How to Measure Customer Experience in Pharma

Measure whether your customers moved, not how they felt about you.

That single swap is the whole answer. It is also harder than it sounds, because nearly every instrument you own was built to do the opposite. What follows is the replacement set, where the numbers come from, and the test I use to decide whether a measure has earned a place on your dashboard.

Why does your score stay flat while your business leaks?

Because the person answering your survey is not the person who failed.

A physician chooses your therapy. A payer decides whether to cover it. A patient uses it and pays part of the cost. Three people, three sets of interests. Your survey usually reaches the first one, and she is the least likely of the three to know what went wrong after she signed.

So the score holds. Meanwhile insurer rejections of brand name prescriptions reached 40.7% of initial attempts in 2024, up from 24.3% in 2018, in a JAMA study summarized by Johns Hopkins. Of those rejected scripts, 48.4% were never followed by a fill of that drug or anything in its class within 90 days. Nearly half of a rejection cohort disappears. Your relationship survey will not flinch, because nobody it asked was there.

That is the first thing a measurement system in pharma has to solve. You cannot measure a three person market with an instrument built for one buyer.

What does a progression measure actually look like?

It has a numerator, a denominator and a date. That is the whole specification.

Seven of them carry most of the weight:

  • Script to start conversion. Of the prescriptions written for your brand last month, what share became a patient on therapy, and in how many days?
  • Time to therapy. Median days from the clinical decision to the first dose, cut by payer and by site of care. The median hides less than you think once you cut it.
  • Stall points. Where patients stop moving. Benefit check, prior authorization, appeal, copay, hub intake, the specialty pharmacy handoff. Count how many sit at each one and how long they sit.
  • Barrier resolution speed. Once you know a patient is stalled, how long does it take you to clear it? This is the one measure your field team can move next week.
  • Persistence at 90 and 180 days. Starting is not benefiting.
  • Realization Rate. Realized therapeutic and commercial value against the value your brand had already earned when the clinician decided. This is the headline number.
  • Customer Value at Risk. CVaR is the money sitting inside unresolved stalls right now. It turns a service backlog into a forecast problem, which is the only form in which a commercial leader will act on it.

Notice what every one of them has in common. Someone can own it, and each moves money. We call the gap they are built to expose value leakage.

How do you measure experience when you cannot talk to the patient?

You stop measuring the patient and start measuring the system acting on the patient.

Your feedback loop is partly closed by law and partly invisible by structure. In most markets you cannot discuss the product with the patient. You often cannot see the pharmacy counter or the payer's adjudication. A survey strategy that depends on reaching the patient is dead before it starts.

The good news is that the loop you cannot close leaves timestamps everywhere. Benefit verification requests, hub intake records, prior authorization submissions and their outcomes, appeal files, specialty pharmacy dispense data, copay program redemptions.

None of that was designed as experience data. All of it tells you where your customers stopped and for how long, which is the only question that matters.

Your field force is the other half. Your reps and MSLs meet a new payer policy weeks before any dashboard registers it, and most companies have nowhere to put that signal. Build somewhere to put it.

Access is tightening while you decide. Veeva Pulse data reported by BioSpace found 45% of HCPs accessible to biopharma, down from 60% eighteen months earlier. The visits you still get are too expensive to waste on information you already have.

What should you still ask physicians?

Effort. Not affection.

Your physician does not think of herself as your customer, and asking her to rate her loyalty to your company produces a number that is real and nearly useless. As I put it to CXM last year, doctors do not go around asking about loyalty.

Ask her what it cost her to work with you. How many calls to get one patient started. How many times her staff supplied the same information twice. How long she waited to learn a case had stalled.

Effort is measurable, attributable and fixable, which is three more properties than sentiment has. Outside pharma the link is established. Gartner found 62% of customer service channel transitions are high effort, in industries where the company can watch the transition happen. You usually cannot watch yours, which makes asking about it more important rather than less.

Ask about channel fit too, and be ready to dislike the answer. Deloitte's 2025 research found that only 28% of HCPs believe pharma's engagement strategies meet their needs, against 82% of life sciences executives who say they are satisfied with those same strategies. Somebody in that pair is measuring the wrong thing.

Does regulation stop you from measuring any of this?

No, and this is where most measurement programs quietly give up.

Regulation governs claims. It constrains what you may say about efficacy and safety, to whom, through which channel, in which market. It says almost nothing about operational burden. You may not promise a patient an outcome. You may absolutely count how many days she waited.

Look at what the burden numbers already show. In the American Medical Association's latest survey, 93% of physicians said prior authorization delays care and 82% said it at least sometimes leads patients to abandon treatment. IQVIA data reported by Managed Healthcare Executive puts abandonment at 61% once a prescription costs the patient more than $250. Not one of those figures required you to make a claim about your product. They are all counts of friction, and counting friction is legal everywhere you operate.

How do you know a measure has earned the dashboard?

Three tests. Apply them to every number in your current pack and watch how few survive.

It has an owner outside the CX team, by name. It moves money in a way you can describe in one sentence. It can change inside a quarter, which means someone can be held to it.

Your advocacy score fails all three. That is not an attack on the instrument, which was built in good faith for a different market. Bain's own published range has relative score differences explaining anywhere from 10% to 70% of the variation in subsequent revenue growth. A measure with that much room in it cannot carry a brand plan.

The deeper reason the swap works is timing. The imported model counts the transaction, and in retail the transaction is the value event. Your value event is sustained therapy, months later, handled by payers, pharmacies, hubs and office staff you do not employ. Progression measures follow the patient into that interval. Sentiment measures stay at the door.

Get these on your brand reviews and the argument changes shape. You stop defending a program and start managing a system. That is what Customer Excellence is for, and the standard it reports against is Consumer-Grade.

Key takeaways

  • Progression measures beat sentiment measures because each one has an owner and each one moves money.
  • Your chooser, payer and user are three different people, so a single survey respondent cannot tell you where value was lost.
  • The loop you cannot close still leaves timestamps, in hub, benefit verification, appeal and dispense data you already hold.
  • Ask physicians about effort rather than loyalty, because effort is attributable and fixable.
  • Regulation limits what you may claim, not what you may count, so the burden data is yours to measure.

Questions to ask your leadership team

  1. Of last month's prescriptions, how many became treated patients, and does that number appear anywhere in your reporting?
  2. What is your median time to therapy, and how much does it vary by payer?
  3. Name your top three stall points and the owner of each, by name.
  4. How much money is sitting in unresolved barriers right now, and who reports that figure?
  5. Which numbers in your current CX pack would pass the three tests above, and what are you planning to do with the rest?

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, Why consumer CX does not translate to pharma and What is value leakage in pharma?

March 15, 2026
Why healthcare professionals now judge pharmaceutical engagement against the best experiences in their lives, and what that means for the future of commercial leadership. When commercial performance falters, the reflex inside many pharmaceutical organizations is to adjust the machinery of field execution. Leaders revisit call plans, recalibrate targeting models, and increase the volume of activity in the hope that more precision or more frequency will restore momentum. For decades this system has been treated as the central instrument of commercial performance, determining which physicians are prioritized, how frequently representatives engage, and how resources are deployed across territories. Yet the growing gap between commercial effort and commercial impact suggests a deeper issue. T he problem is rarely the design of the call plan itself. It is the context in which healthcare professionals now operate. Physicians are navigating increasingly complex clinical, administrative, and informational environments, and that evolving reality now shapes prescribing behavior far more than the cadence of promotional interactions. What many organizations are experiencing is a widening Customer Context Gap. Commercial systems were designed for a time when prescribing decisions could be influenced primarily through promotional interaction and product information. Today physicians operate inside a far more complex reality shaped by administrative burden, reimbursement constraints, digital information overload, and growing expectations for seamless support across the entire care journey. In this environment the physician’s decision is influenced not only by clinical evidence but also by how easily a therapy fits into the practical realities of care delivery. When commercial models remain anchored in promotional activity while the customer’s context has fundamentally changed, even the most disciplined call plan struggles to deliver the outcomes it was designed to produce. Closing this gap requires a different way of thinking about commercial performance. The question is no longer how to optimize promotional activity but how to align the organization around the real journeys through which physicians help patients receive therapy. Prescribing decisions unfold within complex sequences of clinical evaluation, reimbursement navigation, patient readiness, and ongoing support. When commercial strategy is designed around these journeys rather than isolated interactions, the role of the field force begins to evolve. Representatives are no longer positioned primarily as messengers of information but as partners in removing barriers that slow care. Organizations that recognize this shift begin redesigning their commercial systems accordingly, aligning field engagement, digital support, access programs, and patient services around the same goal: helping healthcare professionals help patients move from clinical intent to successful treatment. From Promotional Activity to Customer Journeys The pharmaceutical industry has historically organized commercial activity around the moment of promotion. Call plans, targeting models, and message sequencing were designed to influence prescribing behavior primarily through informational engagement with healthcare professionals. While this model brought structure and scale to commercial operations, it reflects an earlier era in which the path from clinical awareness to prescribing action was comparatively linear. Today the journey is far more complex. Physicians must navigate an intricate landscape of clinical evidence, treatment guidelines, payer requirements, prior authorization processes, patient affordability concerns, and adherence challenges. Prescribing a therapy is no longer a single decision point. It is the beginning of a chain of events that determines whether a patient ultimately receives and remains on treatment. This is why the commercial conversation must expand beyond the traditional moment of prescription to encompass three interconnected journeys. The first is the Path-to-Prescribe , where scientific evidence, clinical education, and confidence in the therapy shape the physician’s willingness to recommend treatment. The second is the Path-to-Fulfill, where access, affordability, patient readiness, and operational support determine whether that recommendation ultimately becomes therapy in the patient’s hands. The third is the Path-to-Adhere , where ongoing patient support, monitoring, and engagement determine whether patients remain on therapy long enough to realize the intended clinical benefit. Science drives the Path to Prescribe, where evidence, clinical education, and confidence in the therapy shape the physician’s willingness to recommend treatment. Experience shapes the Path to Fulfill, where access, affordability, and patient readiness determine whether that recommendation becomes therapy in the patient’s hands. Sustained outcomes depend on the Path to Adhere, where ongoing support, monitoring, and engagement ensure patients remain on therapy long enough to realize its intended clinical benefit. When commercial organizations focus almost exclusively on the first while leaving the latter journeys fragmented and burdened, a significant portion of therapeutic value is lost between intention and impact. In many therapeutic areas, the result appears in the persistent gap between prescriptions written, prescriptions filled, and therapies sustained—gaps that reflect not a failure of science but a failure of system design. Recognizing these three journeys shifts the unit of focus from promotional activity to the real-world pathways through which care is delivered. It reframes the role of the field force, the purpose of digital engagement, and the design of patient support programs around a single objective: reducing the friction that stands between clinical intent, treatment initiation, and sustained patient outcomes. Customer Context Is the New Commercial Variable For much of the pharmaceutical industry’s history, commercial performance was largely explained by a familiar set of variables. Product efficacy, clinical differentiation, promotional reach, and sales force execution determined the trajectory of most brands. When performance lagged, leaders adjusted those levers by refining segmentation, optimizing targeting, and recalibrating call plans. Today those traditional levers still matter, but they no longer explain commercial outcomes on their own. A far more powerful variable has entered the equation: customer context. HCPs now operate within an environment defined not only by clinical complexity and administrative burden but also by rising expectations shaped by their experiences outside healthcare. Physicians are also consumers. In their personal lives they interact daily with companies such as Apple, Amazon, Tesla, and Netflix that anticipate their needs, remove friction, and simplify complex processes through thoughtful design. These experiences quietly reset the benchmark for competence, responsiveness, and respect for their time. When those same physicians step into their clinical roles, they do not shed those expectations. They carry them with them. The contrast between the seamless orchestration of their consumer experiences and the fragmented systems surrounding many healthcare interactions becomes difficult to ignore. What once felt acceptable now feels unnecessarily burdensome. This dynamic represents the Consumer-Grade Imperative. Healthcare professionals increasingly evaluate pharmaceutical engagement not against other pharmaceutical companies but against the best experiences they encounter anywhere in their lives. In this environment even a clinically superior therapy can struggle if the surrounding system makes it difficult to initiate treatment, navigate reimbursement, or support patient adherence. Customer context therefore becomes the new commercial variable. It determines whether scientific differentiation translates into practical adoption. It shapes whether prescribing intent becomes therapy initiation and whether therapy initiation becomes sustained patient outcomes. Call plans were designed to manage activity. Customer context requires organizations to manage journeys. The Field Force in the Era of Customer Context Recognizing customer context as the defining commercial variable inevitably reshapes how the role of the field force is understood. For decades the pharmaceutical sales representative has been positioned primarily as the carrier of scientific information. Call plans optimized the frequency and sequencing of these interactions to ensure that physicians received consistent messaging. That role does not disappear, but the environment surrounding it has changed profoundly. Physicians today are navigating administrative burden, payer complexity, digital information overload, and increasing time pressure. In this environment they are not simply seeking more information. They are seeking clarity, simplicity, and support that helps them navigate the complexity surrounding treatment decisions. This shift transforms the representative from a messenger of information into something far more valuable: a partner in removing friction from the care journey. Conversations move beyond repeating clinical claims toward understanding the practical barriers that physicians and their teams face as they attempt to initiate and sustain therapy for patients. The most effective field forces are therefore supported by commercial systems designed around journeys rather than activities. Representatives are equipped not only with scientific messaging but with the insight and coordination required to address obstacles across prescribing, reimbursement, and patient support. Field engagement becomes a catalyst for problem solving rather than simply a vehicle for promotion. From Call Plans to Customer-Aligned Commercial Systems If customer context has become the defining commercial variable, then the systems designed to support the field must evolve accordingly. The traditional call plan was built to manage activity. It provided structure for how frequently physicians were engaged, how territories were covered, and how resources were deployed. Yet activity alone does not determine whether therapies ultimately reach patients. What determines impact is whether the commercial system surrounding the physician reduces or increases the burden of delivering care. A customer-aligned commercial system begins with the journeys through which physicians help patients move from diagnosis to treatment and beyond. Marketing clarifies the scientific story. Sales provides trusted relationships and real-time understanding of physician needs. Access teams simplify reimbursement pathways. Patient support programs reduce administrative burden. Digital engagement reinforces and extends human interaction. The result is a commercial system that operates less like disconnected functions and more like an integrated network designed to help physicians help patients. This is the essence of Customer Excellence. It aligns the entire commercial enterprise around the real-world context in which care is delivered. The problem was never the call plan. The problem was the context. Key Takeaways Commercial performance in pharma organizations has traditionally been managed through field execution mechanics, yet the effectiveness of those mechanics increasingly depends on how well they reflect the real-world context in which physicians operate. Customer context has become the most pivotal commercial variable as administrative burden, payer complexity, and consumer-grade expectations reshape how prescribing decisions are made. HCPs now evaluate pharmaceutical engagement against the best experiences they encounter anywhere in their lives, raising the standard for clarity, responsiveness, and ease. Optimizing promotional activity alone is no longer sufficient. Commercial success depends on reducing friction across the journeys physicians navigate as they move patients from diagnosis to treatment. Customer Excellence represents the structural response, aligning marketing, sales, access, digital engagement, and patient support around the real journeys of care delivery . Diagnostic Questions to Consider Are we optimizing the activity of our field force, or designing commercial systems that support the real journeys physicians navigate to help patients receive therapy? How well do we understand the administrative, reimbursement, and operational barriers physicians encounter after they decide to prescribe a therapy? Do our commercial systems reduce the burden placed on physicians and their staff , or unintentionally add to the complexity of care delivery? Are we benchmarking our engagement against other pharma companies , or against the best experiences physicians encounter in their lives as consumers? Have our investments in digital platforms simplified the physician’s experience, or multiplied the number of disconnected interactions they must manage? Are we still managing performance through activity metrics alone , or beginning to understand the context that ultimately determines whether therapies reach patients? Closing Reflection The pharma and life sciences industry has spent decades refining the mechanics of field execution. Call plans, segmentation models, and targeting systems brought structure and discipline to commercial organizations. Yet the environment surrounding physicians has evolved far more rapidly than the systems built to support them. Healthcare professionals now operate in a world defined by consumer-grade expectations for clarity, responsiveness, and ease. When the experience of engaging with a pharmaceutical company fails to reflect those expectations, the contrast becomes impossible to ignore. Organizations that recognize this shift will redesign their commercial systems around the realities of modern care delivery. They will move beyond managing activity and toward understanding the context in which physicians help patients receive treatment. In doing so they will close the gap between scientific innovation and real-world impact. Your breakthrough science deserves experiences worthy of it. Together, we turn customer excellence into real-world impact. About the Author Wayne Simmons is a hands-on commercial excellence architect and founder of The Customer Excellence Agency, where he partners with pharmaceutical and life sciences leaders to turn customer-centric ambition into durable commercial advantage. He previously served as Global Customer Excellence Lead within Pfizer’s Chief Marketing Organization and has held leadership roles with Bayer Pharmaceuticals and The Ritz-Carlton Leadership Center. Wayne writes The Customer-Centric Marketer newsletter and is the author of The Customer Excellence Enterprise: A Playbook for Creating Customers for Life. The Customer Excellence Agency: Advancing the Pursuit of Excellence in Service of Science.
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