Five or so years ago, healthcare agencies were bracing for the looming end of the lucrative blockbuster drug era, fearing that factors from expiring patents on big-name brands like Lipitor to the exorbitant cost of bringing new drugs to market were going to tank their business.

But here we are, not even half-way through 2018, and the sector is flourishing, with healthcare agencies of all stripes demonstrating growth that outpaces their counterparts serving other industries. That much is clearly reflected in the Holmes Report's 2018 Agency of the Year finalists, which featured a disproportionate number of healthcare firms, not just in the healthcare category, but across size and specialty areas.   

CURA Strategies, for example, was named New Agency of the Year, while WPP’s GCI Health and Interpublic’s dna Communications were shortlisted in the midsize and small agency categories respectively. Jarrard Phillips Cate & Hancock was a boutique firm finalist; and JPA Health Communications was a public affairs agency of the year contender.

The healthcare category itself, won by Finn Partners, featured another four firms that are thriving in Biosector2, RxMosaic, Spectrum and Weber Shandwick. And it is worth noting that while W2O and Marina Maher Communications, the latter of which was named Agency of the Year, serve multiple sectors, both are well-known for their superior healthcare capabilities

The key to these performances? Big pharma, long the core of healthcare PR, didn't go away as feared. It just changed.

Rather than focusing foremost on creating the next  $1 billion a year blockbuster drug, pharmaceutical companies today are concentrating more heavily on finding treatments for rarer, but possibly more serious, conditions than the ones blockbusters address — widespread ailments like arthritis and high cholesterol. There are, for instance, reportedly 4,000 cancer treatments alone in development.

Those kinds of drugs don't have the reach that blockbusters do. They could, however, have greater impact, and are in demand among patients and healthcare providers seeking options for treating debilitating and terminal diseases. And drug companies, which only recently have become more comfortable non-traditional communications options, are turning to PR practitioners to help bring them to market in ways that match complexity of the healthcare industry.

It doesn't hurt that healthcare remains an enormously relevant sector, with topics from public health scares and breakthrough treatments to the politics of affordable care foremost on consumers' minds, as well as on the national agenda. Increasingly, agencies serving the sector are being called on to expand their efforts in a bid to make their clients meaningful participants in the public discourse.

Just take a look at some of the issues healthcare firms addressed in 2017 — opioid abuse, veterans care, diabetes and heart disease. They partnered with patient advocacy groups, health organizations and hospitals, as well as the big pharmaceutical companies that have long been the core of their business, helping guide those players as they faced steeper challenges in everything from reaching consumers, rallying healthcare providers as well as a navigating the rigorous regulatory process.

All of which helps explain why healthcare PR practitioners are flourishing. They practice an art that few outside the sector can do with the same savvy and expertise. Revolving around a highly regulated industry, healthcare communications has to make exceedingly complex science easy to understand, reach target groups grappling with disease of varying severity and advocate for patients and healthcare providers, while also lobbying for change.

“It’s high-level, it’s high-touch and it’s a very complicated space,” said Emily Poe, who is W2O's global healthcare practice leader.

Healthcare companies, which have long played their public relations conservatively, are opening up to new strategies in communications, triggering a noticeable shift in terms of creativity and channels they will leverage in campaigns, said other industry insiders.

"It’s no secret that those of us in healthcare were feeling behind or stalled in our ability to engage the community in a social or digital way as we watched other industries power forward,” said Michele Schimmel, managing director of Rx Mosaic Health, which is part of Marina Maher. “But we are finally catching up, and saying yes, we can do that."

Earned media is still critical to the practice (W2O has roughly two dozen earned media specialists in its healthcare sector). But there are also more initiatives like the social effort Rx Mosaic crafted in support of Pfizer's pneumococcal vaccine Prevnar, which Schimmel said had measurable impact.

GCI Health CEO Wendy Lund is also seeing an uptick in business due to that change in mindset. “The industry is just taking a much more integrated approach,” she said, adding that PR firms are able to elevate creativity, while leveraging insights and strategy in new ways. “We find that clients are coming to us over advertising agencies, which is our goal.”

Big pharma and biotech are still behind much of the rise in business. But agencies today are getting business from a host of other players in the arena — biotech companies, healthcare providers, nonprofits and medical tech and device manufacturers among them.“All these sectors are contributing to the overall industry growth, and it all knits together,” Lund said.

Promoting those treatment options, however, comes with challenges beyond reaching core stakeholders, notably healthcare providers and patients. Much work now involves helping clients in areas such as pricing and reimbursement strategies to the expansion of patient access to their products. At the same time, there are sensitivities particular to speaking to patients looking for cures.

“There is some really cool science happening in oncology, and so there is an even greater need to understand that science and to understand its benefit,” Poe said. With that, however, campaigns must “not unrealistically raise patients’ expectations,” she said.

Agency expansion may also be helped by an industry that is under increasing scrutiny, upping the importance of proactive reputation management, said dna EVP Michael Rinaldo.

“The need to actively direct your own storyline has never been more important,” he said.

But doing that is not only about averting potential issues or maintaining a reputation. “The stakes are higher but there are opportunities for these companies to grow as options expand and patients and providers are taking note,” he said.

“For a lot of years in this business we spent a lot of time in the preapproval part of the process, determining how we were going to tell the science story. Today you have to understand what your value story is as well," he said, adding that drug companies now expect their messages to patients and providers be embedded in all communications.

“You may get all the science right,” Rinaldo said. “But if you haven’t crafted a story about the value of what you’re bringing to the marketplace, you are going to face challenges.”