manage incoming requests and coordinate with different pharmacies and platforms for fulfillment. Over time, this could even influence prescribing behavior—potentially fostering new forms of manufacturer loyalty based on ease of process, patient satisfaction, or administrative simplicity.

What Does This Mean for Marketers?

These shifts can create new opportunities for marketers, as regulatory precedents now support more customer-first branded solutions, and there are now more DTP capabilities that have become easier and faster to implement. However, there are also potential threats, especially for smaller biotechs, that must be carefully considered.

Opportunities

Virtual Fulfillment Experiences Are Now Table Stakes

Branded telehealth, fulfillment, and savings and support programs, once designed to address specific brand challenges, such as limited access or low coverage, are now becoming standard expectations. They must serve as a core component of a brand’s go-to-market strategy rather than a niche solution implemented for a specific need, but designing and implementing them through an impeccable customer experience is more important than ever.

Category Growth

In many therapeutic areas, expanded access options and manufacturer discounts may stimulate overall category growth. Patients who had previously discontinued treatment may re-enter the market to take advantage of these new solutions and reduced costs.

A More Holistic Brand Value Story & Broader Access

Historically, DTP efforts have focused on communicating co-pay support for commercially insured patients, often overlooking those without coverage or who would prefer to pay out of pocket. These new solutions allow brands to tell a more inclusive value story—one that addresses a broader range of patient needs, including discounted solutions for medicare/Medicaid patients—but doing so will require stronger internal and external alignment, particularly with managed markets teams. Additionally, these solutions may expand access to patients who are not in large metro areas or close to specialists

Threats

Risk of Patient Confusion and Switching

As the landscape continues to evolve, there’s a risk that satisfied patients may reconsider how or where they obtain their medication—or even switch to competitors offering these DTP solutions and/or discounts. It’s critical to clearly communicate that your brand remains easy to access, be transparent about cost and programs available, and to dispel any misconceptions that switching therapies offers an advantage. Brands should also be prepared to address patient questions about why certain DTP solutions and/or discounts are not currently part of their offering.

Unexpected Competitive Moves Eroding Market Share

  • New DTP purchasing solutions or discounts for in-market brands drive share towards them
    • As larger pharmaceutical companies form more partnerships, they may introduce new DTP solutions or drug discounts for in-market brands that could undercut direct competitors. For smaller biotechs, it’s essential to scenario plan—anticipating how these shifts could impact the business and preparing proactive messaging or alternative fulfillment strategies.
  • Accelerated approvals for new brands bring new options to market, potentially stealing share
    • Additionally, these partnerships for in-market brands may lead to accelerated approvals for new launches through the CNPV program. Brands should proactively monitor competitors’ pipelines, plan for the potential impact of early launches, and develop strategies to mitigate any resulting risks.

In Summary

Particularly for smaller biotechs, it’s valuable to establish a cross-functional DTP task force to proactively identify opportunities, anticipate risks, and monitor new announcements, partnerships, and launches. This task force should also evaluate the level of impact of any of these factors. In some cases, for example, where cash-pay volume is tiny, it may not actually equate to a large business impact.

As this space continues to evolve rapidly, staying nimble, agile, and prepared with a plan for likely scenarios will help minimize risk to your brand. We can help you proactively build a DTP strategy or competitive scenario plans to navigate this changing environment.

Chris Millsom

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March 5, 2026 0

Progress is nothing without innovation, and innovation is impossible without exploring new frontiers. Embracing the new can be exhilarating. It can also be intimidating because it forces us to move beyond the comforting and familiar. Innovation doesn’t always render old models obsolete—sometimes, they may even come full circle to represent the real next frontier. 

Nothing better represents the promise and peril of the new than AI. AI tools are front and center in our online and office spaces while they also operate imperceptibly behind the scenes. It’s impact on our digital lives is profound. As we scroll through our socials, scanning content, swiping away ads, it’s right there in our faces, even if it doesn’t advertise itself. 

It’s easy to understand the attraction to AI. Of course, it’s shiny and new, but it also democratizes content generation in a way that wasn’t always possible. While the “artificial” in artificial intelligence is still front and center, AI content is becoming indistinguishable in some formats. The lines between reality and AI will continue to blur as the technology improves, and it will be harder to differentiate between the real and the artificial. 

This is the new frontier of content creation. From marketing emails and imagery to audio and video, the volume of automated content is growing quickly and evolving before our eyes. It’s fast, fluent, and frictionless, and it’s getting more sophisticated every day. 

AI saturation of communication is also fueling a shift we’ve seen coming for a while. AI has not and will not replicate authentic human experiences. No matter how much the digital space is flooded with synthetic stories, real human narratives, especially those that carry emotional weight, have become more valuable than ever. But as marketers continue churning out AI content, authenticity is quickly becoming a premium asset. Not because it’s novel, but because it works—and because, at our core, all of us crave real connection: to see ourselves in someone else’s experience and to know we are not alone. Consumers are used to seeking out real, authentic voices. And as real becomes rare, people will gravitate even more toward authentic content. 

Looking Back to Look Forward 

If this moment feels like déjà vu, it’s because we’ve been here before. A few decades ago, healthcare marketers began to question the industry’s reliance on staged testimonials, hired actors, and polished but generic messaging. It looked and sounded good, but it lacked authenticity, and people knew it. A small but growing number of people believed that real patients sharing real experiences could deliver something far more powerful: trust. Confidential – Not for Public Consumption or Distribution 

That idea sparked a quiet revolution and opened up the next frontier in pharma marketing: real, authentic patient stories. Over time, patient storytelling evolved from a niche offering to the industry standard, redefining the way healthcare brands engage with their most important stakeholders. This shift was something even the FDA acknowledged when it established its Patient-Focused Drug Development initiative in 2012 to more systematically collect patient experience and perspectives as part of regulatory and development decision-making. Today, authentic patient stories are a mainstay of modern life science communications, and the key to building trust. 

And that authenticity is just as important as it ever was. Even before AI, many of our live connections and interactions had been pushed online by COVID. While virtual can be a boon for some, it can also create a pronounced isolation for patients living with serious health conditions. Now, replacing real, authentic content with AI-generated content runs the risk of deepening patient isolation and chipping away at hard-won patient trust. 

Today, we find ourselves back at a similar inflection point. It’s no longer dramatization that stands in the way of authenticity but digitization. The new “fake” isn’t a paid actor; it’s a perfectly plausible AI-generated testimonial. And the new premium? It’s still the same as it was before: truth. 

Providing Proof of Authenticity 

What was true then is just as true now: patient audiences can spot the real from the fake. As the market gets better at producing content, audiences will get better at discerning what matters. In that environment, the real differentiator won’t be polish, it will be proof. Did a real person say this? Did this actually happen? Is there a real story behind the message? 

Going forward, simply claiming authenticity won’t be enough. Organizations will need to prove it. Regulatory conversations around AI transparency in advertising are already happening as we speak, and we’re seeing the start of a nascent verification era. The technology and policy are racing to catch up. Standards like C2PA (Coalition for Content Provenance and Authenticity), NIST (National Institute of Standards and Technology) protocols, and Google’s SynthID are establishing what could become digital signatures for truth. The goal of these technologies is to distinguish between human- and machine-generated content, giving creators a tool to validate the authenticity of their work. 

That matters, because audiences will demand it. For companies that have built their reputations on patient-centered work, verification tools for authentic stories will become critical. Some are already quietly aligning their processes with these tools because they recognize where the tide is going. 

Why Authenticity Matters to Healthcare Marketers 

In healthcare, trust isn’t optional. It’s everything. The messages we share have to ring true because they impact so much: treatment decisions, care choices, even the emotional journeys of people navigating serious diagnoses. 

Yes, generative AI carries promise. It enhances and augments productivity in ways that can improve healthcare marketers’ work: organizing information, interview preparation, Confidential – Not for Public Consumption or Distribution 

automating routine communications, even enhancing compliance. But it cannot duplicate human emotion or replace a real human voice. It cannot capture the emotional nuance of a patient facing a life-altering condition. 

None of this is a rejection of AI. It’s a call to use it wisely, embrace what it can do, and elevate what it can’t replicate. And stories cannot be replicated because they come from people, not prompts. AI may be able to mimic story structures or overlay messaging. But the real voice is key to creating a story that connects a brand to a patient. Protecting that real, authentic voice is an ethical imperative, but it’s also strategically smart. Authenticity builds connection, fosters credibility, and does something AI cannot: it makes people feel. 

Stepping Into the Future 

Some fear a future where AI devalues human creativity. But history suggests a different outcome. Photography did not erase art: it gave artists new tools to explore their creativity. Email did not destroy handwritten letters; it made them more meaningful. And streaming did not put an end to live concerts; it made them a premium experience. Automation increases creativity’s worth. And worth isn’t measured by profit alone, but by impact. The pioneers of the new frontier won’t be the ones who generate the most but those who make what’s real, authentic, and emotionally resonant.

Anna Cunningham

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February 17, 2026 0

The violation letters that started last September and continue this year might alter how brands craft DTC advertising. FDA is using a “totality of the evidence” standard to decide if an ad is in violation. That means they are now interpreting individual statements and creative elements together. While each statement might be true, FDA is deciding that when taken together, consumers are misled as to efficacy and risk.

This “totality” rationale gives FDA wide latitude to decide if commonly used DTC scenes of active patients enjoying life contribute to misleading claims. Many letters use these scenes as a reason to find greater efficacy claims than the drug really provides. I find the “totality” standard problematic. One could find almost every ad in violation by parsing each scene. There now seems to be a highly subjective degree of oversight.

While each statement might be true, FDA is deciding that when taken together, consumers are misled as to efficacy and risk.

I understand the new FDA is showing it is tougher on advertisers. We all get it. They are taking the desire to ban DTC on television and doing the next best thing by sending more letters. As an industry we have little choice but to respond with ads more likely to pass muster. It is hard to fight an agency that has been directed by Secretary Kennedy to eliminate what we do. They are trying to end adequate provision, the regulation that allows :60 ads, but that plan will face court challenges.

The good news is almost all the ads cited by OPDP can be fixed with a few copy changes and by toning down some of the happy scenes. That may be disappointing to agency creatives, but the reality is ads can still be interesting enough to get consumer attention. I am sure MLR internal groups are increasingly nervous in their review process and will make it harder to get approval. That means brands will need more time to develop ads, create alternatives, and allow for internal review resulting in changes.

I am not overly concerned with what I have seen from OPDP. Their letters are obviously frustrating and, as I said, too subjective. What was acceptable in the past will no longer be allowed. The reality is DTC is running at record spending levels, so drug makers are adapting to the new regulatory crackdown. A few campaigns that received letters needed dramatic changes, but most were just tweaked to satisfy OPDP concerns. I am hoping FDA is satisfied by being “tougher” and drops further regulatory action relating to adequate provision. The drug industry can do its part by showing it is crafting ads that meet the new requirements.

Bob Ehrlich

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February 10, 2026 0

Direct-to-consumer (DTC) advertising once again took center stage during the Super Bowl. This year, four commercials aired that were directly related to prescription drugs or diagnostic testing—an increasing trend as pharmaceutical companies seek to make big, cultural-impact moments out of major live events.

Historically, drug manufacturers have not heavily invested in Super Bowl advertising. That appears to be changing, as companies recognize the power of this massive national platform to reach both patients and healthcare providers simultaneously.

Novartis led the way with another highly creative disease-education ad—this time focused on prostate cancer screening. Last year, the company ran a widely discussed breast cancer awareness spot. This year’s commercial cleverly played on the concept of “tight ends,” featuring NFL stars Rob Gronkowski, Tony Gonzalez, and George Kittle in relaxed settings. The message: men do not need to fear prostate cancer testing because today’s screening can be done with a simple blood test rather than a digital rectal exam.

Even under rising regulatory pressure, pharma is doubling down on the Super Bowl as a must-have DTC stage.

The second ad came from TG Therapeutics and featured actress Christina Applegate, who has lived with multiple sclerosis (MS) for years. In her characteristically candid style, she bluntly stated that “having MS sucks.” The ad directs viewers to a platform where Applegate will share more content about living with MS, while also raising awareness of TG Therapeutics’ treatment, Briumvi, which is designed to slow disease progression. Applegate has long been open about her MS journey, which has profoundly affected both her career and personal life.

The third ad spotlighted Ro, with tennis legend Serena Williams promoting weight loss using a GLP-1 medication available through the company. Williams has been a compelling spokesperson for a range of brands, and this commercial was particularly well executed and persuasive. Ro markets branded medications directly to consumers while also providing ongoing clinical support through its membership model.

The fourth ad promoted Wegovy, Novo Nordisk’s newly launched weight loss pill. The tone was lighthearted and star-studded, featuring celebrities such as Kenan Thompson, John C. Reilly, and Danny Trejo. Given that the pill only became available in January, the spot functioned largely as an announcement to build awareness.

This is a critical moment for Novo Nordisk, as it currently has a limited window to dominate the emerging oral weight loss market before Eli Lilly introduces its own pill version of Zepbound later this year. Novo Nordisk had also faced potential competition from Hims & Hers, but legal pressure and FDA warnings prompted that company to withdraw its lower-cost alternative.

Overall, it is encouraging to see pharmaceutical companies continue to embrace television advertising—even amid growing regulatory scrutiny. The FDA has signaled its intent to make branded DTC ads more difficult to execute by flagging more commercials as non-compliant and by reconsidering rules that currently allow abbreviated risk disclosures in 60-second spots. While the regulatory landscape remains uncertain, it is clear that drug makers are committed to maintaining their presence in major broadcast advertising.

Bob Ehrlich

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January 28, 2026 0

AI is transforming healthcare engagement at unprecedented speed. Here's what most organizations are missing: automation without cultural intelligence creates irrelevance, inequity, and missed opportunity.

 

With over 40% of Americans identifying as multicultural, our groundbreaking white paper reveals how the convergence of AI and cultural intelligence is reshaping patient engagement and why brands that master this intersection will own the future of personalized healthcare.

Who This Report Is For

  • Pharma Brand Leaders
  • Marketing Executives
  • CX Strategists
  • Research & Insights Teams
  • Cross-Cultural Marketing Specialists

Developed by Leading Experts Across Research, Strategy, and CX

This white paper represents collaborative expertise from:

  • República Havas Health | Award-winning cross-cultural healthcare marketing experts
  • Havas CX | International CX network with 1,800+ specialists
  • M3 MI | Marketing intelligence with insights from 40,000+ patients annually

Analysis based on M3 MI's syndicated data covering 23,000 multicultural patients and 3,800+ physicians across 25 specialties. Nationally representative, weighted to U.S. Census and CDC prevalence targets.

Key Learnings: Roadmap to Transformation

  • Converging trends reshaping multicultural patient healthcare engagement
  • Data-driven shifts in patient behaviors across the journey in an AI-driven era
  •  Four-layer CX model for embedding cultural intelligence from inception
  • CX best practices for personalization that respect intersectionality
  •  Measurement strategies demonstrating ROI
  • Future hypotheses to anticipate emerging pressures and convert them to advantage

 

The Paper at Glance

  1. The AI and Cultural Intelligence Imperative
  • The Multicultural Patient Shift: Traditional patient funnels are collapsing. Multicultural patients are building personalized ecosystems blending cultural practices with AI-interpreted health information. They encounter AI content before verified sources. 76% lack the ability to assess this content for accuracy.
  • The AI Opportunity and Interpretation Gap: AI generates unprecedented data and insights. Cultural interpretation transforms this data into actionable strategy. When AI shows Hispanic patients prefer WhatsApp groups, cultural intelligence reveals the underlying drivers: affordability considerations, institutional dynamics, information needs.

 

  1. The Breakthrough Formula:
  • AI identifies patterns at scale: what patients do, where they engage, when they convert
  • Cultural intelligence explains causation: why patterns emerge, what they mean, how to respond authentically
  • This intersection transforms efficiency into relevance: and relevance into trust, adoption, and measurable growth

 

The distinction between correlation and causation is the difference between generic targeting and authentic engagement.

  1. The Perfect Storm: Four Trends Converging Now
  • AI-Generated Misinformation spreading faster than trusted content
  • Affordability Crisis driving patients to unverified sources
  • Political Polarization eroding institutional trust
  • Regulatory Retreat pushing pharma away from culturally specific communications when needed most.

 

As a result, multicultural patients navigate AI-saturated platforms from positions of economic pressure, evolving institutional relationships, and minimal culturally relevant guidance.

  1. The Multicultural Patient Journey in an AI-Driven Era

Our research analyzed health behaviors for a sample of 23,000+ multicultural patients (Hispanic, African American, and Asian American.)

 

The paper examines the complete multicultural patient journey from awareness through adherence, revealing how AI and converging trends are fundamentally shifting behaviors at every phase.

 

The data shows that traditional funnels are collapsing as patients create personalized health ecosystems, with community networks becoming the primary touchpoints and adherence evolving into community-sustained engagement.

  1. Strategic Implications for Messaging and Customer Experience

First-Party Data Foundation: Organizations that leverage transparency to build trust through culturally informed data can see increased accuracy and revenue.

 

Four-Layer Implementation Framework:

  • STRATEGY LAYER → Cultural expertise defines what context AI needs (historical grievances, social determinants, within-community diversity, decision logic)
  • INTERPRETATION LAYER → Cultural intelligence explains causation behind AI-identified correlations, distinguishing rational adaptation from demographic preference
  • EXECUTION LAYER → Cultural intelligence reviews AI-generated content for bias, guides toward culturally native strategies
  • OPTIMIZATION LAYER → Cultural intelligence redirects AI efficiency metrics toward effectiveness outcomes (trust-building, barrier reduction, sustained adherence)

 

Measurement That Matters: Success should be evaluated through metrics that go beyond traditional engagement rates, focusing on conversion and adherence by cultural segments, trust and satisfaction scores, media effectiveness within specific communities, and community-specific KPIs that ensure equity across all touchpoints.

  1. The Data Is Clear: Cultural Intelligence Equals Competitive Advantage

Organizations leveraging culturally informed strategies see:

  • 2.9x more revenue and 1.5x greater cost savings by leveraging first-party data ecosystems for precision and efficiency.
  • 95% accuracy in connected data systems compared to 70% with traditional methods, enabling better decision-making and personalization.
  • 2.6x higher engagement when deploying in-language AI conversational agents, driving relevance and trust at scale.
  • 25–40% reduction in treatment abandonment through predictive AI informed by cultural context, improving adherence and outcomes.

 

The opportunity window is closing. Early adopters are establishing trust, building data ecosystems, and capturing market share.

  1. Looking Forward: Six Hypotheses for the Future
  • Data Ecosystem Advantage
    First-party data will evolve beyond demographics to enable segmentation that reflects cultural values, language preferences, and decision-making norms.
  • The In-Language Imperative
    Success will depend on AI systems trained in medical terminology, colloquial expressions, and regional variations—not just translation.
  • The Co-Design Requirement
    Community partnership will become essential. Patients will trust AI only when cultural stakeholders help shape design, validate outputs, and mitigate bias.
  • The Transparency Advantage
    Transparency in AI decision-making will move from a compliance checkbox to a trust-building requirement. Clear, culturally sensitive explanations will be key.
  • Predictive Intervention
    AI integrating social determinants of health will enable proactive support, financial counseling, transportation, and community resources before treatment abandonment.
  • The Emotional Resonance Shift
    Micropersonalization will evolve into emotional resonance. AI will adapt tone, framing, and narrative to cultural context, blending empathy with technology to build authentic trust.

 

The Moment Is Now: As AI advances, human cultural expertise becomes MORE critical. Technology reveals opportunity; cultural intelligence ensures organizations capture it effectively.

 

The Minds Behind the Paper

  • Eirásmin Lokpez-Cobo, MS, MA | Executive Vice President, Brand Strategy Health, República Havas Health
  • Jayne Krahn, BS | Senior Vice President, Product & Research Operations at M3 MI
  • Mark Makuch, MBA, MA | Executive Vice President of Strategy, Havas CX
  • Marcela Turner, MA | Director of Strategy, República Havas Health

Download the Full Executive Report Now

“Where Culture Meets AI: Scaling the Human-Centered Healthcare Experience”

Discover the complete framework, data insights, and implementation strategies that leading organizations are using to win with the 40%+ of the U.S. population driving healthcare growth.

DOWNLOAD THE WHITE PAPER

Want to Discuss How These Insights Apply to Your Brand?

Connect with our team for a consultation on implementing cultural intelligence + AI strategies for your organization.

[CONNECT WITH US]

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December 11, 2025 0

The FDA 9/9 letters reshaped DTC advertising. Three months later the real impact is emerging, from ad pauses to pushback on net impression claims. On September 9 the FDA issued 27 untitled letters to pharma companies over allegedly misleading television ads. We reviewed what has actually happened to the DTC efforts of those cited brands.

Nine brands have gone completely dark on television. Eleven are still running what appear to be the same ads, which likely means they are disputing FDA’s interpretation or are negotiating modifications. Four brands have revised the cited ads and returned to air. Three have introduced entirely new creative.

Only four matters have been formally closed, indicating FDA has accepted the company response. The fact that eleven cited ads are still on air suggests drug makers believe they remain in compliance and are prepared to defend their position.

FDA’s rationale for citations varies, but the most common is overstated efficacy. Sometimes FDA points to clinical data they believe contradicts the claim. Other times they argue the “net impression” overstates benefit, even when the supers are clinically accurate. In those cases, FDA says the emotional tone—patients looking “too happy,” “too energized,” or “too cured”—creates an impression inconsistent with the drug’s actual performance.

Another recurring issue is distraction during fair balance: rapid scene cuts, visually stimulating footage, heavy music, or supers that are difficult to read. These are adjustments drug makers can fix relatively easily. Consumers are not harmed by a more subdued fair balance section; in fact, boring is often better.

A tougher FDA means advertisers must be more cautious, not that they should abandon television.

What troubles me most is the widening use of the net impression standard. It gives FDA enormous latitude to declare a violation based on the subjective view of a single reviewer. Several letters cite nothing more than “smiling patients” as evidence of overstated efficacy. That is an arbitrary benchmark and I expect companies will push back hard.

The good news: after the 9/9 blitz, FDA appears to have cooled down. They made their point, and the entire DTC ecosystem is now paying attention. The bigger question is what comes next—specifically, whether FDA intends to eliminate the “adequate provision” pathway that has enabled broadcast advertising for nearly three decades. Any attempt to restrict it will ultimately be a First Amendment fight, and courts have historically required a very high bar to curtail commercial speech. With 28 years of DTC television and no demonstrated public health harm, FDA would need overwhelming evidence to justify new limits.

I remain confident that DTC television will endure. A tougher FDA simply means advertisers must be more cautious in claims and more disciplined in fair balance. The industry will adapt. And we should not let FDA bluster scare us off the broadest reach channel we have.

Bob Ehrlich

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December 1, 2025 0

“When you talk to a doctor or a lawyer, there's medical privileges, legal privileges. There's no current concept of that when you talk to an AI, but maybe there should be.”

—Sam Altman, The Atlantic (2024)

Take it from the CEO of OpenAI: Confidentiality and privacy protections are among the biggest unresolved issues for those interested in using emerging artificial intelligence tools in settings such as law and healthcare. Strict professional privileges exist for a reason. We ask people to share the most sensitive moments of their lives so we can educate, support, and guide them. They open up because they believe their words will be handled with care, kept in context, and never used against them.

AI promises speed and scale, but it does not confer privilege. The tension shows up in daily work. A team wants to turn a powerful interview into a plain-language explainer. Another wants multilingual versions of an adherence story. A third needs a short script for a Patient Ambassador™ video. AI could help each project move faster.

Yet the raw ingredients (transcripts, recordings, voice messages, emails) can contain names, dates, locations, adverse events, trade secrets, and distinctive phrases. Feed those into a general model and you may create a trail you can't fully see or control. Even when policies say inputs aren't used for training, exceptions exist. Retention rules evolve. Humans sometimes review snippets. The words you were trusted to protect may travel further than you intended.

Evolved Privacy Policies

Across the world, legislators have passed regulations to protect their constituents from overly intrusive data harvesting practices. The life science industry and their agencies have established processes to comply with regulatory mandates, in many cases being more restrictive than required. For example, the European Union's GDPR rules have emerged as the industry’s best practice, even outside of the EU's jurisdiction. The point is to be as restrictive with data, and as respectful with patients’ safety and privacy, as possible.

Such good faith efforts are important when building a trust-based partnership among equals. And they're expected. Privacy, for patients, isn't abstract. It's protection from harm that could affect an already vulnerable population. Patients and caregivers are motivated to work with the life science industry for many reasons: human connection, empowerment, motivation, education, inspiration. Becoming a dataset or having sensitive information exposed isn't one of them. So, to enter the AI era respecting privacy, three rules apply.

Rule #1: Guide the Process

The lead in patient engagement needs to be held by a sentient human being like yourself. A human can be held accountable. A human also knows that they could, now or in the future, be a patient themselves. So, they understand the gravity of their responsibility and know how to address concerns and apprehensions.

This only works if that human is more than just an order taker. They have to be familiar with the patient, competent at their craft, and able to guide through a regulatory-compliant cocreation process.

Rule #2: Have a Conversation About Consent

If a patient contributes to creative content, they should know exactly how that piece will be created, where AI may help, and where humans will review.

They should understand the process for creation, publication, and future reuse. If they change their mind, the path to withdraw should be simple and honored quickly. A checkbox at the bottom of a long policy is paperwork. A clear discussion about purpose, limits, and control is respect.

Rule #3: Maximize Meaning, Not Data

Once the ground rules for cocreation are understood and the humans have sorted out how they will work together, AI assistance can come into play. Generative AI can be a detriment to authenticity and has a measurable image problem within the patient and caregiver community[i]. So if you introduce AI, do so only on a need-to-know basis and preferably only on behind-the-scenes processes.

For example, for an LLM to assist with drafting, it won't need the full, raw record of life. It will need meaning. That means removing identifiers and letting AI operate on a focused, safe excerpt or summary of the original notes. Always ask: “Is this information necessary to accomplish what we're looking for?” If the answer is yes, and if the information is privileged, manual work or a secure, on-site system is required.

Keep the Human Voice at the Center

The reason we always emphasize authenticity is because real human stories change behavior more than engineered, sterile content ever will. AI can help translate and organize those stories. It cannot live them.

We can safely expect AI to become better at mimicking human nuances: imperfect phrases, deliberate pauses, heart-wrenching rawness, elevating inspiration. But as generative content floods every channel, audiences will reward not only what feels true but what they know to be real and accountable. Whatever you do, never pass artificial patients off as real ones. Break that promise once, and all your work could be called into question.

Respecting these guardrails prevents rework. When teams avoid over-collection on the front end, they spend less time redacting. When consent is explicit, legal reviews move faster. When provenance is built in, Medical-Legal-Regulatory discussions focus on substance, not process.

The result is a speedy and satisfying mode of engagement with predictable cycles, fewer surprises, and assets that stand up months later when someone asks, “Where did this come from?” If you wouldn't want to read a prompt and its source materials in a public forum, don't put them in a model you don't control.

Environment and Expertise

Teams that want to use AI will need the right environment and the right expertise. The environment should match the stakes: private instances when identifiable data is unavoidable, zero-retention settings, strong access controls, short retention windows, encryption in transit and in storage, and separation between systems that store identifiers and systems that generate content.

The expertise is the human part: interviewing that captures meaning without excess detail, editorial judgment that keeps education separate from advice, cultural fluency in every language we publish, and regulatory rigor that anticipates hard questions before they're asked.

This is not easy to build, but the right agency can help select the right use cases for AI, set up the protected environment, convert legal principles into usable workflows, and defend the final product. After all, they know exactly how it was made.

AI can have a place in responsible patient engagement. Privacy has the first place. Until society gives AI conversations the protections we expect from medicine and law, act as if every patient word entrusted to you is a promise. Keep that promise, and you'll earn the speed AI offers without spending trust you cannot afford to lose.

[i] Data from a recent survey SNOW conducted with 297 patients and caregivers suggests there is a strong negative feeling toward generative AI in patient content: 42% are not open to AI being used at all in the creation of content involving patients or caregivers.

Oliver Portmann