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Building the Ideal Targeting Strategy

Choosing endemic vs non-endemic inventory

Have you ever had concerns over whether your programmatic ads are being shown on the most effective websites? Underscore Marketing champions a strategic blend of endemic and non-endemic inventory sources within our programmatic campaigns, recognizing the nuanced benefits that both contribute to maximizing brand awareness, audience engagement, and campaign effectiveness.

Situational Analysis

Our Programmatic campaigns allow us to purchase digital advertising within milliseconds in an automated, real-time-bidding environment where ads are served to the highest bidder, much like the stock market. We commit ourselves to strategizing and efficiently optimizing each campaign to provide the strongest campaign performance possible while considering the parameters pertaining to our clients’ goals, such as budget, disease-state, competition, target audience, approvals, and more.

Within these programmatic campaigns, the usage of endemic and non-endemic inventory sources is an important strategic consideration. Clients have the option to either include them individually or provide a mix of both. Often, brands are focused on ensuring their ads are being served on websites that are of the nature of their brand, and websites where their target audiences (Healthcare Professionals, Patients, or Caregivers) are actively looking for information. Those contextually relevant websites are considered endemic and making campaigns a part of the endemic marketplace is integral in allowing programmatic to do its primary job of increasing brand awareness.

Impact of Endemic Media
A recent study found 61% of HCPs indicated that they trusted ads in endemic environments.

“Doctors are Influenced by where they see professional ads.” 21 Sept 2023

Additionally, endemic allows us to use partners that can leverage other powerful first party access such as identity solutions, which are important in the upcoming cookie-less future. Publishers also view endemic content as more premium inventory. They may do things like prioritize that demand of their own programmatic inventory, in many cases making an endemic strategy a requirement to successfully reach this inventory. These are common occurrences, and all these benefits help to reinforce endemic as a powerhouse.

Non-endemic websites would refer to all other websites that are not contextually relevant to the brand. Utilizing contextual advertising enables you to promote your brand on non-endemic websites, characterized by lower competition. The outcome? Enhanced cost efficiency in your advertising campaigns. It is useful to include non-endemic inventory in programmatic campaigns as it tends to only reach desktops, while non-endemic has the capability of reaching users on both desktop and mobile devices, allowing us to extend messaging to a high-value audience across multiple environments.

Furthermore, investing in non-endemic environments will allow Brands to stay nimble across the consumer journey, as a user’s increased time on mobile devices has led to a shift amongst advertisers towards greater mobile investment. While desktop advertising spend is forecasted to increase from $97 billion in 2022 to $142 billion in 2026, mobile advertising spend is expected to exceed that threshold, surpassing $413 billion this year.


While we know that HCPs are nearly twice as likely to click on ads in endemic environments, we also know that non-endemic inventory allows us to reach mobile devices. Individuals, including healthcare professionals, dedicate an average of 5.4 hours per day to mobile device usage. With mobile devices increasingly integrated into the healthcare sector, this advertising format offers a practical and proficient means to reach physicians on the devices they actively engage with. Endemic environments are ideal because these ads are served when HCPs are actively seeking information about treatments, what is advertised should be top-of-mind for them here.

However, non-endemic environments also contribute to raising awareness. It’s essential to recognize that physicians are frequently online, and neglecting to reach them in these environments represents a missed opportunity. Our programmatic advertising strategy aims to connect with healthcare professionals throughout their digital journey, ensuring consistent engagement across various platforms and contexts. Non-endemic also means contextual targeting, according to a 2016 study of 8,600 consumers conducted by IPG Media Lab and ZEFR, people were 83 percent more likely to recommend products seen via contextual strategies compared to non-contextual targeting. Contextual advertising also led to a 63% increase in purchase intent. Hence, HCP behavior suggests that a strategic mix of endemic and non-endemic allows us to ensure as much inventory, cost efficiency, and brand awareness as possible. Since this is already considered a best practice, we can mold this into a perfect fit for our clients’ initiatives.

Incorporating both an endemic and non-endemic strategy within our programmatic campaigns has been the best approach and has yielded the strongest campaign performance results. Combining both endemic and non-endemic inventory has also been proven to result in higher reach, script lift, and CTR.

With all the capabilities that we can leverage via our partnership with PulsePoint, we can leverage endemic site lists into our programmatic campaigns, provide granular inventory targeting, comprehensive reporting, automated physical level data, and measurement integrations. Underscore excels at creating customized programs for our clients that drive the most impact and ROI for their investment. With our consultative and collaborative approach, we work seamlessly as an extension of a client’s team, while utilizing our expertise to challenge norms and deliver results. Learn more about how we can help make an impact on your campaigns today!

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