The rise of NP/PA influence: Why and how pharma marketing strategies must adapt
For decades, pharma marketing strategies have been built around the assumption that physicians sit at the centre of treatment decision-making. Yet, that model no longer reflects the evolving reality of patient care. Nurse practitioners (NPs) and physician associates (PAs) are now among the most influential prescribers in the United States. This must drive a fundamental shift in how pharmaceutical brands think about prescriber engagement.
POCN Group, an IQVIA business, has data that shows NPs and PAs are responsible for 40.9% of all US prescription claims, totalling more than 1.1 billion prescriptions each year across a range of specialties. This estimate reflects true prescribing attribution, not just the clinician listed on a claim, which addresses the common undercount that occurs when NP or PA prescriptions are billed under a supervising physician.
These clinicians are authorised to prescribe in all 50 states and the District of Columbia and are gaining greater autonomy. Thirty-one states and DC have granted NPs full practice authority. Six states have extended optimal team practice privileges to PAs, allowing them to practice without a mandated supervisory agreement while collaborating within team-based care structures.
Furthermore, the Bureau of Labor Statistics projects NP employment to grow 40% and PA employment 20% between 2024 and 2034. This is among the fastest growth rates of any health profession.
The acceleration of NP/PA influence is not just based on a set of numbers, though; it is behavioural. NPs and PAs are delivering front-line care, managing chronic disease and taking on new leadership roles in both independent and team-based practices. Alongside increasing clinical responsibility, patients are growing more comfortable receiving care from NPs and PAs. A national study of Medicaid patients by the University of Arkansas reports that, “analysis comparing patient experiences between providers revealed NPs to be rated significantly higher than their colleagues.” Together, this signals a structural change in healthcare delivery that pharma marketers must not overlook.
From outdated “physician extender” stereotypes to autonomous influencers
The healthcare system’s shift toward distributed, team-based care has elevated the role of NPs and PAs from supporting physicians to driving clinical outcomes. The pandemic accelerated this change as these clinicians took on more patients and broader care responsibilities to free up physicians to focus on acute or complex cases.
Additionally, NPs and PAs play a vital role in helping mitigate the physician shortage in the US across all specialties. There is a projected shortage of 187,130 full-time equivalent physicians in 2037, according to the Health Resources & Services Administration (HRSA), assuming current trends in retirements, graduations, and practice patterns hold.
Today, POCN Group data shows that more than 685,000 active NPs and PAs are practicing across every specialty, from primary care to oncology, dermatology, cardiology, and rare disease. The data also signals that NPs and PAs are active across nearly every stage of the patient journey, from diagnosis through long-term management.
Still, marketing investment has not kept pace with their growing impact. Across multiple industry trend reports, marketers report plans to increase spending toward physicians at nearly twice the rate of budgets directed to NPs and PAs. Despite representing a third of all US prescriptions, this audience continues to be underfunded and under-engaged in most brand strategies.
This gap represents a significant opportunity for pharma brands and agencies to gain competitive advantage by building trust and influence across the full spectrum of where care decisions are made.
Why NPs and PAs have been overlooked in pharma marketing
Many data teams use National Provider Identifier (NPI) taxonomies to build specialty audiences. These are outdated because the codes don’t accurately reflect how NPs and PAs practice. PAs can only register under “general” or “surgical” codes. And while NPs choose from 17 classifications, they work across all specialties, making taxonomy-based targeting an unreliable source to capture real-world behaviour. This has often led to these high-value prescribers being left off specialty-specific outreach.
Misattribution compounds the problem. Prescriptions initiated by NPs or PAs are frequently billed or recorded under a supervising physician’s name, an artefact of legacy paper forms and EHR systems that default credit to the physician of record. Even within advanced health systems, behind-the-scenes coding and data integration rules often credit physicians instead of the clinicians who initiated the prescription. This prevents NPs and PAs from being accurately represented in many datasets and obscures the full scope of their influence on prescribing decisions.
So, how can pharma marketers ensure this attribution gap doesn’t creep into their targeting? The answer lies in AI-powered datasets that link prescriber activity to actual diagnosis, claim behaviour, and office-level affiliations. A behavioural approach gives more accurate insight into who is driving treatment initiation, adherence, and patient counselling.
Another barrier is content misalignment. Historically, when marketers have targeted NPs and PAs, they’ve traditionally repurposed physician-directed materials, assuming both audiences process information the same way. But NPs and PAs think and act differently from physicians. They are holistic, patient-centred decision makers who see beyond the diagnosis to the person living with it. For example, where a physician may see a patient with osteoporosis, an NP or PA sees an older adult who lives on the second floor and is at risk of a fall on the stairs. For a patient with diabetes, they see someone struggling to afford medication and navigate complex support programmes. Their focus extends beyond efficacy and safety to the everyday realities that factor into whether a patient can start and stay on treatment like access, affordability, and adherence.
To engage this audience effectively, marketers must reframe information through the lens of holistic patient care. NPs and PAs value the same clinical evidence physicians do, but they also want context that helps them support adherence, manage access barriers, and sustain long-term treatment success.
A new framework for NP/PA engagement
To capture the true value of this NP/PA clinician segment, pharma marketers can apply a framework rooted in three principles:
- Identify: This is where leveraging data with best-in-class methodology matters. Pinpointing the most influential NP/PAs requires shifting beyond title-based targeting to uncover who is diagnosing, prescribing, and managing patient care. Marketers can look to claims-based analytics and behavioural data to uncover clinicians driving decision-making beyond physicians.
- Understand: Consider how this segment thinks and what they need. Integrate quantitative insights with qualitative market research to understand their motivations, potential barriers, and learning preferences, and therefore what existing messaging and creative content will resonate most with them. For example, 80% of NPs and 78% of PAs prefer peer-led education, rather than sales representative engagements or static brand materials.
- Engage: Activate with credibility and precision. Reach NPs and PAs through trusted channels that align with how they learn, connect, and care for patients. Combine data-driven targeting with educational and brand messaging that’s relevant to their clinical practice and decision-making moments. Every touchpoint should feel purposeful, reinforcing confidence, supporting patient outcomes, and sustaining long-term trust.
The rise of NP/PA influence is not a passing trend; it is a structural realignment of US healthcare. These clinicians are the connective tissue between patients, physicians, and the broader system of care. They are clinically authoritative, digitally fluent, and accessible at every stage of the patient journey.
Pharmaceutical marketers have an opportunity to rethink how influence is defined and measured. NPs and PAs are now integral to care delivery as they shape prescribing decisions, patient access, and long-term treatment success.
As the balance of clinical influence continues to evolve, the most effective brands will be those that treat NP and PA engagement as central to their strategy, not a future adjustment. The next era of pharma marketing belongs to organisations that already recognise these clinicians as essential partners in improving patient outcomes.
About the authors
Deb Nevins is the director of product strategy at POCN Group, an IQVIA Digital business. She partners with life sciences, medical, and agency organisations to clarify, prioritise, and activate nurse practitioners and physician associates using a data-grounded, human-centred approach. With more than two decades in pharmaceutical marketing and a deep understanding of clinician attitudes, behaviours, and decision-making, Nevins develops narratives and strategic frameworks that help teams recognise and act on the growing influence of NPs and PAs in patient care. She is known for translating complex market dynamics into clear, practical insights that elevate NP and PA inclusion across modern healthcare strategy. A frequent contributor and speaker, Nevins brings forward the opportunities created when these clinicians are meaningfully understood and integrated into commercial and medical planning.
Cristin Liberatore is a dynamic leader with over 14 years at IQVIA and is the head of digital strategy & enablement for IQVIA Digital. She drives innovation, strategic planning, and commercial enablement across segments, balancing internal leadership with direct client engagement. She leads the development of business and go-to-market strategies, supports sales with high-impact proposals, and aligns teams to client needs. By partnering with senior leaders and driving innovation with clients, Liberatore delivers competitive positioning, actionable insights, and measurable results for brands.
