Influencers are becoming a bigger part of pharmaceutical companies’ marketing mix, and not just for helping firms gain a better understanding of their audiences. The industry is also employing savvy patients for a more distinctly bottom-line goal: drumming up awareness for launch brands. 

After Eli Lilly received Food and Drug Administration approval for Alzheimer’s drug Kisunla last month, a company exec was quoted as saying the drugmaker “really needs to raise awareness that there are now medicines available.” 

Lilly declined to disclose specific details of its Kisunla marketing initiatives for this article. But there is reason to believe the plan for raising immediate awareness may include use of the subset known as “granfluencers.”

Recent years have seen the rise of a growing cohort of older-adult content creators who have gone viral on TikTok and Instagram. Grandmothers, some well into their 90s, have drawn millions of fans by portraying themselves in a much younger light than their biological age, openly discussing their ailments and doling out homespun wisdom.

Researchers studying this phenomenon have suggested that these silver-haired celebs can combat ageism in the media and empower peers by moving them toward “successful aging.” Granfluencers are “changing how we think about how older adults engage in social media,” explained Amelia Burke-Garcia, author of the 2020 book Influencing Health: A Comprehensive Guide to Working with Online Influencers.

“These can be persuasive voices on key health issues affecting this community,” added Burke-Garcia, who leads the Center for Health Communication Science and the digital strategy and outreach program for NORC at the University of Chicago. 

Usage trends are fueling the rise. Although those on the older end of the spectrum make up the smallest share of TikTok users, between 2021 and 2023 the 55-and-up cohort was the platform’s fastest-growing user segment. Meanwhile, YouTube users already skew gray: As of December, 17.8% of viewers were at least 55. That’s a huge audience for health-adjacent brands.

To that point, there are “great opportunities” for granfluencer outreach to support Alzheimer’s-related communications, Burke-Garcia noted.

They’re powerful messengers, both inside and outside their communities — which makes them well-suited for use in the Alzheimer’s realm, where the patient journey tends to focus on the support team. Various audiences are involved, including older children making decisions on their parents’ behalf.

Granfluencers “also have a growing following of younger people, which is great for reaching caregivers and others who provide support to this community,” Burke-Garcia said, adding that they have the ability to share personal experiences and answer questions based on what they’ve gone through.

“They can have more nuanced conversations with their followers about specific steps and/or decisions that need to be made related to a health issue or new diagnosis.” 

When industry marketers tap influencers, it’s usually for disease or market awareness. But they can also help stimulate demand for new products.

As proof, Burke-Garcia cites growth in the market for global influencer marketing, which has more than tripled since 2019 and is estimated to reach $24 billion this year. “This growth speaks to the effectiveness of influencer marketing to connect businesses with their audiences and drive sales,” she explained. 

Agencies say they’re putting medical- and health-focused influencers to work for clients on both the HCP and patient sides, and at all points in the marketing funnel. This past year, for example, the IPG Health network launched a capability called Influencer ID. The platform offers clients the ability to identify and engage with the right influencers for client brands. 

IPG Health’s Area 23 serves as AOR for Kisunla.

“When we have a launch brand that needs to get impact quickly, influencers are certainly part of the media mix,” said Casey Ross, SVP and social media strategy group director at FCB Health NY, an Area 23 sibling. “They establish credibility for the pharma company in a specific patient community or HCP peer-to-peer communities.”

That’s important in an age when some influencers exacerbate the spread of health misinformation. Considering the magnitude of falsehood festering online, there’s a “need for that credible, authentic information to be parsed out,” Ross added.

All of which would seem to feed speculation that Kisunla may take advantage of influencers as a marketing tool. 

The first drug in the anti-amyloid class to earn an FDA green light was Eisai/Biogen’s Aduhelm. But even before its initial approval in June 2021, Aduhelm was beset by a myriad of challenges. The treatment never established itself in the market and, in its wake, left a great deal of skepticism about the category. 

Next came Eisai/Biogen’s Leqembi, a similar treatment which won traditional approval from the FDA a year ago. It too struggled to gain traction due to an early data-collection requirement for Medicare payment and limited diagnostic infrastructure, as well as the availability of infusion centers for receiving the twice-monthly drug. Only about 6,500 patients have received the therapy; second-quarter sales were around $40 million globally. 

An Eisai spokesperson said that a significant number of health systems have established a diagnostic and care pathway for Leqembi, and that the company continues to assist HCPs and hospitals in establishing that infrastructure. Meanwhile, it’s focused on raising awareness about the importance of early diagnosis and treatment through an educational campaign, “You Still Can Be with Leqembi,” and has launched a branded Facebook page.

Lilly is hoping for a faster start from Kisunla, which was approved July 2 as a drug infused once monthly to clear amyloid plaque the hallmark of Alzheimer’s disease from the brain in adults with mild Alzheimer’s. In clinical trials, the drug was shown to slow patients’ cognitive decline by 35% versus placebo over 18 months of treatment.

Analysts point to differences between Kisunla and Leqembi that may affect their competitive profiles. While both are I.V. infusion meds, Biogen is expected to launch a subcutaneous form of Leqembi next year which will make it the more convenient option. 

Kisunla has more safety liabilities. And whereas Leqembi is designed for chronic use, Lilly has positioned its drug for cessation of therapy after plaque clearance, based on imaging of the brain, after either six, 12 or 18 months of use. 

Thus far, Lilly has invested in awareness efforts to lay the groundwork for Kisunla’s arrival. A series of videos in 2022 featured Lilly execs talking about their personal experiences with Alzheimer’s. 

Last year, a consumer-focused ad drove people to a patient-facing website that describes early signs of memory issues. This year’s TV spot, dubbed “Don’t Forget,” portrayed life with the disease. 

Now that Kisunla has marketing clearance, a Lilly spokesperson said the manufacturer is proceeding in a manner “similar to other recent product launches.” 

The company has “deployed Kisunla educational information and resources through various personal and digital channels to support and engage a broad set of external stakeholders, including healthcare professionals, integrated health system decision-makers, as well as patients and their loved ones,” the spokesperson said.

Field forces have met with hospitals to educate them on the unique aspects of the treatment including the need to monitor patients for brain bleeds, which impacted about a quarter of trial subjects. Medicare is expected to reimburse for the drug, as it has with Leqembi, but getting Kisunla on commercial plans will be a heavier lift. A consensus of Wall Street analysts forecast Kisunla’s annual sales to reach $3.7 billion by 2030.

There’s precedent for tapping celebrities in the rollout. The Indiana drugmaker has featured Simone Biles in both its latest corporate video and in a branded commercial for diabetes drug Mounjaro that began airing earlier this year.

That said, adding granfluencers to the playbook wouldn’t be a straightforward matter. Why? Because influential seniors are harder to find.

“There simply aren’t as many of them,” Ross shrugged. “A beauty blogger or a gamer throw a rock outside and you’ll hit 30 of them. The granfluencer space isn’t as big.”

To be a fit, a granfluencer like any other influencer must have natural synergies with a disease state or brand. Additionally, extensive vetting must be done to verify not only that the person is who they claim to be, but to hedge against the possibility that they might say something down the road that may sully the brand, pharma company or advertising network.

Still, the granfluencer trend is only expected to increase, especially as Gen X ages up. “They take the brand out of the way. They take ‘talk to your doctor about our product’ out of the way,” Ross said. “They just deliver our message in an authentic way.”

Helen Elam Van Winkle one of the most popular granfluencers, with 3.1 million followers on Instagram has brand deals with MGM Resorts, Tillamook Ice Cream and Smirnoff Ice. Will we see the grannies and grandads of TikTok and Instagram enter paid collabs with a pharma brand to deliver messages to peers, or even to Gen Z, about the importance of pulling out all the stops in the fight against cognitive decline? Time will tell.