What 40 Conversations About a Pandemic Taught Me About How Pharma Communicates

We have been telling ourselves a story about pharma communications for the past 20 years. The story goes like this: Global sets the strategy. Local affiliates adapt it for market. Trade, and maybe mainstream, media carry it. Health care professionals (HCPs) receive it. Patients, when included at all, are downstream. The job is to manage the cascade with as much sophistication, integration and measurement as we can afford. The story has been refined, digitized and omnichannel-ized. Yet the fundamental dynamic remains.

It needs replacing.

I have spent the past five years writing a doctoral thesis on how COVID-19 pandemic-era health information actually moves across mainstream and social media environments. It involves 40 in-depth interviews with 20 HCPs and 20 members of the public, 35 hours of recorded conversation, 15 months of rigorous qualitative analysis, with artificial intelligence-assisted thematic review running alongside it. I did the work in evenings and weekends while running global video and digital content strategy at Bayer. It was, in the technical sense, optional. I did not need a doctorate for the job. I did it because I wanted to know whether the pandemic communications model we have been operating on — which shares the shape of pharma’s global-local cascade, with the public at the bottom — still describes the world we are communicating in.

It does not.

The core research finding relevant to pharma audiences? Information about health no longer flows the way our models assume. People are no longer willing to passively receive what they are handed from the top — the deferrer society that traditional broadcast media produced. They now actively seek and weigh advice from friends, colleagues and peer networks — the referrer society that social platforms have built. Authority has moved sideways.

The substantive findings belong to the academic write-up, where they can be defended with the full apparatus of an interpretative phenomenological analysis. What I want to share here is the operational implication. Three shifts. None of them speculative. All of them visible in the data.

Shift one

The audience is not one audience. It is two, sometimes three. The HCPs and members of the public I interviewed inhabit overlapping but distinct media environments, with different information hierarchies, exposure patterns and relationships to authority. We design pharma communications as though there is a single “general public” downstream of the HCP audience. There is not. There is a heavily mediated information environment in which the public is increasingly sophisticated, HCPs are increasingly time-poor, and the gap between them is structural rather than accidental. A communications strategy that assumes a homogeneous public is one that lands late, with no one in particular.

Operationally: Stop designing for the average reader. The average reader does not exist. Segment your audiences by information-consumption pattern, not by demographic. One of the people I interviewed — a taxi driver who read the BBC scrupulously every morning — was, in the way he sourced and trusted information, structurally closer to a time-poor HCP than a pharmaceutical professional who takes their news exclusively from TikTok was to either of them. Demographics underpredict; information habits overpredict.

Shift two

Trust now attaches to individuals, not to institutions. Every participant in my study had lost institutional trust in at least one major source during the pandemic. Almost none had lost trust in specific named individuals — their own general practitioner, a clinical figure they followed on social media, a particular World Health Organization scientist, a named BBC correspondent. The unit of trust is now a person, not a logo. Pharma has historically organized itself around the institutional voice: the company spokesperson, the medical-affairs lead, the corporate communications function. The referrer-society architecture rewards something else: the named, credentialed individual who has done the work to be referred through networks, rather than the institutional voice that expects audiences to come to it.

Operationally: Invest in your named individuals. Not as media spokespeople in the old sense — the polished, message-controlled, risk-managed corporate voice — but as bona fide participants in the lateral networks where information now moves. This is more difficult for pharma than for most industries, because compliance, regulation and brand reputation all push against the kind of platform investment that medical affairs leaders genuinely need. The companies that solve this early will build a lead that compounds; the companies that do not will find, by 2030, that the networks have learned to route around them.

Shift three

The lateral network is faster than the institution. The pandemic demonstrated it repeatedly. The taxi driver I described took protective action against COVID-19 three weeks before government advice caught up. The medical student was being briefed by senior trainees on Twitter weeks before the consultants on her placement. The retired teacher in Yorkshire, England, heard of the virus’s arrival pattern from her son in Australia ahead of her own government. None of these were misinformation cases. They received correct information through the “wrong” channels — wrong only from the perspective of the deferrer-society architecture that pharma communications was designed for.

Operationally: Communication timing has to be benchmarked against the lateral network, not against institutional convention. By the time a clinical question is moving through HCP WhatsApp groups, the moment for the company to enter the conversation has usually passed. The function that treats the polished news release as the finish line is missing the reach that the modern environment now offers.

I want to be careful about what I am not saying. I am not saying compliance does not matter, that traditional media has stopped working or that pharma should operate like the creator economy. I am saying that the operational defaults we have inherited do not match the media environment we are communicating in, and that the gap is widening rather than closing.

Navigating ahead

What does this mean for like-minded leaders in life sciences? Three recommendations for the global-local model in this new world: First, treat segmentation by information-habit as the primary lens, with demographics as the secondary one. Second, invest in named clinical and scientific individuals as platform participants rather than as institutional spokespeople, with appropriate compliance scaffolding around them. Third, build faster decision rights for content release into the cascade, accepting that the content will sometimes be less polished than the legacy process produces, but that it arrives while it can still shape the conversation rather than after it has resolved.

None of this lets compliance off the hook, and none of it is easy in a regulated industry. The constraints on what pharma can say in public are real. But they are the constraints of a deferrer society architecture that was already eroding by 2015, and that the pandemic confirmed had given way. We are five years past that confirmation. That pharma communications still operates, broadly, as though the old architecture were intact: This is a strategic vulnerability — and a more urgent one than it looks, given the public-health threat of mass medical misinformation moving through exactly these lateral networks. The reassurance is that the hard part is already in place: An industry required to make every claim fair, balanced, accurate and substantiated is well built for an environment that rewards trustworthy sources. It is the operating model that needs to change, not the standards.

The PM Society recognition I received in 2025 was for the applied work that grew out of this research, not for the thesis itself; the citation described that work as “disrupting the global-local model.” I will be honest: At the time, I had not fully understood what the disruption would require. I do now. It requires us to stop optimizing for an information environment that no longer exists, and to start designing for the one we have. Forty conversations and a doctorate later, I am as sure of that as I am of anything in this field.

The companies that move first will compound the advantage. The companies that wait will, by the end of the decade, find themselves talking with great sophistication into an empty room.

Kishan Rees is senior director, video and digital content strategy, within global medical and evidence at Bayer.