Research in Progress: Patient influencers – An ethics of care investigation

August 16, 2021

Erin Willis, Erin Schauster, Maria Len-Rios, and Marjorie Delbaere

By Erin Willis, University of Colorado-Boulder; Erin Schauster, University of Colorado-Boulder; Maria Len-Rios, University of Georgia;  and Marjorie Delbaere, University of Saskatchewan

In very recent years, we’ve seen the rise of the social media influencer – someone who creates content for their social media followers. Brands are working with social media influencers to build trust through authentic, curated content. Followers perceive influencers as being experts on specific topics with relevant sources of information, and support for opinions and behaviors.

We’ve seen influencers emerge on all of the various social media platforms, although research shows that Instagram is still the most lucrative for brands, producing the greatest return-on-investment. eMarketer reported that more than two-thirds of North American retailers use some form of influencer marketing.

Influencer marketing is popular in markets like fashion and beauty, travel and lifestyle, and entertainment. It is unexpected that pharmaceutical drugs or medical devices would be supported by influencers, or that patients’ experiences would be commercialized in this way.

However, a recent article in Vox described the entry of pharmaceutical brands into influencer marketing and the value patients play in brand-building for these medications. Pharmaceutical brands have struggled for years to build trust among patients, despite half of all Americans taking at least one prescription drug, reports the CDC. Thus, pharmaceutical companies are employing social media to dialogue with patients and learn about their preferences. Social media influencers have become a popular way to reach target audiences and influence their brand perceptions and buying behaviors.

There’s been debate on the ethics of direct-to-consumer advertising since it was first legalized in the United States in 1985. Pharmaceutical companies are embracing social media marketing, being early adopters of digital communication platforms and social media influencers. The Federal Trade Commission provides vague social media marketing guidelines on how brands and influencers should work together and how to include disclosures of this relationship. The guidelines are up to interpretation if no pharmaceutical brand name is mentioned.

The adherence to FTC guidelines is difficult to monitor, especially when considering the many stakeholders involved in social media marketing (i.e., retailers, pharmaceutical companies, and influencers). Arguably, adherence to regulations and guidelines are more likely to occur when those involved have a heightened sense of morality, which suggests that stakeholders involved acknowledge the importance of care and respect for others.

Understanding patient influencers from an ethics of care perspective provides a framework for understanding an influencer's moral approach to pharmaceutical advertising, including their ability to empathize with others and perceive  the impact their influence has on the wellbeing of audiences. Research on social media influencers is still a new area in the literature, yet little known research examines influencer morality.

Our project seeks to investigate the moral justifications that go into social influence practices and the implications for ethics training, if any, as well as what guidelines and brand values are given to influencers related to projecting the image of the company.

Pharmaceutical companies are already employing patient influencers to build relationships directly with consumers.  By leveraging social media and patient influencers, pharmaceutical companies hope to be viewed favorably in terms of trust and credibility. This is an opportunity for pharmaceutical companies to identify some ethical practices in this new frontier.

For further information on this study, please email Willis at This project is supported by the 2021 Page/Johnson Legacy Scholar Grant from the Arthur W. Page Center. Results from the study will be available in 2022.