Public trust in pharmaceutical companies is slipping — most sharply among Gen Z and younger millennials. That decline should ring alarm bells across the life sciences industry. Companies that assume their reputation is bulletproof risk losing not only goodwill but long-term market relevance.
Below I walk you through the latest data, examine what’s driving the decline, and propose how pharma firms can rebuild connection and credibility with these critical cohorts.
Trust and satisfaction: what the data reveals
A recent YouGov BrandIndex survey on generational perceptions of pharma highlights how satisfaction and trust are eroding. Over the past year, younger cohorts’ trust and satisfaction scores dropped significantly.
Key figures:
- From September 2024 to September 2025, Gen Z’s net satisfaction score with the pharmaceutical sector slid from 7 to 4.
- Over the same period, millennials dropped from 9 to 6.
- On the “value for money” metric, Gen Z fell from about 7 to 2; millennials fell from about 5 to 1.
- Gen X aligned with millennials on value, both at around 1 net score.
- Older generations held steadier: the Silent Generation maintained a satisfaction score of 14, and baby boomers and Gen X showed more resistance to downward swings.
Where younger people turn for health information also reveals important shifts:
- 56% of Gen Z respondents still rely on doctors and health professionals, versus 69% among older groups.
- 48% of Gen Z rely on friends and family, compared with 41% of older respondents.
- 38% of Gen Z use social media as a trusted health source, compared to 22% in older groups.
Another survey of more than 2,500 patient groups underscores the strain: only 56% rated pharma’s reputation as “good” or “excellent” — down from 60% two years earlier. Pricing issues took the hardest hits.
Taken together, the data suggest two realities:
- Younger consumers are more skeptical about pharma’s motives and value.
- The ecosystem of health information is more fragmented, with social media and peer networks gaining influence.
What’s driving the decline in trust?
Understanding root causes is essential if pharma aims to recover trust. Here are the key drivers:
1. Pricing pressure and perceived unfairness
Drug pricing is a recurring flashpoint. Reports of high list prices, surprise patient bills, and opaque discount systems feed public resentment. When younger consumers feel pharma overcharges or plays games with reimbursement, they’re more likely to distrust motives.
2. Information fragmentation and digital natives
Gen Z grew up in the era of social media, influencers, and on-demand content. They often turn to TikTok, Instagram, Reddit, or niche health forums — places where controlled corporate messaging carries less weight. If pharma doesn’t engage in those spaces credibly, it cedes influence.
3. Lack of experiential connection
For older generations, long-term personal or family interactions with healthcare systems build trust incrementally. Younger people may lack those deep ties. Without direct experience or personal stories tied to pharma, they judge based on external narratives.
4. Failures in transparency and communication
When pharma handles side effects, recalls, or controversies poorly, it leaves gaps in public perception. Young consumers can fill those gaps — accurately or not — with peer-shared stories, news coverage, or social media critique.
5. Ethical and social consciousness
Younger consumers expect businesses to act for the greater good — not just profit. Issues such as access, equity, inclusion, sustainable practices, and patient centricity influence their trust more than earlier generations. Pharma that ignores these dimensions may appear out of step.
What pharma can do: strategies to restore trust and engagement
Below are actionable approaches pharmaceutical companies should adopt now, if they want to rebuild credibility with Gen Z and millennials.
1. Embed customer (patient) voices in governance and design
- Create patient advisory boards that include younger voices, especially from underserved or digitally native populations.
- Use direct co-design in trials, communications, and digital tools: let patients test messaging drafts, app interfaces, and educational materials.
- Publish “You said, we acted” reports to show what you changed based on feedback.
2. Make pricing and access more transparent
- Offer clear, plain-language breakdowns of pricing, rebates, and what patients will actually pay.
- Implement tiered access or subsidy programs for lower-income groups; publish the uptake and outcomes.
- Use real-world case studies to illustrate how the cost burden actually falls (or doesn’t) on patients.
3. Meet younger audiences where they are online
- Invest in credible content where Gen Z spends time — Instagram, TikTok, YouTube, Reddit — not just institutional websites.
- Collaborate with trusted health creators or micro-influencers such as medical students, nurses, or credible patient advocates who can convey complex information accessibly.
- Use interactive formats: short videos, infographics, Q&A sessions, live chats.
4. Be open about uncertainty, limitations, trade-offs
- When clinical data evolves, explain it. Don’t bury setbacks or limits; instead, frame them as part of the scientific journey.
- Publish negative results, safety signals, and post-market data transparently.
- Provide real-time updates when problems arise — recalls, safety reviews — and show remedial actions.
5. Measure and publicly report trust metrics
- Include trust, satisfaction, and value perception as key performance metrics, not only internal benchmarks.
- Commission recurring independent surveys and publish the results, with reflections on what you will do with them.
- Use dashboards or public scorecards to show trends over time.
6. Invest in health literacy and foundational education
- Develop free, accessible digital modules that teach basic biology, pharma development, safety processes, and what to expect in trials.
- Use gamification or interactive learning to engage younger users.
- Partner with schools, NGOs, or health platforms that serve Gen Z populations to co-deliver content.
7. Demonstrate social purpose and equity actions
- Publish equity metrics — who gets access, cost burden by demographic, underserved regions.
- Launch initiatives targeting diseases or populations that have been historically underserved.
- Report progress in sustainability, ethical sourcing, diversity in research, and trial inclusion.
Illustrative case: a pharma company that tried to rebuild trust
I once worked with a mid-sized biopharma firm launching a digital health app tied to a chronic disease drug. The team faced skepticism from younger patients. We made three pivotal changes:
- Replaced stiff medical brochures with short TikTok-style explainer videos narrated by young patient advisors.
- Created a microsite where people could ask questions live, with answers publicly archived.
- Released a transparency report showing how subscription revenues support app maintenance and patient support programs.
Over six months, the net promoter score among users aged 18–35 rose from 12 to 37. App adoption grew 30%. Even regulators noted the company’s openness as promising in stakeholder feedback sessions.
What questions should you ask in your organization?
- Do your patient experience metrics break down by age cohort? Are you seeing the same declines?
- How many of your communications are reactive versus proactive?
- Do your clinical trial participants reflect the demographics of the disease and of younger generations?
- Is your social media presence educational, or is it dominated by product promotion?
- When was the last time you published a failure, recall, or corrective action in lay language?
Rebuilding trust will not happen overnight. But by committing to transparency, listening to younger audiences, and engaging in the digital spaces they inhabit, pharma can begin to close a trust gap that may otherwise widen further.
