How to Evaluate a Healthcare Marketing Agency

Most "how to choose an agency" guides are written by agencies selling themselves; this one is written by a marketplace that vets them.

A buyer searching how to evaluate a healthcare marketing agency will find that every guide on the first page of Google is written by an agency selling itself. That is not a conspiracy. It is rational content marketing, but a guide written to attract clients is not the same as a guide written to filter agencies. Refero is a marketplace, not an agency: we match buyers with vetted specialists across pharma, health systems, medical devices, digital health, and clinical trials, and earn a fee from the match, not the campaign. What follows is the evaluation framework behind that vetting, published so buyers can use it whether or not they use Refero.

What healthcare marketing agency evaluation looks like in practice

Evaluation runs in two stages: disqualifying criteria that vets an agency before a single conversation happens, then scored criteria that rank whichever agencies survive. Most buyers skip straight to the scored stage, comparing portfolios and pitch decks without checking the gates first, and that shortcut is where compliance failures and mismatched sub-vertical specialization start showing up months into a contract, not during the pitch.

The next section covers the hard gates. The section after that covers the scored evaluation and its weighting. The one after that covers what to actually ask once an agency has cleared both.

Every criterion below applies regardless of the agency model on the other side of the table: a full-service agency of record billing one retainer across every channel, a specialist billing for one discipline, a project-based shop scoped to a single campaign, or a marketplace-matched team assembled per engagement.

Red flags that disqualify a healthcare marketing agency

When vetting a healthcare marketing agency, you'll need a robust checklist of hard gates. With hard gates, an agency either passes it or it does not, and there is no partial credit. If an agency fails even one gate below, considering dropping them out from the consideration list and refrain from scoring them on further criteria in the next section, regardless of portfolio, size, or price.

No named healthcare case studies

If an agency cannot name a single healthcare client with a described outcome, the buyer is paying for that agency's healthcare education. General-market creative skill does not transfer to a regulated category on its own; a compliance learning curve sits in between, and someone pays for the time it takes.

No credible source publishes how long that curve runs, so treat any agency that quotes a number as guessing. Ask for two or three named clients in your sub-vertical, with what happened after the campaign ran, not a logo on a slide.

No evidence of regulatory fluency

Ask who handles compliance review, and whether that person sits on staff or gets pulled in only when a client raises it. HIPAA, FDA advertising guidance, and state telehealth marketing rules are table stakes for anyone running healthcare campaigns, not a specialty add-on. If the agency's answer is "we work with your legal team," it has not built an internal compliance process; it has moved the gap onto you.

Enforcement here is documented, not theoretical: the Federal Trade Commission fined GoodRx $1.5 million in 2023 for sharing health data with advertising platforms without user consent, a violation of the Health Breach Notification Rule [1][2].

Health systems and other HIPAA-covered entities carry a related obligation: HHS guidance on online tracking technologies treats certain ad pixels and analytics scripts on patient-facing pages as protected health information disclosures [3]. None of this is legal advice; confirm the specifics with counsel before signing anything.

Guaranteed outcomes

No agency that understands the channels it sells should guarantee a ranking, a lead volume, or a patient acquisition cost. Google's own documentation states plainly that no one can guarantee a first-page ranking [4]. In healthcare, a guaranteed patient volume carries a second risk on top of the broken promise: it incentivizes the kind of aggressive ad copy that regulators flag first.

Locked accounts and assets

If the agency keeps ownership of the ad accounts, the analytics setup, or the creative assets once the contract ends, the buyer starts over with the next agency instead of switching to it. Ask who owns what, in writing, before the first meeting, not after the contract is signed.

No vertical depth beyond "healthcare"

Healthcare is not one market. An agency built around dermatology or aesthetics clients may know nothing about pharma MLR review, and a pharma specialist may never have marketed a telehealth platform. Ask for case studies in your specific sub-vertical, pharma or biotech, health system, medical device, or digital health, not a general healthcare portfolio.

Clinical trial marketing is its own sub-vertical with its own rules: the FDA treats recruitment advertising as the start of informed consent and requires institutional review board review before an ad runs [5]. Clinical trials have their own evaluation layer for recruitment vendors, and it sits outside the scope of this guide.

Subcontracted core work without disclosure

If strategy, creative, or media buying is quietly outsourced to a white-label provider, the buyer cannot evaluate the team actually doing the work. Ask directly whether any core function is subcontracted, and if so, to whom and under what oversight.

Scored criteria: how to rank the agencies that pass the gates

Score every agency that clears the gates on five weighted criteria, and fix the weights before reviewing a single agency so the process stays consistent across every conversation.

‍Weights are a starting point. Adjust them for the launch or program you are evaluating against, as the paragraph below explains.

These weights are a starting point, not a rule. A buyer launching a new drug or a new indication should weight compliance integration higher than the default 20%, since a regulatory misstep at launch costs more than a slow campaign. A buyer optimizing an existing, already-compliant program should weight attribution higher, since the marginal dollar there buys efficiency, not risk reduction.

These five rows are not an invented rubric. They map directly to the five criteria Refero publishes and screens every agency against before introducing one to a buyer: niche proof, verifiable results, team stability, pricing transparency, and responsiveness. Sub-vertical proof is niche proof. Attribution and measurement is verifiable results. Team continuity is team stability. Pricing transparency keeps its name. Compliance integration is the one addition specific to healthcare, folded into responsiveness in Refero's general vetting and broken out here because a healthcare buyer needs to see it scored on its own.

Questions to ask in the agency review meeting

The review meeting tests whether an agency's answers match what the scorecard predicted on paper. Ask these by criterion, and note whether the answer names dates, numbers, and people, or stays in the abstract.

1. Walk me through a campaign you ran for my sub-vertical

What was the outcome, and what would you do differently? A specific campaign with a real outcome tests sub-vertical proof directly; a vague answer means the agency has not done the work in your segment.

2. Show me the last healthcare ad your team submitted for compliance review

How long did it take, and what changed before it was approved? The answer shows whether compliance review is a real step in production or an afterthought.

3. Is your compliance reviewer on staff, or brought in from outside when a client asks?

An outsourced reviewer with no seat in the production process gets bypassed under deadline pressure.

4. How do you track a patient from the first ad impression to a booked appointment or an enrolled patient?

A dashboard that stops at leads or website visits is not attribution; it is a vanity metric with a healthcare label on it.

5. Name the three people who will work on our account, and their average tenure on your healthcare team.

The team that pitches is not always the team that executes, and high turnover on a healthcare account restarts the compliance learning curve every few months.

6. What is your fee structure, and what specifically triggers a scope change?

A blended retainer with no breakdown hides which part of the budget is fixed and which part grows with scope creep.

7. Which sub-vertical inside healthcare would you turn down?

An agency willing to name what it does not do is more credible about what it says it does well.

8. What happens in your reporting when a referral goes cold at the site or clinic level instead of inside your ad account?

That answer tests whether attribution ends at the ad platform or actually follows the patient.

Listen for specificity over generality. An agency that names dates, numbers, and people has done the work. An agency that describes its process in the abstract, "we have a rigorous process" or "we always prioritize compliance," either has not done the work or is not planning to put the team that did it on your account.

How Refero evaluates agencies, and where this framework came from

Refero is a marketplace that matches healthcare buyers with vetted marketing specialists.

The five criteria in the scorecard above, sub-vertical proof, compliance integration, attribution and measurement, team continuity, and pricing transparency, are the same criteria Refero screens every agency against before it introduces one to a buyer.

Publishing them does not cost the business anything real. A buyer who runs this evaluation alone and finds a good fit has no reason to come back. A buyer who finds the process slow, or wants a shortlist instead of a long list, is the buyer Refero serves.

If you would rather not run that evaluation alone, Refero screens healthcare marketing agencies against five published criteria and introduces up to three that fit your brief. It is free for buyers, and there is no obligation to hire anyone we introduce. Tell us what you need.

Frequently asked questions

What should I look for in a healthcare marketing agency?

Five criteria: sub-vertical proof, compliance integration, end-to-end attribution, team continuity, and pricing transparency. Start with the hard gates, named case studies, regulatory fluency, no guaranteed outcomes, before scoring anything. An agency that clears the gates but scores low on the criteria that matter most to your launch is still a worse fit than one with a lower overall score and a better match on your top-weighted criterion.

How is a healthcare marketing agency different from a general marketing agency?

Regulatory fluency separates the two: HIPAA, FDA advertising guidance, and state telehealth marketing rules are not optional reading for a healthcare specialist. Add patient-journey attribution across conversion cycles that run months instead of days, and sub-vertical depth that a dermatology campaign does not transfer to a pharma launch. A general agency can learn all of this. The compliance learning curve is the buyer's cost while it happens.

How much does a healthcare marketing agency cost?

There is no single answer. Retainers, project fees, and performance-based models all exist side by side, and none of them is standard. Ask for the fee structure and what triggers a scope change before comparing quotes. Published ranges on other sites are self-reported by the agencies writing them and vary by a factor of roughly 25, from a few thousand dollars a month to well over a hundred thousand.

How many agencies should I evaluate?

Three to five scored agencies is a practical ceiling. More than five produces diminishing returns on the time invested; fewer than three leaves no real comparison baseline. The hard gates do the first cut, reducing a long list to a shortlist before the scored evaluation begins. Most buyers over-invite at the top of the funnel and under-invest in scoring the survivors.

How do I know if my healthcare marketing agency is working?

End-to-end attribution answers this: appointments booked, patients enrolled, or qualified pipeline generated, not impressions or clicks. If the agency cannot show that chain today, ask what it would take to build it. A specific technical answer, naming the tracking gap and a timeline to close it, is a different signal than a vague answer about the limits of healthcare data that never gets solved.

Sources

• Federal Trade Commission. GoodRx Holdings, Inc. Consent Order, 2023. Link
• Federal Trade Commission. Health Breach Notification Rule. Link
• HHS Office for Civil Rights. Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates. Link
• Google Search Central. Do You Need an SEO? (SEO Starter Guide). Link
• US Food and Drug Administration. Recruiting Study Subjects: Information Sheet. Link