Why Consumer CX Does Not Translate to Pharma
Pharma is different is the most overused sentence in this industry, and it is usually an excuse. On this one question it happens to be correct.
The customer experience discipline that arrived here was built somewhere else, for markets that work differently in four specific ways. It underperformed. The industry watched that happen and concluded that experience does not drive commercial outcomes in pharma. The right conclusion was narrower. The imported version did not fit, and nobody had yet built the version that would.
I say that as someone who taught the imported version. Before pharma I led delivery at the Ritz-Carlton Leadership Center, where service is an engineered system and the Credo is a working document rather than a wall poster. That model is superb. It also assumes four things about your market that are not true.
What did pharma actually import?
Three things, and none of them were adapted on the way in.
An instrument, built on surveys and an advocacy score, which Fred Reichheld set out in the Harvard Business Review in 2003 for industries where customers choose freely and buy repeatedly. An organizational shape, the CX function, sitting beside commercial rather than inside it. A logic, which says a satisfied customer buys again.
The results were visible early. Bain's pharma work noted that the industry rated among the least customer friendly in a 2011 Harris poll, down 43% from a similar poll in 1997. That reading is old now, and the direction has not reversed. In 2025, a DHC Group survey reported by eMarketer found just 16% of respondents view the pharma industry as patient centric.
Why does a three person market break the instruments?
Because your customer is not one person.
A physician chooses. A payer decides whether to cover. A patient uses the therapy and pays part of the cost. Three people, three sets of interests, and none of them holds the whole relationship with you.
Every consumer instrument assumes those three are the same person. Loyalty assumes the chooser can come back. Repeat purchase assumes the user controls the next transaction. Advocacy assumes the person recommending you is the person who paid. Take that unity away and the arithmetic stops working.
Here is what it looks like in practice. A physician who thinks highly of your company writes a prescription that a payer refuses and a patient abandons at the counter. Your survey score holds steady. Your realized value does not. The instrument cannot see the failure because the failure happened to someone it never asked.
Why can you not close the loop the way retail can?
A retailer hears a complaint and fixes it with the customer directly. That loop is the engine of the whole discipline. Yours is partly closed by law and partly invisible by structure.
You often cannot contact the patient. In most markets you cannot discuss the product with them. You frequently cannot see what happened at the pharmacy counter, inside the payer's adjudication, or in the thirty seconds when the office staff decided the appeal was not worth filing.
Consumer service has its own version of this problem and it is instructive. Gartner found that 62% of customer service channel transitions are high effort for customers, in industries where the company can watch the transition happen. You often cannot watch yours at all. An instrument designed around a loop you do not have will report that things are fine right up until they are not.
Why does the value event sit outside your control?
In retail the value event is the purchase, and it happens in front of you. In pharma the value event is sustained therapy, months later, handled by payers, pharmacies, hubs, specialty distributors and office staff you do not employ.
The numbers on that interval are not subtle. A 2026 study in JAMA, summarized by Johns Hopkins, found insurer rejections of brand name prescriptions reached 40.7% of initial 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 a prescription costs the patient more than $250.
The imported model counts the transaction. Your transaction is a prescription, and a prescription is intent. Everything that determines whether intent becomes value happens after the point where your commercial system stops counting. We call the difference value leakage.
Does regulation really prevent better experience?
Ask most commercial leaders why the experience is what it is and regulation comes up inside a minute. It is the industry's standing answer, and it is mostly wrong.
Regulation governs claims. It constrains what you may say about efficacy and safety, to whom, through which channel, in which market. Those constraints are real and they are not going away.
Regulation says almost nothing about operational burden. It does not require a prior authorization to take three calls. It does not require a hub to ask for the same information twice. It does not require anyone to leave a physician's office guessing about whether a case stalled. 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. Almost none of that delay is a regulatory requirement.
That is the most commercially useful distinction in this argument. Most of the friction your customers meet is not required of you. It is unowned, which is a very different problem and a much more solvable one.
What had to be rebuilt
Four substitutions, each replacing something that came in the imported box.
Measurement moved from sentiment to progression. Not how your customers feel, but whether they advanced: script to start conversion, time to therapy, stall points, persistence, barrier resolution speed, realized value against earned value.
Accountability moved from functions to handoffs. Access, brand, field, medical and patient support can each hit their internal standard while the patient stops moving, because the failure lives between them. Somebody has to own the seam.
The field moved from a delivery channel to a sensing system. Your reps and MSLs meet a new payer policy weeks before any dashboard registers it, and most companies have nowhere to put that signal.
Experience moved from a downstream consequence to a design variable, sitting beside brand and product rather than inheriting whatever those two leave behind. That is the discipline we now call Customer Excellence, and the bar it is built to clear is Consumer-Grade.
Where does it have to live?
Inside the commercial system, not beside it.
A program has its own budget line, its own team and its own dashboard, which is exactly why it can be cut in a bad quarter without anything else changing. What replaced it has to be carried on commercial numbers, owned by commercial leaders, and visible in how brands are run and reviewed. If your experience work disappears when the CX team does, you built the wrong thing.
The industry is arriving at the same place from a different direction. When Eli Lilly launched LillyDirect, David Ricks framed it around how the healthcare system "adds to the burdens patients face". Novartis launched its Cosentyx platform because, in its US president's words, the company needs "new ways to reach patients more directly by removing barriers in the system." Neither of those is a CX program. Both are commercial system changes aimed at burden.
Meanwhile the gap the imported model left behind is still open. 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.
Key takeaways
- Consumer CX arrived in pharma with its instrument, its org shape and its logic unchanged, and all three assume a market you do not operate in.
- Your chooser, payer and user are three different people, which breaks loyalty, repeat purchase and advocacy as measures.
- The feedback loop the discipline depends on is partly closed to you by law and partly invisible by structure.
- Your value event is sustained therapy, months after the transaction your system counts.
- Regulation governs claims, not burden, so most of the friction your customers meet is unowned rather than required.
Questions to ask your leadership team
- Which of your experience measures would still mean something if the chooser, the payer and the user were three different people, because they are?
- When a patient stalls, how do you find out, and how long does it take?
- Name three sources of friction your customers meet that you have attributed to regulation. How many are actually required?
- Who owns the seam between access and patient support, by name?
- If your CX team were dissolved tomorrow, which commercial numbers would change?
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 learned service delivery at the Ritz-Carlton Leadership Center before leading global customer excellence in Pfizer's first Chief Marketing Organization and in Bayer's Customer Powerhouse. Related reading: Why pharma CX programs fail, Pharma customer experience, why it stalls and what replaces it and What is Customer Excellence in pharma?







