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It’s becoming increasingly clear that pharma is moving toward a more consumer-driven model. If you follow the industry with any regularity, you can already see this shift taking shape -- perhaps most notably in the attention, demand, and cultural visibility surrounding the GLP-1 class.
Patients today are more informed, more engaged, and more involved in their own care than at any point in the past. They are exposed to a growing stream of information, through direct-to-consumer marketing, social platforms, patient communities, and increasingly, AI-driven tools that help them interpret symptoms, evaluate options, and even rehearse conversations with their healthcare providers (HCPs).
They arrive at appointments not just with questions, but with context. Primed with specific language. With expectations shaped not only by their own experience, but by what they have seen, read, and heard from others.
And yet, for all of this change, one thing remains remarkably consistent:
Behavior is still incredibly difficult to shift.
This creates a fundamental paradox at the heart of modern brand strategy. On one hand, there is more opportunity than ever to reach and influence patients directly. On the other, the behaviors we are trying to influence are often deeply entrenched -- set in stone through years of repetition, reinforcement, and lived experience.
Which raises a critical question:
If we are increasingly in the business of influencing patient behavior, do we truly understand how that behavior works?
Much of pharmaceutical marketing still operates, implicitly, on a decision-based model. We assume that if we communicate the right information -- efficacy, safety, mode of action, administration convenience -- patients and their HCPs will weigh the options and make a rational choice.
But as Charles Duhigg and others have written, much of human behavior does not operate this way.
It is mostly habitual.
Human behavior is shaped by cues, reinforced by rewards, and repeated until it becomes second nature.
Taking a medication. Managing a condition. These are not one-time decisions. They are patterns of behavior that unfold over time, often with minimal conscious deliberation.
And once established, they can feel remarkably fixed.
Not because they are optimal -- but because they are familiar.
What is increasingly clear, however, is that these habits do not form in isolation. They are shaped, and continually reinforced, by a broader social and informational environment.
Patients today are embedded in communities: online forums, social media groups, advocacy networks, and informal peer circles where experiences are shared, normalized, and interpreted. A single story, positive or negative, can travel quickly and cause an outsized impact.
At the same time, AI is beginning to play a more active role in how patients process information. It can summarize treatment options, suggest questions to ask an HCP, and provide a sense of clarity, or confidence, before a clinical conversation even begins.
These influences do not replace the physician. But they do shape the context in which the HCP is heard.
In behavioral science terms, they function as part of the feedback loop.
They reinforce beliefs. They validate decisions. They can either stabilize an existing habit -- or begin to unhinge it.
Which means that if we are trying to understand behavior, we cannot look only at the individual. We have to understand the ecosystem in which that behavior is embedded.
One of the most underestimated forces in healthcare is behavioral inertia. We call it "investment."
Patients adapt to their current routines. They've learned how to manage side effects. They build treatment into the rhythms of their daily lives. Over time, what may have once felt like a burden becomes normalized -- absorbed into a broader lifestyle.
And that normalization is often reinforced externally. A peer who says, “I’ve been on this for years.” A community that frames a certain experience as typical. An AI-generated summary that reinforces that the current approach is “standard.”
In that sense, a treatment approach is rarely evaluated in isolation. It is evaluated in context.
These questions are often more influential than we acknowledge.
Because changing treatment is not just a clinical decision. It is a behavioral, and increasingly, a social one.
From a brand perspective, this has important implications. We often think about adoption in terms of product attributes: what makes a new therapy better, faster, or more effective.
But from the patient’s point of view, the question is often different:
What would it take for me to change what I am already doing?
That change can feel like a big leap.
Not only because of the individual adjustments required -- learning a new routine, managing uncertainty -- but because it may also mean stepping away from a set of reinforced norms. From what feels familiar not just personally, but collectively.
When a behavior is supported both internally and externally, it becomes even harder to dislodge.
This is where the concept of what we call the "behavioral cascade" becomes important. Because adoption is not a single moment. It is a sequence.
Each step matters.
Nir Eyal’s work emphasizes the importance of feedback loops in shaping behavior. In today’s environment, those loops extend beyond the individual. They include community validation, shared narratives, and increasingly, algorithmically mediated information.
If those signals are aligned, a new behavior can take hold quickly.
If they are not, even a strong initial trial can stall.
One of the most important roles of ThinkGen's Habit Lens methodology -- something I’ve written about extensively -- is to surface what is often overlooked: hidden frictions.
These are not always the obvious barriers. They are the small, accumulated points of effort that patients learn to navigate over time. The extra step. The moment of inconvenience. the point where conscious thought is still needed. The uncertainty that is manageable, but far from ideal.
But in a more connected world, friction is not just personal -- it can also be social.
A patient may hesitate not because something is difficult, but because it feels different. Because it sits outside what they have heard from others. Because it introduces a narrative they are not yet comfortable with.
Through carefully structured questioning -- asking patients to thoroughly walk through their routines, to reflect on what they have adapted to, to describe what would need to change before they reconsider -- we begin to identify where those frictions exist.
And, importantly, where they intersect with influence.
If there is a central challenge in consumer-driven pharma marketing, it is this:
How do we make a new behavior not just appealing -- but sustainable?
This requires more than awareness. More than interest. Even more than intent.
It requires alignment.
The new behavior must fit within the patient’s life. It must reduce, or at least justify, the effort required. It must quickly begin to feel familiar -- on its way to becoming second nature.
And increasingly, it must feel validated.
By the care team. By peers. By the broader informational environment in which patients are operating.
Because when those signals reinforce the behavior, repetition becomes easier. And when they do not, even a strong product can struggle to take hold.
As pharma continues to move toward a more consumer-driven model, the ability to influence behavior directly will only become more important.
But influence, in this context, cannot rely on messaging alone.
It requires a deeper understanding of how behaviors are formed, how they are sustained, and how they are shaped -- not just individually, but collectively.
That is what Habit Lens is designed to do.
To uncover not only the mechanics of individual behavior, but the broader system in which that behavior resides: the cues, the routines, the reinforcements, the hidden frictions, and the social and informational loops that bind them together.
In practice, the difference is not in stated preference, but in sustained behavior.
What ultimately matters is whether a choice is taken up, repeated, and integrated into the fabric of everyday life, often with reinforcement from the environment around it.
That is where habit takes hold.
