MM+M’s June 2021 issue chronicled the healthcare marketing industry’s encounter with the first year of the global pandemic. In year two, some of the trends changed, but the unpredictability that characterized the landscape of 2020 only intensified, as did the need for companies to navigate the near-constant fluidity.

As such, “the plot thickens” seemed like an apt metaphor. From the reopening of the medical system and resumption of in-person engagement to the legion of digital product launches and opportunities to leverage technology, 2021 was another eventful year for healthcare marketing firms and health-focused consultancies. 

Most seem to have adapted well. Each year, MM+M surveys the industry on its performance, basing the Top 100 list on those companies with the highest North American revenue. This year’s survey, fielded between January and March, portrays an industry going from strength to strength, despite (or perhaps because of) the upheaval.

Record revenue

Combined 2021 revenue for the Top 100 firms reached a record high of $7.8 billion, thanks to a 19% surge over the prior year’s adjusted level of $6.6 billion, which in itself represented a new high*. Staff counts, meanwhile, rose a collective 24% to 34,888, from 2020’s adjusted tally of 28,077.

A second consecutive year of double-digit growth in both billings and head count is certainly remarkable, but also understandable when viewed in context. Probably the most defining factor of 2020 from a pharma-marketing perspective was the prospect of zero or very low in-person contact with doctors, a situation which extended well into 2021 and necessitated many new forms of virtual engagement.

The impact is still being felt. Consider that, for 87% of respondents, business continued to ramp up in early 2022, per our survey results. How high have they seen it go? 37% said their business was up 11%-25%, although most (41%) said it was up 0%-10%. Another 18% said business was up more than 25%.

Companies had to shift into digital mode in order to keep their drug, device and diagnostic launches on track in 2020. One look at last year’s service mix shows biopharma and med-tech companies got no reprieve from that tricky task. 

The service mix

Professional web/digital/mobile work accounted for the lion’s share of billings, with sales materials coming in third and promotional med-ed fourth. At the start of the pandemic, such work may have involved digitizing glossy sales aids, expanding virtual meetings and retooling historically in-person events (product theaters, advisory boards, rep details) for the web. 

Moving into year two, that work entailed digital and virtual work while bringing back physical events. When it comes to professional marketing, the new standard became a hybrid approach balancing non-personal promotion with in-
person touchpoints in a way that maximizes options for busy clinicians

Meanwhile, consumer web/digital/mobile work ranked second on the list of revenue drivers. The need to design engaging ways for patients to learn about conditions and products, whether those people are homebound or able to access the medical system in traditional ways, clearly remained paramount.

AI’s import

One would be hard-pressed to find an area in which healthcare marketing is not becoming more data-driven. The rise in marketing research/analytics billings (from fifth place to fourth) likely reflects its importance to the industry’s future: 93% of respondents cited analytics as a trend they expect to see to a greater extent this year, with 78% saying the same for data science.

AI and machine learning are not only being used to help clients more efficiently deploy their field forces, but also to generate tailored insights for driving creative. Moreover, data science is being tapped to design conversational agents that automate various aspects of customer engagement, from chatbots on brand.com sites to virtual assistants able to provide information to HCPs 24/7/365.

Among other changes, user experience moved up a spot to seventh place. Perhaps belying the trend toward personalization, the most dynamic mover was consumer broadcast, gaining three places. 

Closely tied to the revenue mix is the nature of companies’ growth. When we asked respondents what percentage of their growth came from existing clients versus new ones, the breakdown was 65% to 35%. 

That lends credence to the popular refrain among the Top 100 firms about the importance of deepening their client relationship. They’re doing so by adding brands from familiar clients and extending longtime accounts into new channels and disciplines. 

Challenges and perks

That the vast majority of firms seem to be finding success organically is perhaps another reason for a perceived lack of interest in private-equity funding. When asked about the need for such backing, 97% cited it as a “minimal” challenge.

The finding highlights a growing schism in the industry between firms that have accepted PE monies and those that have not. PE capital to an agency is like anabolic steroids to an athlete. For businesses, the backing can lead to quick growth through bolt-on acquisitions; organic progress is typically slower.

On the other end of the spectrum, talent acquisition and retention continues to be far and away the industry’s main gripe, as it has been for several years. It was rated a “significant” challenge for nearly half of respondents, up from 32.5% last year. That the problem has only worsened, even after a full year of talent managers being able to recruit free of the usual geographic restrictions, is saying something. 

Prior to the pandemic, some firms had allowed staff the freedom to work remotely. Coming out of it, more plan to make WFH a fixture: 97% of the Top 100 noted that it’s an element of their company’s COVID-19 response that will remain in 2022. Other perks set to endure include mental health support (88%), stipends to cover home office expenses (49%) and child care (40%). 

With year three of the pandemic well underway, most respondents (95%) said their digital experimentation will continue. At the same time, only 7% said securing an audience with HCPs, either virtually or otherwise, was a “significant” challenge. That’s a sign that perhaps companies are doing digital less out of a sense of desperation than a desire to improve their omnichannel offerings.

Moreover, half of respondents cited “ongoing fallout from the pandemic” as something they expect to be dealing with this year — which suggests that the other half is ready to move on from COVID. Given the aforementioned volatility, anything is possible in the latter part of 2022. 


* Revenue and head count totals are based on data that companies submitted as part of MM+M’s annual agency review and reflect the agencies in the Top 100. Data are taken from the annual agency reviews and supplemented by estimates made by the MM+M data team, and includes numbers from certain firms that had been unavailable in 2020. Revenue and employment numbers for parent companies and certain network-owned firms were accounted for to prevent double-counting in these totals.