Economic uncertainty, rising costs and a challenging political environment hit the healthcare PR sector hard in 2025 as the top 50 firms combined for a 1.6 percent decline in fee income to $757,393,014, according to O'Dwyer's ranking of healthcare public relations firms for 2026.

That lackluster performance compares to a 3.8 percent income gain in 2024 and a 2.6 percent increase in 2023. But it's a far cry from the COVID-19 spending that fueled a 24.8 percent income rise in 2022 and 46.6 percent surge in 2021.

As healthcare PR firms struggle to gain traction, the sector is front and center in the lives of Americans.

Access to healthcare and affordability have re-emerged as the No. 1 domestic worry for Americans, according to a Gallup poll released March 31. More than six in ten (61 percent) of respondents cited healthcare as their top concern.

The economy and inflation were the major worries during the Biden administration. They now clock in at 51 percent and 50 percent, respectively, in the Gallup survey.

Americans are right to be concerned about healthcare now that President Trump has vowed to prioritize “military protection” in his 2027 budget.

He has asked Congress to slash $73B in the upcoming fiscal for cuts in healthcare, education, housing and nutrition assistance.

Tricky days lie ahead for healthcare communicators.

Finn Partners Leans into Stability

GIl Bashe
Gil Bashe

Gil Bashe, Global Health and Purpose Chair, said the health communications sector is recalibrating in real time, shaped by incredible scientific advancement, increased regulatory engagement and economic pressure, alongside a clear expectation that communication must do more than inform.

That reality guides Finn Partners’ agency performance and client priorities. Against that backdrop, Bashe views 2025 as a strong year for the health group, which posted a 2.2 percent gain in fee income to $59.3M.

He noted that performance reflects a sector shaped by disruption and high expectations, as well as growing interest in the firm’s culture, knowledge, stability and cross-ecosystem expertise.

Of course, the health system is not a single market, but an ecosystem shaped by patients, payers, innovators, policymakers and providers.

Success requires integration, not silos. “Our role is to help clients and their customers navigate complexity with confidence and enable patients and health professionals to act as informed ambassadors in the marketplace,” said Bashe.

That perspective brings stability. When one part of the ecosystem slows, another accelerates. As regulatory timelines extend, market access, policy and patient advocacy take on greater importance.

“Grounded in the full ecosystem, Finn Partners adapts in real time, close to where decisions are made, Bashe noted.

Stability is also reflected in how the firm values people. The global health practice, which is led by Fern Lazar, is anchored by staffers who have built enduring relationships with clients and teams over many years.

“That continuity matters. It reflects a shared set of values and contributes to client and staff retention rates among the highest in the industry – each metric greater than 80 percent,” said Bashe.

Geography matters as well. Health is global but experienced locally. Finn’s assignments increasingly span the United States, Europe and Asia, with implementation across South America and EMEA, making its collaborative culture a client advantage.

In Africa, Finn’s professionals on the ground bring local understanding to access and trust, strengthening global strategy with real-world perspective.

Bashe said Finn’s differentiation is clear. “Our value lies in the judgment we bring, grounded in experience and connections across the health ecosystem. Values and culture create harmony and collaboration that benefits clients.”

Federal Cuts Hit Crosby

Crosby Marketing Communications’ healthcare practice had a strong performance in 2025 across commercial and nonprofit clients but was hindered by significant cuts and pauses in its federal government contracts. It posted a 23.8 percent slide in fees to $21.9M.

Ray Crosby
Raymond Crosby

“Things have normalized to some degree, and we are optimistic looking ahead,” said CEO Raymond Crosby.

The Annapolis-based firm continued work with mission-driven clients, such as Agency for Healthcare Research & Quality, U.S. Preventive Services Task Force, DAV (Disabled American Veterans), Shriners Children’s, Kaiser Permanente, USDA Food & Nutrition Services, and the American Board of Internal Medicine.

Those clients require omnichannel campaigns to engage key stakeholders across the healthcare continuum, from providers, payers and policymakers to niche patient populations and consumers.

“They want a single source of accountability, and Crosby’s superpower is helping them connect the dots and drive marketing performance in an increasingly complex business, media, and policy environment,” said Crosby.

He noted the pace of change in healthcare is breathtaking. AI is certainly a major driver, and CMC has a full stack of more than 25 tools that teams across the agency use for research and insight development, communications planning, creative, UX design, media buying, analytics and optimization. “It’s a big cultural shift to embrace these tools while also making sure we use them responsibly and ethically,” said Crosby.

But human empathy, creativity, and judgement are at the core of healthcare. Crosby said the goal is to ultimately connect with people’s emotions, change behaviors, and compel them to make decisions that improve health outcomes.

Coyne’s Connects with Human-Centered Stories

Coyne PR’s healthcare practice entered 2025 with momentum and turned it into one of its most defining years as the unit posted a 28.7 percent hike in income to $11.9M.

Kelly Dencker
Kelly Dencker

“The year was marked by breakthrough storytelling, measurable business impact and a clear evolution in how healthcare communications can drive awareness, propel brands and businesses and make a difference for people in need,” said Kelly Dencker, Executive VP.

Across pharmaceuticals, health services and advocacy, the team demonstrated its ability to translate complex science into compelling, human-centered stories that resonate with media, stakeholders and patients alike.

Signature work for Otsuka exemplified this approach, in which Coyne supported the market development and launch of Voyxact through a high-impact communications program tied to the definition of clinical data and FDA approval.

The result? More than 1,700 media stories and 1B impressions across top-tier outlets that helped contribute to a strong launch, positive feedback, and inquiries from physicians, patients and advocacy organizations.

The practice proved its strength in large-scale, culturally relevant campaigns. For Humana, Coyne transformed the National Senior Games and its Humana Game Changers program into a powerful platform for redefining aging and health, generating more than 1,400 placements, leading against its four biggest competitors, achieving a category-leading 35 percent SOV, while its nearest competitor achieved a 23 percent SOV.

Similarly, the Pacira “Be a Champion for Pain Relief” initiative during Super Bowl week blended sports, education and advocacy to spotlight non-opioid pain management, driving more than 1,000 placements and nearly 800M impressions.

“These programs underscore a core differentiator: Coyne doesn’t just secure coverage; it creates movements that shape perception and behavior,” noted Dencker,

Coyne’s healthcare work is designed not only to meet regulatory standards but to break through culturally, ensuring that creative plans are both compliant and compelling.

This integrated model is further strengthened by long-standing client relationships and a focus on organic growth, allowing the team to deepen impact across existing partnerships while selectively adding new, high-value clients.

In 2026, Coyne PR is well positioned to lead the next phase of healthcare communications – one defined by the powerful convergence of credibility, creativity and technology.

The agency’s early commitment to and investment in AI and its proprietary Generative Engine Optimization framework will play a critical role in ensuring clients are not just visible in traditional media but accurately represented in AI-generated answers and emerging discovery platforms.

Dencker said as generative search reshapes how patients, providers and stakeholders access information, Coyne’s focus on structured, authoritative content and “answer-first” storytelling will give clients a competitive edge.

He said Coyne PR wants not just to be a participant in the healthcare conversation but as a force shaping its future.

Supreme Group Stands Out

Tom Donnelly, CEO of Supreme Group, called 2025 a phenomenal year for his firm, marked by five strategic acquisitions and record-setting organic growth that exceeded its expectations.

Tom Donnelly
Tom Donnelly

It achieved the largest percentage increase of any firm in O’Dwyer’s rankings, with fees jumping 147.3 percent to $115M.

“Our growth came from a combination of strategic acquisitions and strong organic expansion across existing client relationships,” said Donnelly. “Retention strengthened and cross-sell accelerated, demonstrating that the Supreme Group integrated model is proving itself.”

At the center of Supreme Group is Supreme Intelligence, the proprietary end-to-end AI platform purpose-built for healthcare and life sciences commercialization.

SI spans the full lifecycle, from strategic insight through campaign creation, activation and performance optimization, all in one connected system. It's embedded into every engagement as the infrastructure Supreme Group’s team uses to move faster and think sharper.

“Strategy timelines compress from weeks to days and buried insights surface before the first creative brief is written,” said Donnelly. “Execution gets tighter across every touchpoint and clients experience the result.”

Backstopping SI are more than 350 specialists, including 55+ PhDs, spanning strategy, science, creativity and technology.

Supreme Group made key leadership additions in 2025. Nicky Battle joined as President from Ketchum, Lisa Schwartz as EVP Operations from EY, and Olly Johnstone as EVP Platform Growth from Inizio Evoke. Each strengthens Supreme Group’s ability to operate as one integrated company across every capability it offers.

Donnelly believes Supreme Group’s structure is the model for the future of healthcare commercialization. “It’s not a traditional service model with AI bolted on, but a company built around an AI operating system from the ground up,” he said.

The firms that will lead this healthcare industry in five years are the ones building that infrastructure now, according to Donnelly.

Conversations with clients have already shifted. It's no longer about choosing a firm for a campaign. It's about finding a commercialization partner that can embed AI into the way work gets done, move across service areas without losing scientific depth, and deliver compounding value over time.

Donnelly said Supreme Group is ahead of that curve, and 2026 is about widening the gap.

MCS Health Repositions for What Comes Next

While 2025 brought challenges across the healthcare communications landscape, it also marked a turning point for MCS Health as it repositioned the business for what comes next.

Eliot Harrison
Eliot Harrison

The Morristown, NJ-headquartered firm posted a 6.4 percent dip in 2025 fee income to $4.3M.

As the year progressed, the firm saw a clear shift in what clients are asking for, according to CEO Eliot Harrison.

Communications became significantly more complex as clients looked to tell more sophisticated scientific stories, engage with the right influential voices, and navigate how AI is reshaping the way in which information is created and consumed.

At the same time, demand grew for seamless global capabilities without being limited to a predefined network that lacks the flexibility to bring together the right partners for the right challenge.

In response, MCS made a series of deliberate moves to align the agency with where the industry is heading

“We strengthened our capabilities in AI-enabled analytics and data intelligence to bring greater precision and measurement into our work,” said Harrison.

MCS fine-tuned its approach to influence, focusing on identifying and activating the ecosystem of voices that shape perception and decision-making in healthcare.

It was deliberate about who it partnered with. “We focused on groups that share our values around independence, senior attention, and quality of work, while giving us the ability to scale capabilities globally as client needs evolve,” said Harrison.

The goal was not to replicate the same model in every market, but to expand what we can deliver in a way that is more flexible and aligned to the work.

A critical part of the firm’s transformation is making an investment in people. “We have expanded our senior leadership team across operations, digital, consumer, and integrated communications to build a stronger foundation for sustainable growth,” Harrison noted.

Healthcare PR is no longer channel driven. It is insight driven. Firms that succeed will be those that can connect data, narrative, and influence in a way that drives measurable action.

Harrison said MCS entered 2026 with strong tailwinds and a trajectory that it expects to accelerate.

The O’Dwyer Co. has been conducting PR firm rankings for 57 years and its name is well known in the business world. Our rankings measure counseling and media contact services, not advertising or production expenses.

Rank your firm with O'Dwyer's for 2027.

O'Dwyer's Ranking of the Top Healthcare PR Firms for 2026

FT Emp.

'25 Net Fees

#1

Real Chemistry, San Francisco, CA

2,034

$560,000,000

#2

Inizio Evoke, New York, NY

1,117

$347,000,000

#3

Edelman, New York, NY

5,457

$177,609,000

#4

Supreme Group, Dallas, TX

227

$115,000,000

#5

Spectrum, Washington, DC

313

$88,100,000

#6

Ruder Finn Inc., New York, NY

1,350

$74,100,000

#7

FINN Partners, New York, NY

1,267

$59,252,000

#8

APCO, Washington, DC

1,108

$55,400,000

#9

imre, LLC, Baltimore, MD

169

$48,000,000

#10

ICR, New York, NY

379

$30,643,673

#11

JPA Health, Washington, DC

105

$30,000,000

#12

Crosby, Annapolis, MD

95

$21,942,093

#13

Zeno Group, New York, NY

841

$16,991,307

#14

Sam Brown LLC, Wayne, PA

34

$15,647,643

#15

Highwire PR, San Francisco, CA

259

$13,272,450

#16

MikeWorldWide, New York, NY

237

$12,932,750

#17

Coyne PR, Parsippany, NJ

143

$11,822,495

#18

Hunter, New York, NY

320

$11,000,000

#19

Padilla with SHIFT Communications, Minneapolis, MN

162

$7,959,677

#20

BRG Communications, Alexandria, VA

33

$6,446,824

#21

Fenton Communications, Inc., New York, NY

96

$4,895,662

#22

MCS Health, Bedminster, NJ

17

$4,342,505

#23

Cura Strategies, Arlington, VA

16

$3,846,531

#24

MediaSource, Columbus, OH

18

$3,831,512

#25

PAN, Boston, MA

182

$3,682,560

#26

Moore, Inc., Tallahassee, FL

49

$3,245,015

#27

Raffetto Herman Strategic Communications, Seattle, WA

37

$2,316,578

#28

Public Communications Inc., Chicago, IL

27

$1,943,941

#29

Global Gateway Advisors, New York, NY

24

$1,880,000

#30

TASC Group, The, New York, NY

18

$1,820,000

#31

Antenna Group, New York, NY, NY

91

$1,750,210

#32

MP&F Strategic Communications, Nashville, TN

71

$1,589,522

#33

French | West | Vaughan, Raleigh, NC

139

$1,496,187

#34

G&S Integrated Marketing Communications Group, New York, NY

151

$1,489,625

#35

Bospar, San Francisco, CA

76

$1,435,681

#36

Pierpont Communications, Houston, TX

36

$1,431,601

#37

Red Thread PR, Philadelphia, PA

14

$1,185,386

#38

LaunchSquad, San Francisco, CA

109

$1,150,000

#39

rbb Communications, Miami, FL

59

$1,135,882

#40

Tunheim, Minneapolis, MN

23

$1,109,750

#41

Alloy, Atlanta, GA

88

$1,069,345

#42

Taylor, New York, NY

100

$950,000

#43

Jackson Spalding, Atlanta, GA

133

$922,194

#44

V2 Communications, Boston, MA

44

$905,852

#45

Beehive Strategic Communication, St. Paul, MN

11

$852,916

#46

L.C. Williams & Associates, Chicago, IL

22

$845,853

#47

Trevelino/Keller, Atlanta, GA

43

$800,000

#48

Communications Strategy Group (CSG), Denver, CO

36

$790,606

#49

Thunderly Marketing, Allen, TX

7.7

$788,188

#50

3E Public Relations, Pine Brook, NJ

8

$770,000

#51

Landis Communications, San Francisco, CA

7

$759,000

#52

Singer Associates Public Relations, Inc., San Francisco, CA

15

$657,438

#53

Bellmont Partners, Minneapolis, MN

23

$595,837

#54

LLYC in the U.S., Grand Rapids, MI

110

$581,000

#55

Otter PR, St. Petersburg, FL

23

$533,223

#56

Ehrhardt Group, The, New Orleans, LA

22

$522,123

#57

PSC (Princeton Strategic Communications), Trenton, NJ

10

$475,073

#58

Gregory, Ardmore, PA

126

$420,326

#59

360PR+, Boston, MA

54

$388,805

#60

O'Connell & Goldberg PR Firm, Fort Lauderdale, FL

20

$360,125

#61

Rasky Partners, Inc., Boston, MA

16

$352,800

#62

Slide Nine Agency, Columbus, OH

14

$328,851

#63

Stanton Communications, Washington, DC

8

$298,000

#64

Shiftology, Springfield, OH

6

$259,923

#65

Hoyt Organization Inc., The, Torrance, CA

0

$256,322

#66

Pugh & Tiller PR, LLC, Annapolis, MD

3

$246,332

#67

Boardroom Communications, Inc., Ft. Lauderdale, FL

18

$200,000

#68

Tier One Partners, Boston, MA

15

$165,927

#69

Racepoint Global, Boston, MA

37

$160,206

#70

Attention Comms, Inc., New York, NY

3

$158,713

#71

Inspire PR Group, Westerville, OH

19

$141,713

#72

Rosica Communications, Fairlawn, NJ

10

$133,825

#73

Marketing Maven Public Relations, Camarillo, CA

10

$115,572

#74

Lee Andrews Group, Los Angeles, CA

29

$107,852

#75

Idea Grove, Lewisville, TX

10

$90,550

#76

Lawlor Media Group, New York, NY

4

$70,600

#77

Red Banyan, Fort Lauderdale, FL

24

$46,250

#78

O'Malley Hansen Communications, Chicago, IL

7

$41,300

#79

Scenario Communications, Stevenson Ranch, CA

17

$5,000