What Is the ROI of Customer Experience in Pharma?
You cannot calculate the return on a feeling, which is why most pharma CX business cases die in the room.
I have sat on both sides of that meeting. The deck has a benchmark from another industry, a satisfaction number, and a claim that better experience drives growth. Someone in finance asks which line of the P&L moves. The room goes quiet. The request gets deferred to next cycle, and everyone agrees experience is important.
Here is the version that survives the question.
Why does the usual business case fail?
Because it asks your CFO to accept a chain of inference with four links in it.
Better experience raises satisfaction. Satisfaction raises advocacy. Advocacy raises prescribing. Prescribing raises revenue.
Each link is defensible on its own. Multiply four probabilities together and you have handed finance something they are trained to discount to near zero.
Cross industry proof does not rescue it. Forrester found that customer obsessed organizations reported 41% faster revenue growth, which is a real finding about companies that sell directly to the people who use their products. Your CFO knows you do not. Bain's own range for score to growth runs from 10% to 70%, and a range that wide is not a business case, it is a shrug.
Drop the chain. There is a one link version.
What is the actual unit of return?
Value your brand has already earned and is losing before the patient gets it.
That is a different claim from "experience drives growth," and it is a much easier one to prove, because the loss has already happened and it is sitting in data you hold. You are not forecasting a lift. You are recovering a leak. Finance understands recovery.
Every prescription written for your brand is a clinician choosing you. The decision is made. The selling is done. What happens next determines whether that decision becomes revenue, and most of what happens next is operational rather than persuasive. We call the gap value leakage, and the money sitting in it right now is Customer Value at Risk.
How do you size it without running a pilot first?
Four numbers, three of which you already have.
Start with prescriptions written for the brand in a period. Your data team has this. Then the share that never became a patient on therapy. Then the gross value of a treated patient over a defined horizon, which your forecasting team already models. Then your recoverable share, which is the one you have to estimate.
That last number is where the argument lives, so be conservative in public and rigorous in private. Not every abandoned script is recoverable. Some patients were never going to start, some were switched for good clinical reasons, and some barriers sit well outside anyone's control.
The published data tells you the pool is large. A 2026 JAMA study summarized by Johns Hopkins found insurer rejections reached 40.7% of initial brand name attempts in 2024, up from 24.3% in 2018. Of those rejected scripts, 48.4% were never followed by a fill of that drug or anything in its class within 90 days. IQVIA data reported by Managed Healthcare Executive puts abandonment at 61% once the patient pays more than $250. The American Medical Association's latest survey has 82% of physicians saying prior authorization at least sometimes leads patients to abandon treatment.
Those are industry figures, not yours. Use them to justify the exercise, then compute your own. A business case built on your own denominator is unarguable in a way that a borrowed benchmark never is.
What does the arithmetic look like?
Illustrative only, with round numbers, because yours will differ and you should not present mine.
Take 100,000 prescriptions in a year. Say 35% never become a patient on therapy, which puts 35,000 scripts in the leak. Put gross value per treated patient at $12,000 over the horizon you model. That is $420 million of earned value that did not convert.
Now be harsh with yourself. Assume only 15% of it is operationally recoverable, which means you are writing off 85% as clinical, competitive or structural. You are still looking at $63 million against a program that costs single digit millions.
Run that with your own figures before you show anyone. If your recoverable share comes out at 5% the case usually still clears, and if it does not, you have learned something more valuable than a budget approval.
What will finance actually challenge?
Three things, in this order. Have the answers ready.
"How do we know you caused it?" You do not, yet. Do not claim you do. Propose a comparison instead: matched territories, or a staged rollout where some regions get the intervention first. Pharma runs this design constantly for field tactics and your finance team already trusts it.
"Is this not just patient services doing its job?" Partly, and say so. The incremental claim is about the seams between access, hub, field and medical, where nobody currently owns the handoff. Point at a specific seam and the days patients sit in it.
"What is the payback period?" Barrier resolution speed moves in a quarter, which is unusual in your world and worth leading with. Persistence takes longer. Give them a short horizon number and a long one rather than a blended figure that is wrong at both ends.
What return should you actually promise?
A measured baseline, not a multiple.
This is the part I would do differently if I were starting over. The temptation is to promise a number, because a number gets approved. A promised multiple on an unproven chain is also how CX programs end up defunded eighteen months later when nobody can show the link.
Commit instead to three things you can be held to. A baseline Realization Rate published by the end of the first quarter. A named owner for each of the top three stall points. A quarterly figure for Customer Value at Risk that goes into the brand review alongside every other number.
Promise measurement first and the recovery argument becomes self funding, because the first baseline usually produces a number large enough that nobody asks for the business case again. The full measurement set is in how to measure customer experience in pharma.
One caution on where the money shows up. The savings rarely land in the budget that funded the work, which is a political problem rather than an analytical one. Agree in advance who books the benefit, because an unclaimed benefit becomes nobody's win and the program dies in the next planning round. That is the same reason Customer Excellence has to sit inside the commercial system rather than beside it.
Key takeaways
- The standard business case fails because it chains four inferences together, and finance discounts the product of four probabilities to nothing.
- Your unit of return is value your brand already earned and lost before the patient started, which is recovery rather than forecast.
- Three of the four numbers you need are already in your building, and only the recoverable share needs estimating.
- Expect three challenges: causation, overlap with patient services, and payback period. Answer causation with a staged rollout rather than a claim.
- Promise a measured baseline rather than a multiple, because a promised multiple is how the program gets defunded later.
Questions to ask your leadership team
- What share of last year's prescriptions became treated patients, and who owns that number today?
- What is a treated patient worth to this brand over the horizon you forecast?
- Of the value lost between script and start, how much do you believe is operationally recoverable, and what is that belief based on?
- If you recovered it, whose budget books the benefit?
- What would you need to see in one quarter to keep funding this, and does anyone currently measure it?
About the author
Wayne Simmons is the founder of The Customer Excellence AGENCY and the author of The Customer Excellence Enterprise (Wiley, 2024). He is founding faculty of the MS in Customer Experience Management at Michigan State University's Broad College of Business. He led global customer excellence in Pfizer's first Chief Marketing Organization and in Bayer's Customer Powerhouse. Related reading: Why pharma CX programs fail, How to measure customer experience in pharma and Why consumer CX does not translate to pharma







