New 5W AI Visibility Index: Pharma Spends Billions on DTC Ads. The AI Engines Talk About Eli Lilly and Novo Nordisk Anyway

Drugmakers run the largest direct-to-consumer advertising category in the United States. New 5W research finds AI citation share does not follow the ad budget — it follows the drugs patients self-research. Eli Lilly and Novo Nordisk lead the answer. Merck makes the world's best-selling drug and ranks fifth.

BOCA RATON, Fla., June 19, 2026 /PRNewswire/ -- 5W AI Communications, the AI Communications Firm and one of the largest independent public relations and digital marketing agencies in the United States, today released the Pharma / Rx AI Visibility Index 2026, with a focused cut on the gap between pharmaceutical direct-to-consumer ad spend and AI citation share. The Index is part of the 5W AI Visibility Index series, which tracks how leading brands are cited across ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews.

The Index ranks the top 25 pharmaceutical companies by AI citation share across more than 60 patient and consumer prompts run in Q2 2026 — five times per engine, in clean sessions. The Pharma DTC cut isolates one structural finding: the U.S. pharmaceutical industry spent an estimated $8 billion on direct-to-consumer advertising in 2024 — the largest category-level DTC ad commitment in the country — yet ad spend does not predict where the AI engines land.

The headline numbers

12.5% — Estimated AI citation share held by Eli Lilly, the most-cited drugmaker.
11.5% — Novo Nordisk, citation co-leader on the back of Ozempic and Wegovy.
~$70 billion — Combined 2025 sales of Ozempic, Wegovy, Mounjaro, and Zepbound (GLP-1 receptor agonists).
$5.6 trillion — Estimated size of the global pharmaceutical market.
$1 trillion — Market cap milestone Eli Lilly briefly crossed — the first healthcare company to do so.
5th — Where Merck lands in citation rank, despite producing Keytruda, the best-selling prescription drug in the world.

The top fifteen drugmakers by AI citation share — Q2 2026

01. Eli Lilly — Metabolic & GLP-1 — 12.5%
02. Novo Nordisk — Metabolic & GLP-1 — 11.5%
03. Pfizer — Diversified / vaccines — 8.5%
04. Johnson & Johnson — Diversified — 7.0%
05. Merck — Oncology — 6.0%
06. AbbVie — Immunology & inflammation — 5.0%
07. AstraZeneca — Oncology & specialty — 4.0%
08. Moderna — Vaccines & mRNA — 3.5%
09. Amgen — Biologics & specialty — 3.0%
10. Novartis — Specialty & gene therapy — 2.6%
11. Bristol Myers Squibb — Oncology & cardiovascular — 2.3%
12. GSK — Vaccines & respiratory — 2.0%
13. Sanofi — Immunology & vaccines — 1.8%
14. Gilead Sciences — Antivirals & oncology — 1.5%
15. Roche — Oncology & diagnostics — 1.3%

Source: 5W analysis of AI-generated responses across ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews, Q2 2026. Share represents the estimated proportion of company citations across 60+ tracked patient and consumer prompts. Remaining citation volume splits across ranks 16–25 and unranked companies. See full Top 25 and methodology at the source report.

The structural finding: DTC spend does not buy citation share

Pharma is the largest DTC advertising category in the U.S. — drugmakers spent an estimated $8 billion on consumer ads in 2024, with AbbVie, Pfizer, and Bristol Myers Squibb among the highest individual spenders. The Index finds that scale of spend does not translate into proportional AI citation share.

AbbVie's Humira franchise — historically the most-advertised brand in U.S. healthcare — ranks sixth at an estimated 5.0%. Lilly and Novo combined hold roughly a quarter of all pharma citations in the test set, driven not by ad spend but by the public consumer-research footprint that Ozempic, Wegovy, Mounjaro, and Zepbound generated across earned media, PubMed, Wikipedia, and the business and health press.

The mechanism is the structural difference between paid attention and AI-retrievable record. A 30-second TV spot can move share-of-voice for a quarter. A peer-reviewed trial readout in The New England Journal of Medicine, followed by sustained Reuters, STAT, and Fierce Pharma coverage, moves the answer surface for years. The engines retrieve the durable record, not the campaign.

Quote from Ronn Torossian, Founder and Chairman, 5W AI Communications

"Pharma is the largest direct-to-consumer ad category in America. The AI engines are not impressed. They name the companies whose drugs patients actually research — Eli Lilly and Novo Nordisk — not the companies running the most prime-time spots. AbbVie spent the most. Merck makes the best-selling drug on earth. Neither is the answer the chatbox returns. That is the gap. The pharmaceutical industry is paying for share-of-voice on a channel — television — that no longer routes to the buyer the same way. The buyer is in the chatbox, asking ChatGPT to compare Ozempic and Mounjaro. The companies that built the AI-retrievable record around those names own that answer. The ones still buying spots and hoping it carries through to the engines are funding the wrong channel."

"AI Communications is a mix of journalism, psychology, and engineering."

Six structural truths the Index documents

1. Revenue rank does not predict citation rank. The highest-earning drugmakers are not the most-cited.
   
   
2. A blockbuster drug pulls the company name with it. Ozempic and Mounjaro made Novo and Lilly household names.
   
   
3. Self-researched conditions drive citations. Weight, diabetes, and immunology generate citations. Specialist-prescribed oncology does not.
   
   
4. DTC advertising compounds into citations only when it feeds the editorial record. The spot itself is not retrievable; the coverage it generates is.
   
   
5. Diffuse corporate structure dilutes citation share. Conglomerates and private companies under index.
   
   
6. Patients now research before the appointment. Corporate citation share is upstream of the prescription conversation.

Methodology

5W analyzed more than 60 common patient and consumer prompts across six sub-categories of the pharmaceutical market: metabolic and GLP-1, oncology, immunology and inflammation, vaccines and antivirals, cardiovascular and specialty, and generics and biosimilars. Each prompt was run five times per engine in clean sessions across ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews. Citation sources tracked include the business and health editorial press (Reuters, Bloomberg, Fierce Pharma, STAT), reference sources (company filings, Wikipedia, Drugs.com), and brand-owned corporate content.

Full methodology at 5wpr.com/ai-visibility-index/methodology.

Important framing

This Index measures AI citation share for corporate communications and marketing strategy purposes only. It is not medical advice. It does not rank drugs or companies on safety, efficacy, side effects, or value. It does not recommend any treatment. Medication decisions must be made with a qualified physician or pharmacist. Nothing in this report should be used to choose, start, stop, or change a prescription.

About 5W

5W is the AI Communications Firm, building brand authority across the platforms where decisions now happen — ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews — alongside earned media, digital, and influencer channels. 5W combines public relations, digital marketing, Generative Engine Optimization (GEO), and proprietary AI visibility research to help clients measure and grow their presence in AI-driven buyer research. Founded in 2003, 5W is recognized as a Top U.S. PR Agency by O'Dwyer's, named Agency of the Year in the American Business Awards^®, honored as a 2026 Top Place to Work in Communications by Ragan, and named to Digiday's WorkLife Employer of the Year list. 5W serves clients across B2C sectors — Beauty & Fashion, Consumer Brands, Entertainment, Food & Beverage, Health & Wellness, Travel & Hospitality, Technology, and Nonprofit — and B2B specialties including Corporate Communications, Reputation Management, Public Affairs, Crisis Communications, and Digital Marketing across Social, Influencer, Paid Media, GEO, and SEO. Learn more at 5wpr.com.

Media contact

5W AI Communications — Press inquiries:

[email protected]

SOURCE 5W Public Relations