Pharma Has a Trust Problem. Better Marketing Won’t Fix it.

Only five percent of Canadians say they have “a lot of trust” in health information from pharmaceutical companies

by Vijay Wadhawan

Trust cannot be treated as a communications problem. Every patient education initiative, disease awareness campaign, patient support program, and public commitment begins with the same invisible hurdle: before people evaluate the information itself, many have already evaluated the organization behind it. That is why trust should be considered a strategic capability, woven into decisions across all functions, not left to communications alone.

The challenge is not simply that trust in pharmaceutical companies is low. It is that strong trust is almost absent.

2026 Healthcare Trends Report: Five percent of Canadians express a high level of trust in pharmaceutical companies vs. more than half say they have little to no trust. That should fundamentally change how pharma thinks about engagement. In my work with pharmaceutical companies over the years, I’ve heard trust discussed often, but usually as a communications challenge. The assumption is that if we explain things better, communicate more clearly, or tell our story more effectively, trust will follow.

I don’t think that’s enough.

Trust isn’t something you communicate into existence. Trust is something organizations intentionally build, reinforce, and measure across the entire organization. It’s something you intentionally design, earn, and measure across the entire organization. Every interaction either reinforces or weakens trust. Trust is shaped by medical affairs, commercial strategy, patient support, market access, partnerships, government relations, and every experience people have with your organization. Patients don’t experience these functions separately. They experience one company. When trust is damaged in one area, it changes how people interpret everything else the organization says and does.

Because of these high stakes, Environics Research chose to make trust the focus of our 2026 Healthcare Trends report. Trust sits underneath almost every major healthcare issue facing Canadians. It influences whether people seek care early or wait until their condition gets worse. It shapes whether they follow medical advice, take prescribed treatments, ask questions, disclose concerns, seek information from credible sources, or disengage from the system altogether.

Trust is not a soft concept or simply a matter of reputation or likeability. It is one of the conditions that allows healthcare to function. In addition to being critically important, trust is also complex: it’s built and eroded by a myriad of overlapping factors. That is why trust needs to be measured thoughtfully.

Do People Trust Us?
A binary, yes-no measure is inadequate because different people have different reasons for trusting or distrusting an organization. Trust deficits are not all the same, and they cannot be solved with the same strategy. That’s why trust must be gauged with more than a single measure. It’s not enough to know whether people trust you. It’s important to understand why they do or don’t, where trust is being earned or lost, and what different audiences need in order to place confidence in your organization. Pharmaceutical companies operate within two realities simultaneously. They are judged as healthcare organizations, and also as large businesses.

As large enterprises, they face headwinds. Thirty seven percent of Canadians believe that big businesses generally strike a fair balance between profits and the public interest. Sixty-two percent
disagree with the aforementioned statement. As healthcare organizations, pharmaceutical questions face a separate set of questions specific to their field – for example, questions about the quality of their science. Since most stakeholders are not well-equipped to evaluate the nuances of their research, trust deficits will often have less to do with the quality of their science than with perceptions of the organization behind that work. For these reasons, when a pharmaceutical company shares health information, many Canadians are evaluating that information on two dimensions at the same time: Is this scientifically credible? And whose interests does this ultimately serve?

These dynamics are why better communication alone will not solve the problem. Before deciding how to build trust, organizations first need to understand which trust deficit they are trying to solve. Is it transparency? Motive? Competence? Relevance? Fairness? Each requires a different response, which is why trust needs its own strategic framework rather than being treated as a communications objective. The opportunity for pharma is not to become the most trusted voice in healthcare. That is probably unrealistic, and it may not even be the right objective. In my mind, the opportunity is to become a more trusted participant in the healthcare ecosystem.

That means treating trust as something that is built across the organization, measured with intention, and managed as carefully as any commercial or clinical strategy. Because before patients decide whether they trust your information, they have already decided whether they trust you.

Vijay Wadhawan is SVP – Health & Wellness at Environcis.