For pharmaceutical advertisers, building a precise healthcare provider audience is only half the programmatic advertising challenge. A controlled test from healthcare marketing platform Wrango and supply-side platform OpenX suggests that where identity resolution happens in the ad-buying process can materially affect how many physicians a campaign actually reaches. Across specialty pharma campaigns, OpenXSelect’s supply-side targeting produced 32% greater physician reach than a DSP-direct activation using the same audience, budget and campaign parameters.
Wrango, a healthcare marketing platform focused on verified healthcare provider (HCP) activation and clinical measurement, and OpenX have released results from a controlled test examining how different activation paths affect reach in specialty pharmaceutical advertising.
The test compared two ways of activating the same deterministic HCP audience: a direct upload through the demand-side platform (DSP) and OpenXSelect’s supply-side targeting approach. Creative, budgets, flight dates and bid strategy were held constant, according to the companies.
The result was a notable difference in unique physician reach. OpenXSelect generated 32% more physician reach on identical budgets.
The finding challenges a common assumption in HCP programmatic advertising: that once a marketer has built a sufficiently precise physician audience, the job of reaching that audience is largely solved. Wrango and OpenX argue that the activation layer can be just as important.
OpenXSelect applies a multi-signal identity-resolution waterfall at the point of the bid request. Rather than relying solely on the identifier associated with an audience upload, the approach attempts to resolve additional signals closer to the supply side of the transaction.
That distinction matters because a physician audience is not simply a list of names or professional identifiers. Those records must ultimately be translated into addressable digital identities that can be recognized when advertising opportunities enter real-time bidding auctions.
The test provides some evidence that this translation can become a bottleneck.
Importantly, the companies said 100% of impressions delivered through the DSP-direct path landed on publishers also accessible through the SSP Deal ID path. In other words, the reach difference was not attributed to access to an entirely different publisher universe.
That makes the result more relevant to the ongoing debate around supply-path optimization. If two activation methods can reach essentially the same publisher ecosystem but produce different levels of unique audience reach, the differentiating factor may be the data and identity logic applied between the audience and the auction.
OpenXSelect’s supply-side targeting is designed around that premise. OpenX describes the platform as a combination of programmatic curation and supply-side targeting, allowing buyers to apply audience and other data signals before the auction. Its identity graph supports identifiers including cookies, mobile advertising IDs, authenticated IDs and IP addresses.
The test also reported a 22% lower cost per unique HCP for OpenXSelect in open targeting compared with the DSP-direct route.
The difference was not simply a matter of delivering more impressions. According to the companies, DSP-direct activation concentrated impressions among fewer physicians, particularly within narrow specialty audiences. Higher frequency therefore reflected repeated exposure to an already-reachable subset rather than expansion of the unique audience.
That distinction is increasingly important for pharmaceutical advertisers. Frequency can be useful when reinforcement is part of a campaign strategy, but excessive concentration can also consume budget without meaningfully increasing the number of qualified providers reached.
The broader healthcare advertising market is already pushing marketers toward more sophisticated audience infrastructure. McKinsey reported that 77% of healthcare advertisers surveyed in 2024 considered marketing to consumers based on health characteristics a high priority, while 43% said they had difficulty reaching healthcare audiences with their existing tools.
Although that research concerns healthcare audiences more broadly rather than this specific HCP test, it highlights the underlying market problem: healthcare marketers increasingly want precise audiences while finding scalable, privacy-conscious activation difficult.
The competitive landscape is also moving beyond generic DSP targeting. Healthcare-specific platforms such as DeepIntent combine verified HCP audiences, clinical data, identity infrastructure and healthcare-specific measurement across channels including display, video, CTV, audio and EHR environments.
That puts the Wrango-OpenX findings into a wider AdTech trend. Audience identity is becoming less of a static data asset and more of an activation infrastructure problem.
For pharma brand teams, the practical implication is straightforward: two media plans can start with the same HCP list and still deliver materially different outcomes. Evaluating only audience size or match rate before launch may therefore provide an incomplete picture of addressability.
Wrango and OpenX recommend that marketers examine whether HCP audiences are activated using a single identifier or multi-signal identity resolution. They also recommend measuring Active Reach over the previous 30 days, rather than using longer 90- or 180-day windows that can obscure whether an audience remains genuinely reachable.
The result should not be interpreted as proof that supply-side targeting will outperform DSP activation in every campaign. The test involved specialty pharma campaigns and was conducted by the companies involved, so independent replication across different HCP segments, publishers, DSPs and identity environments would strengthen the conclusion.
Still, the experiment points to a meaningful shift in programmatic thinking. In healthcare advertising, the question may no longer be simply whether a marketer owns the right audience data. It may be whether the programmatic infrastructure can preserve and resolve that audience all the way to the impression.
Market Landscape
The HCP advertising ecosystem is becoming increasingly fragmented across DSPs, SSPs, identity providers, healthcare data companies, endemic publishers and clinical-media platforms.
Traditional DSP activation puts much of the audience-matching workflow on the buy side. Supply-side targeting moves some of that decisioning closer to publishers and the bid request. OpenX says its identity graph now spans more than 272 million unique users across multiple identifier types, while OpenXSelect also supports first- and third-party data activation.
Healthcare-specific DSPs are pursuing a parallel strategy. DeepIntent, for example, says its platform reaches more than 3.7 million verified HCPs in the U.S. and combines healthcare data, identity, activation and measurement.
The competitive question is therefore evolving from “Who has the biggest HCP audience?” to “Which technology can maintain the highest-quality addressability between audience creation and media delivery?”
For enterprise pharma teams, that means future media evaluations are likely to place greater emphasis on unique HCP reach, identity match quality, frequency distribution, supply-path transparency and cost per qualified provider—not simply impressions or nominal audience size.
Top Insights
- Wrango and OpenX found OpenXSelect delivered 32% greater physician reach than DSP-direct activation while holding campaign budgets, creative and bidding conditions constant.
- The test found identical publisher accessibility across paths, pointing toward identity resolution rather than incremental inventory as the primary reach differentiator.
- OpenXSelect also produced 22% lower cost per unique HCP, while DSP-direct delivery concentrated impressions among fewer physicians in narrow specialty audiences.
- The findings highlight identity resolution as an increasingly important layer of HCP programmatic advertising, alongside audience construction, supply quality and measurement.
- Pharma media teams may need to evaluate active reach, identity methodology and frequency concentration when comparing DSP and SSP-based activation strategies.
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