Pharma Brands Watch Bluesky Growth Opportunity

As Bluesky’s growth continues post-2024 election, major pharmaceutical companies are setting up accounts — but choosing to observe rather than engage.

Bluesky, the decentralized social media network often positioned as the spiritual successor to Twitter, is quickly becoming a place of interest for marketers — including those in the pharmaceutical industry. With more than 33 million users now onboard, the platform is no longer a niche experiment but a full-fledged player in the social space.

Pharma giants like Novartis, Bristol Myers Squibb, and AstraZeneca already have verified accounts on Bluesky. But despite their presence, these accounts remain inactive — no posts, no reactions, no campaigns (yet).

So, what's holding them back?

Bluesky’s rapid growth was fueled in part by dissatisfaction with other platforms. X (formerly Twitter) continues to lose credibility and user trust, Facebook's influence is waning, and TikTok faces regulatory heat. Meanwhile, Bluesky’s decentralized nature and ad-free environment offer a clean slate.

More importantly, journalists and tastemakers — once the backbone of Twitter — are showing higher engagement levels on Bluesky than on X, giving the platform an increasingly influential tone.

While Bluesky doesn’t yet support paid advertising, that could change. And if it does, marketers — especially from the pharmaceutical industry — should be ready to act.

Amy Steele, digital strategy lead at Studio 44 and Precision AQ, notes that with minimal competition, brands could stake out a dominant early position. Even without ads, there's an advantage to being active now: fewer distractions, more visibility.

“Pharma companies could easily take the lead,” Steele explained, “because almost no one else is there yet.”

Marketers caution that traditional pharma messaging won’t work here. The overly polished, compliance-heavy ads that dominate TV and other digital platforms could feel tone-deaf on Bluesky.

Instead, authenticity rules.

“Think more TikTok than television,” Steele added. “If you're not creating content that people genuinely want to engage with, you're missing the point.”

For now, brands testing the waters are leaning toward unbranded, community-driven content. That means joining conversations, offering value, and showing up in ways that support — rather than interrupt — the user experience.

Helen Hoye of AbelsonTaylor Group emphasized that organic content focused on community relevance is likely to be most effective in the early days of brand-building on Bluesky.

And even over-the-counter (OTC) brands with more freedom must tread lightly. As Adam Daley from CG Life puts it, blunt advertising won’t land here. Instead, he suggests pharma brands explore organic content and even paid search strategies outside the platform.

One big reason brands are slow to engage? Bluesky’s decentralized nature makes moderation more complex. The platform quadrupled its moderator team last year to address content safety concerns — but some experts say that’s still not enough for pharma.

Danielle Rowen of Substance Global warns that without clear content moderation and misinformation policies, Bluesky won’t satisfy legal teams. “It still feels experimental,” she said. “Pharma can’t take that risk — not yet.”

A big shift could come if healthcare professionals (HCPs) start using Bluesky en masse. Right now, the space still lacks the critical density that would make it a true replacement for communities like #MedTwitter.

Daley points out that groups like the American Cancer Society have shown interest, but it’s not enough yet for a wide industry pivot.

For pharma brands eyeing Bluesky, the best strategy might be to tiptoe in.

Post a few updates. Share unbranded educational content. Monitor engagement. See if your audience shows up.

“Treat it like a beta test,” Daley said. “Don’t overcommit, but don’t ignore it either.”