The past few months have been rife with headlines from the world of Twitter. That may not be unusual, but this time, the news has been all about Twitter – and, more specifically, about its new owner and CEO, Elon Musk. Since Musk’s acquisition of Twitter on October 27, he has made changes to the company that have been, at best, chaotic, and, at worst, damaging to the reputation and financial stability of the company.

One of the biggest updates Musk enacted was the selling of the verified blue check mark for $8 in early November 2022, as part of the Twitter Blue subscription. Just days after the new Twitter Blue check marks went up for sale, fake “verified” accounts started popping up across Twitter.

On November 10, a fake – yet “verified” – Twitter account called @EliLillyandCo tweeted, “We are excited to announce insulin is free now.” This was not, of course, the actual Eli Lilly and Company posting this, but they definitely absorbed the brunt of the tweet’s aftermath. Over the next couple of trading days, the Eli Lilly stock dropped more than 6% with other insulin producers’ stocks dropping as well.

In the weeks and months since, most pharma companies have either pulled back on their Twitter Ad spend or paused it entirely, as they determine what to do with this new Musk-run Twitter.

With this industry pause on Twitter advertising, one question arose for us … have they also paused utilizing Twitter from an organic perspective? Did they also stop publishing other content to Twitter? We decided to investigate this question with our Digital Social Analytics team, and the short answer is, no, most pharma companies are still posting on Twitter. The fact of the matter is, Twitter is still functioning as-intended, and audiences are still active on Twitter. While there has been news of users abandoning the platform for other options like Mastodon or Discord, those alternatives are not quite as user-friendly as Twitter, so we don’t expect the sort of simple adoption that Twitter affords. Additionally, Twitter had recently seen a 23% increase in app downloads over the same 31-day period in 2021, which is likely related to constant news headlines Twitter and Musk made.

In an analysis of the Twitter handles of the top-20 pharma companies (including those companies with US-specific Twitter handles), we found that, while total Twitter publishing activity fell throughout November and December of 2022 (post-Musk’s acquisition), it did not go away entirely, as the advertising activity did. In October 2022, those top-20 pharma companies published 1,515 Tweets. In November, there were 1,080 Tweets published, and in December, 627 Tweets were published. And we should note that December typically sees a drop in social media activity, due to the holidays and active awareness days/months in October.


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In terms of what individual companies were doing with their Twitter handles, it varied. Most companies did Tweet less often throughout November and December. A few companies, such as Merck, Astra Zeneca US, Eli Lilly, Astellas, and Boehringer greatly decreased or paused their organic Twitter posts, entirely, in December. Conversely, companies such as Pfizer, Janssen, AbbVie, Novartis, BMS, AstraZeneca, Sanofi, GSK, Amgen, NovoNordisk, and BioNTech have either maintained or even increased their Twitter presence through December.

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And in terms of the types of content the companies were posting, we further analyzed the nature of the posts throughout October, November, and December. What we found was that the companies maintained the distribution of content categories among these types of posts: Conference/Congress, Company News, Disease Info/Awareness, Reply, Science, and Other. Over that time frame, only “Disease Info/Awareness” saw a decrease in the percentage of posts, which seems natural for December and given that October is a big disease awareness month.

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This shows that nearly all pharma companies, despite being spooked by the fake Eli Lilly Twitter debacle, are continuing to utilize their Twitter handles as they had prior to the Elon Musk acquisition. These pharma companies have spent years building up the equity of their Twitter following, so that they can share their news and updates with their key stakeholders. This means using best practices for posting organic content to your Twitter feed. Remember that only around 1-6% of your followers will see your organic Tweets, so it’s all the more important to make those Tweets as engaging as possible. It’s also a matter of when you’re publishing that organic Twitter content. Typically, the best time for engagement on Twitter is 9:00 a.m. ET on Mondays, Tuesdays, Wednesdays, Fridays and Saturdays. Or, if you utilize an SMMT (Social Media Management Tool), you can utilize their “post at optimal time” feature, if they offer that.

As long as the audience and functionality of Twitter remain in place, Twitter can and should still be used as a platform for connecting with patients, healthcare providers, journalists, advocacy, and investors because those stakeholders are continuing to use the platform.

About the Author:

Matthew Snodgrass is a lead in Digital & Social Strategy at Syneos Health in New York. He has more than twenty years of experience in digital marketing with a concentration in health and pharmaceuticals. Matt helps bring digital marketing campaigns to life while shepherding them through MLR review teams with numerous pharmaceutical companies. He has also helped to develop policy and training for employees and brand communicators in the area of social media.