Brand Safety and Suitability for Pharma: Rules That Do Not Kill Scale

Most pharma brands have reasonable worries about adjacency. Nobody wants an oncology ad next to a story mocking cancer patients, or a mental health brand next to graphic violence. The problem is that the controls built for those worries tend to grow. A blocklist starts at 50 words and ends at 2,000. Then someone notices the campaign is underdelivering and the blocked content includes the brand's own disease area.

Brand safety vs brand suitability in pharma

Brand safety covers content almost no advertiser accepts: illegal content, terrorism, child exploitation, hate speech, explicit material, piracy. These are handled through platform rules, verification vendors, and default exclusions. They are rarely controversial.

Brand suitability is where pharma needs judgment. It asks whether this content, for this brand, at this risk level, is acceptable. Disease news is a good example. A story about rising cancer rates may be unsuitable for a cosmetics brand and perfectly suitable for an oncology brand.

Pharma also has a regulatory layer that consumer brands do not. Placements should not imply claims the label does not support, and ad environments should not create confusion about the product. That is less about the publisher and more about creative, ISI, and MLR, but it shapes how conservative brand teams feel.

The GARM framework and suitability tiers

The Global Alliance for Responsible Media, set up under the World Federation of Advertisers, published a common set of sensitive content categories and risk levels. The WFA discontinued GARM in 2024. The categories live on in verification tools and agency policies, so most buyers still work with something close to it.

The basic idea is a grid: categories (such as crime, death and injury, illegal drugs, debated social issues) across risk levels (floor, high, medium, low). You decide, by category, which risk levels to avoid.

These settings are illustrative. Your brand team, regulatory, and agency should set them together and write down why.

Where keyword blocklists overreach

Keyword blocklists check page text or URLs for words and block the impression if they appear. They are blunt. Common problems:

• Disease names and medical terms. Lists copied from consumer brands often block "cancer," "tumor," "HIV," "overdose," "suicide," or "death." That removes much of the health content your audience reads.
• Your own category. An oncology brand blocking "cancer" is not hypothetical. It happens when a default list is applied without review.
• Context blindness. "Shot" blocks vaccine news. "Attack" blocks heart attack coverage. "Kill" blocks "painkiller."
• List growth. Words are added after each incident and almost never removed.

Category-based and contextual suitability tools judge the page as a whole rather than word by word, and generally block less legitimate content for the same protection. They are not perfect, but they are a better default than a long keyword list. The article on pharma contextual advertising covers building positive contextual segments, which is the other side of the same coin.

News adjacency

Blanket news exclusion is one of the fastest ways to lose scale. News sites are among the most visited on the web, and HCPs read them like anyone else. Excluding news can also push spend toward lower quality inventory, including made-for-advertising sites, which are rarely flagged by safety tools because their content is bland.

A better approach:

• Allow established news publishers, ideally through PMPs or inclusion lists
• Avoid high-risk categories rather than news as a whole
• Keep a short, temporary event blocklist for breaking tragedies, with an end date
• Review adjacency through page samples as well as block rates

How to test suitability settings

1. Measure the block rate by reason. Ask your verification vendor which keywords and categories caused the most blocks. The top 10 usually explain most of the loss.
2. Sample blocked pages. Pull 50 blocked URLs and read them. Mark each as correctly blocked or overblocked.
3. Sample delivered pages. Pull 50 delivered URLs. Check whether any would have embarrassed the brand.
4. Change one thing at a time. Remove a set of overblocking keywords, then watch block rate, delivery, and incidents for two weeks.
5. Agree on an incident process. If a bad adjacency happens, who gets the screenshot, who decides, and how fast?
6. Review quarterly. Remove temporary event blocks. Prune the keyword list.

A hypothetical example: a campaign shows a 20 percent block rate. The vendor report shows three disease-related keywords cause half of all blocks. Sampling 50 of those pages finds 44 were legitimate health news. Removing those three words would bring the block rate down to a little over 10 percent with little added risk. That is the kind of finding a page sample produces and a summary metric hides.

Where suitability fits in overall quality

Suitability is one layer. A page can pass every suitability check and still be a poor buy because the impression was not viewable or the site exists only to sell ads. The programmatic media quality guide covers how suitability sits next to supply path, IVT, and audience checks. For the regulatory side of pharma ads, see the pharma advertising compliance guide.

Practical takeaway

Ask your verification vendor for the 10 keywords or categories that caused the most blocks last month, then read 50 of the blocked pages. If more than a handful are legitimate health content, remove those terms and track delivery and incidents for two weeks.

Editorial note. Analysis and frameworks are the author's own and do not represent Acxiom or any current or former employer, client, or named platform. Examples labeled hypothetical or illustrative are not results from real campaigns. Nothing here is legal, regulatory, or medical advice.