Tweeting to the top, GlaxoSmithKline and Pfizer tied for the No. 1 spot in the inaugural ranking of global pharma influencers by Owen Health. The U.K.-based healthcare marketing agency evaluated 22 pharma companies on authority, reach, activity, engagement and influence to rate the most and least adept when it comes to Twitter.

GSK and Pfizer both scored 75 and led the pack in influence, measured by Klout scores. Pfizer scored particularly well in reach—coming in second to Novartis—and also in being active, where it was just slightly behind Roche and Johnson & Johnson, which were Nos. 1 and 2 respectively in that measurement, Dean Mattingley, director at Owen Health, said in an email interview.

Meanwhile, GSK’s strength was engagement, which used a weighted measurement of likes, retweets and replies and took into account the number of followers and the volume of tweets sent during the month-long survey period. Mattingley said that that way, the engagement measure resulted in a score that "provides a clearer understanding of whose content is working the best.”

Owen Health used a snapshot approach for the study, analyzing more than 5,000 data points for the pharma Twitter accounts during the month of October 2017.

At the bottom of the ranking was Teva, with a score of 22. MSD, which is what Merck is known as outside the U.S. and Canada, and Daiichi Sankyo were also at the bottom, both scoring 34 in the final Twitter tally by Owen Health. The key reasons those pharmas ranked low were a lack of a verified account status as well as low scores in reach, activity and influence. In an unusual twist, however, both Teva and MSD ranked high in engagement, thanks to the ranking’s weighted measurement that tempered the typical engagement measures of likes, retweets and replies with overall reach and tweet volume.

The upshot for pharma, Mattingley says, is that while most companies are now firmly established on Twitter, it’s time to take the next step and invest in strategy and development.

“We believe that pharma companies that have invested in building the size of their communities now need to develop content marketing strategies which engage their communities in order to build a sustainable social platform or run the risk of managing zombie communities,” he said.