Advertising Age reported on the perceived proliferation of pitches for pharmaceutical accounts, partly prompted by presidential poppycock.
While no one knows the true reasons behind such account moves, a few points seem certain:
• Big Pharma brands award business exclusively to White holding companies.
• As accounts bounce between holding companies, worker drones become collateral damage—and overall job numbers appear to decrease vs simply shift.
• Independent White advertising agencies are relegated to lesser, subservient roles—or must settle with serving emerging biotechs for significantly smaller billings.
• Independent Non-White shops are non-entities—denied even crumbs and/or positioned for Prime Redlining.
The healthcare system is broken, with tremendous inequities for underserved and underrepresented entities. Ditto the healthcare account awarding system in Adland.
Behind the rise in health care reviews—and how agencies are bracing for a pharma ad crackdown
By Ewan Larkin and Jack Neff
A barrage of health care marketers are putting their agency rosters under the microscope—and the trend shows no sign of abating.
Just this week, there were three major moves in the space: Bayer hired Interpublic Group of Cos. to handle global creative, production and media duties for its consumer health division, which includes over-the-counter drugs such as Claritin, Aleve and Alka-Seltzer; Haleon, the maker of Advil, Panadol and Sensodyne, split its global creative business between Publicis Groupe and WPP; and Tylenol marketer Kenvue launched a comprehensive global creative and media agency review, Ad Age reported.
Health care reviews have been accelerating over the past 12 to 18 months, said Michael Knopf, principal at MediaLink, who added he doesn’t see that slowing anytime soon: “I think it’ll continue to be a very active space.”
The pharmaceutical category represented just $193 million, or 1% of global spend under review, in the first half of 2024, according to billings tracker COMvergence. That figure surged to $975 million, or 6% of total spend under review, in the first half of 2025. Pharma now makes up 13% of all currently active reviews, per COMvergence.
Several factors are driving the uptick, including health care marketers’ lagging transformation efforts, consolidation in the agency sector and the growing strength of independent players. At the same time, marketers and their agency partners are preparing for stricter drug advertising regulations under the Trump administration, developing contingency plans to reach both consumers and health care professionals in new ways.
Stalled by regulatory and privacy constraints, along with reliance on advertising strategies like consumer testimonials, the pharma sector has lagged behind other categories in modernizing its marketing approach, said Knopf. Now, brands are racing to become “leading consumer brands,” investing in more personalized content and exploring areas such as sports sponsorships, he added.
These transformation efforts—including a greater focus on data and technology for audience targeting—are partly driving marketers to reassess their agency relationships, Knopf said.
“A lot of pharma clients are looking to optimize or, in some cases, upgrade their agency partners,” Knopf said.
Samantha Avivi, chief marketing officer of Bayer’s consumer health division in North America, previously told Ad Age the company’s review was driven by tech shifts and a need to future-proof brand-building strategy. Explaining its decision to hire IPG, Bayer this week pointed to a need to “capitalize on the acceleration of generative AI tools and capabilities to better engage with consumers at the local level.” It also stressed the need to produce more personalized content.
Bayer set up its review process to show how the winning agency could foster a faster, more agile creative development approach that the company terms “Dynamic Shared Ownership,” Avivi said in an interview Sept. 30. That included having small teams globally and locally working together with agency teams on projects that were briefed in the morning and produced creative work by the end of the day. The process helped Bayer understand the agencies’ strengths and weaknesses, as well as their chemistry with its marketers.
“By the time we were done with the global work, and then the local variations, it was probably done in the matter of a month from pitch to execution,” Avivi said, including feedback and revisions. At each step, the approach reduced a process that once took three or four months down to a day, she said.
It was all part of an effort to meet consumers’ increasing demands to be better connected with brands they’re using and understand them better, as well as meet the growing demand for personalization and take advantage of industry progress in efficiency and automation. “So I would call that modernization for sure,” she said.
How the Omnicom-IPG merger fits into the health care moves
The agency landscape is shifting rapidly, particularly as Omnicom nears completion of its acquisition of IPG. That consolidation, combined with increasingly robust independent options, has prompted marketers to reevaluate their partnerships, said Greg Paull, president of global growth for marketing consultancy MediaSense.
“Independents are getting far more professional and active thanks to private equity,” said Paull, pointing to agencies including Klick Health, Syneos Health and Fingerpaint as examples.
Bayer nodded to the Omnicom-IPG deal in its review announcement Monday, with Consumer Health Chief Marketing and Scientific Officer David Evendon-Challis noting the “opportunity of what is possible” when the merger is complete.
Health care marketers, like peers in other sectors, are under “a lot of pressure,” said Frank Mazzola, global chief creative officer of medical marketing agency Real Chemistry. As a result, many are trying to work with fewer agency partners, streamline costs and combine overlapping areas like advertising and medical education, he added.
“They’re moving into more of a consolidation world,” Mazzola said.
Haleon’s review provides a clear example. The consumer health giant consolidated its roster from three primary holding companies to two—Publicis and WPP—while IPG, which said it declined to participate in the pitch, was removed. Publicis (OTC drugs) and WPP (oral care and wellness) have been assigned by categories to “enable a more simple, focused way of working,” according to Haleon.
How the industry is preparing for stricter pharma ad regulations
President Donald Trump last month signed a new memorandum ordering his health department to crack down on direct-to-consumer pharma advertising. The Food and Drug Administration (FDA) also sent warning letters to pharma companies related to misleading ads.
Some ad agency executives downplayed the immediate impact of the FDA’s enforcement letters; Mazzola noted that most of the actions reinforce existing rules rather than introducing new ones. However, he raised concerns about the possible elimination of the adequate provision, the FDA rule that lets drugmakers run TV ads with only a summary of major risks as long as they direct viewers to full prescribing information through another source.
In a statement about its crackdown on drug advertising, the FDA said it is “initiating rulemaking to close the adequate provision loophole created in 1997.” The federal agency stated that drug companies have used the policy “to conceal critical safety risks in broadcast and digital ads, fueling inappropriate drug use and eroding public trust.”
“If adequate provision went away, then it would be very hard for marketers to do TV in a branded way,” said Mazzola.
While Real Chemistry doesn’t expect that to happen, it is planning for such a reality. Contingency strategies include shifting dollars out of branded TV into unbranded disease-awareness campaigns, then using those spots to steer patients toward social and digital platforms such as TikTok or YouTube for deeper education, Mazzola said.
Marketers are taking precautionary measures, too. One marketing consultant, speaking on the condition of anonymity, noted that their contract with a brand to run an agency review included a clause allowing the process to be paused depending on how new federal rules around pharmaceutical advertising play out.
“Honestly, it’s just such a crazy time,” the consultant said. “It’s difficult for all marketers.”
Agencies heavily focused on paid DTC marketing need to broaden their services to reflect where marketers are headed, said Knopf. This includes expanding into influencer campaigns, earned and owned media, community engagement, and healthcare professional-focused or unbranded educational content.
“Agencies are going to need to diversify their services to really stay relevant here,” he added.
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