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
- Of last month's prescriptions, how many became treated patients, and does that number appear anywhere in your reporting?
- What is your median time to therapy, and how much does it vary by payer?
- Name your top three stall points and the owner of each, by name.
- How much money is sitting in unresolved barriers right now, and who reports that figure?
- 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?







