For Healthcare Advertisers, Optimization Belongs with the Agency


Buying media on a cost-per-action (CPA) basis sounds like a win-win situation when your objective is to drive a single action. Instead of paying for impressions or clicks, you’re compensating publishers only when a consumer takes a defined action. While this model may be appropriate for some advertisers, it is a very risky proposition in pharmaceutical advertising. Partners claim they are running only in brand-safe environments, but without standards, that definition is unclear and plausible deniability isn’t a viable excuse. Context is key when defining what is brand-safe and no two brands are the same.

Putting aside the environment, other challenges exist when running a CPA campaign for healthcare advertisers:

1. Lack of visibility into campaign optimization

Publishers may know how best to get their audience to sign up for a program or download a brochure or coupon, but these may not be the same people you are trying to capture for long-term marketing initiatives. Pulling levers on the front end often results in high initial conversion rates, and high volumes of leads; plus that upfront price tag and guaranteed “performance” is enticing. However, when you look at a database’s performance over time, lack of engagement makes it apparent that not having access to the controls can prove costly in the long run and results in diminished lead quality.   

2. Inconsistent lead quality

Speaking of lead quality, publishers optimizing CPA campaigns are making decisions based on a combination of front-end metrics and the likelihood to take that initial action (sign-up, download, etc.). They may not be fully aligned with your long-term business goals, objectives and target audience, which can result in a database full of unresponsive consumers. Without the ability to quickly verify the quality of the lead and apply learning back to the media campaign, a large volume of poor quality leads can easily develop.

3. Unpredictable volume

CPM-based buying is a model based on historical impression trends, making it easy to predict delivery. The unpredictable nature of a CPA campaign makes it difficult to predict how your leads will pace over time. When you sign a CPA contract, you not only relinquish control of the campaign’s optimization and targeting parameters, but you may also eliminate the ability to control and influence the pacing of delivery. Everyone has horror stories of a campaign delivering 50% of its volume in a weekend, and it’s an awful feeling.

CPA campaigns can play a pivotal role within the digital media mix. However, it is important to bring the responsibility of campaign performance back where it belongs: your media agency.

Given the potential upside for an agency-driven program and the challenges associated with contracting media on a CPA basis, it’s almost shocking that the CPA media buy is still the default path many advertisers take when the campaign’s goal is to generate sign-ups or downloads.

Underscore generates significant success for clients when we purchase the media on an efficient CPM or cost-per-click (CPC) basis and play an active role in the campaign’s optimization. Aggressively optimizing the media partners and creative while in market, versus deriving insights only after the campaign is over, has consistently driven high-quality actions for our advertisers and equaled or exceeded our CPA goals.

To demonstrate what we mean, here is a case study showing how optimization allowed us to exceed our CPA goals when driving sweepstakes entries.


This column was written by Krystina Rubino, Associate Director, eDR, at Underscore Marketing, an independent media agency that creates and manages digital marketing programs.