Why Getting Found by AI Is a Marketing Problem, Not a Technical One — and Why Pharma Must Lead It

The patients and HCPs your brand needs to reach are already using AI to navigate health. A 2026 Boston Consulting Group survey of more than 13,000 consumers across 15 countries found that nearly 60% already use AI in some form for their health — and their expectations are moving fast. They want AI to flag dangerous drug interactions, recommend treatments based on personal data, and guide them through clinical complexity. They are doing this before they speak to a clinician, before they visit a brand website, and before your content has any chance to reach them through traditional channels.

What the BCG data also makes clear is that this trust is conditional. Consumers welcome AI for information and navigation, but draw a firm line when the stakes are clinical — and they will not extend that trust to AI answers that feel promotional, inaccurate, or unsourced. That is the opening for pharma. If the information environment AI draws from is shaped by your medically reviewed, clearly structured, externally validated content, you serve patients at the exact moment they are most receptive. If it isn’t, someone else’s version of the answer fills that space instead. Generative Engine Optimization — GEO — is the discipline of making sure it’s yours.

What Is GEO?

Generative Engine Optimization (GEO) is the practice of optimizing content and brand presence to appear as authoritative sources or direct responses within generative AI platforms — tools like ChatGPT, Perplexity, Google’s AI Overviews, Claude, and Gemini. Unlike traditional SEO, which aims to rank a URL in a list of results, GEO aims to earn inclusion inside a synthesized, conversational answer.

In healthcare, that distinction is not subtle. It changes nearly everything about how pharma visibility works, who creates it, who measures it, and — critically — who should own the strategy.

Pharma has already been through one version of this disruption: a shift from the sales rep visit to the search engine. The next shift — from the search engine to the AI-generated answer — is underway now, and it demands the same response: marketers must lead it, not delegate it. 

The Numbers That Make GEO Urgent

AI-referred web sessions jumped 527% between January and May 2025, from 17,076 to 107,100 sessions across 19 GA4 properties analyzed by Previsible. ChatGPT alone controls approximately 84% of all AI referral traffic, and while volume is still small relative to Google, the quality is dramatically higher: AI referral traffic converts at roughly 14% compared to 2.8% for Google organic search — nearly five times better (Previsible, 2025 State of AI Discovery Report).

This is not a future trend. It is already in your analytics.

Why GEO Is Fundamentally Different From SEO

Traditional SEO is primarily a technical and content discipline. You optimize a URL. You fix crawl errors, improve page speed, build backlinks, target keywords, and structure metadata. The goal is a ranking in a list. A developer or SEO specialist can execute most of this work.

GEO is something else entirely.

“SEO is your space: your website, blog, technical optimization. GEO is all that stuff plus external influences. We don’t really optimize for generative engines; we influence them.” — Foundation Inc. (2024)

The shift in language matters. You cannot optimize your way into an LLM’s answer the way you can engineer a page to rank. LLMs do not rank pages. They form an opinion about your brand based on everything they have seen across the entire web — third-party articles, reviews, forum discussions, press coverage, Wikipedia entries, social commentary — and then decide whether your brand is credible enough to mention.

That is not a technical problem. It is a reputation and positioning problem.

GEO Is Driven by Signals You Don’t Fully Control

Search Engine Land published a direct challenge to the mainstream GEO narrative in 2025: most promoted GEO “hacks” — creating an AI info page, generating markdown versions of content, or automating an llms.txt file — have limited impact because they don’t address how LLMs actually decide which brands to recommend (Search Engine Land, 2025).

What does drive GEO performance? The signals are largely external:

• Third-party mentions and earned media. Brand search volume shows a 0.334 correlation with AI citations — the single strongest predictor identified in a 7,000-citation study, stronger than backlinks (The Digital Bloom, 2025, via obapr.com).
• Entity consistency across the web. LLMs form opinions through consensus. If your brand is described differently across LinkedIn, G2, Wikipedia, and press coverage, models struggle to characterize you with confidence.
• PR and thought leadership. Agencies and practitioners now treat PR as a required component of GEO, not an optional add-on. Firebrand Marketing (2026) puts it plainly: “For an effective GEO strategy, PR is not optional. It’s a highly influential ranking factor.”
• Social presence and community signals. Platforms like Reddit, LinkedIn, and Quora influence LLM perceptions of brand authority in ways that bear no resemblance to traditional link-building.

For top-of-funnel queries, approximately 85% of AI citations come from off-site sources (Contently, 2025). The implication is stark: even a technically perfect website cannot compensate for weak external brand presence.

Who Should Own GEO?

This is where the organisational debate gets interesting — and where companies often go wrong.

The assumption has been that GEO belongs to the SEO team. But SEO teams typically control only a narrow portion of the signals that determine LLM behavior. They own on-site content and technical infrastructure. They do not own PR, brand positioning, social strategy, executive thought leadership, or the third-party publications that LLMs weight most heavily.

As Search Engine Land argues: “GEO is a strategic issue at the executive level, not an SEO issue at the operational level.”

This does not mean SEO is irrelevant to GEO. Technical foundations — structured content, clean crawlability, schema markup, E–E–A–T signals — remain necessary conditions for AI discoverability. But they are a floor, not a ceiling. The ceiling is set by marketing, communications, and brand strategy.

GEO belongs to a cross-functional team led by marketing, not a siloed SEO function.

The Practical Marketing Implications

If GEO is a marketing discipline, the tactical toolkit looks less like a developer’s checklist and more like a CMO’s playbook:

• Consistent brand narrative. LLMs form opinions through pattern recognition across multiple sources. If your messaging is fragmented, the model cannot reach a confident conclusion about your brand.
• Earned media strategy. Press coverage in authoritative publications creates the kind of validated, third-party signal that LLMs use as a credibility proxy. Paid placements, typically marked as sponsored or nofollow, provide almost none of these signals (obapr.com, 2026).
• Category ownership content. Content that defines your category, answers comparative questions, and positions you against alternatives performs strongly in LLM citations — especially in B2B SaaS, finance, legal, and healthcare contexts.
• Measurement reorientation. Traditional KPIs — organic sessions, keyword rankings, CTR — do not capture GEO performance. Marketing teams need to track brand mentions in LLM responses, monitor branded search trends, and shift toward engagement and pipeline metrics (Pharma Marketing in the Age of AI Search).

The Bottom Line

GEO is not SEO with a new name. It is a fundamentally different discipline that operates at the level of brand reputation and ecosystem authority rather than page-level optimization. The technical prerequisites are real but insufficient. The determining factors — third-party validation, consistent brand narrative, earned media, entity recognition — are owned by marketing, not engineering.

The organisations that will win in AI-driven search are not those that hack their robots.txt or generate llms.txt files. They are the ones that build genuine, consistent authority across every surface that informs how an LLM thinks about their category.

That has always been the job of marketing. GEO just makes it measurable.

References:

1. BCG (2026). Consumers Are Ready for AI-Enabled Health Care. Health Systems Need to Be, Too. Boston Consulting Group. https://www.bcg.com/publications/2026/consumers-are-ready-for-ai-health-care-are-systems
2. Search Engine Land / Previsible (2025). AI traffic is up 527%. SEO is being rewritten.https://searchengineland.com/ai-traffic-up-seo-rewritten-459954
3. Foundation Inc. (2024). SEO vs. GEO: How to Optimize for Search Engines and AI.https://foundationinc.co/lab/seo-vs-geo
4. OBA PR (2026). How AI/LLM Tools Like ChatGPT and Perplexity Choose PR Agencies to Recommend. https://obapr.com/resources/how-ai-llm-tools-like-chatgpt-and-perplexity-choose-the-best-ai-pr-agencies-to-recommend-in-2026/
5. Firebrand Marketing (2026). GEO Best Practices for 2026. https://www.firebrand.marketing/2025/12/geo-best-practices-2026/
6. Search Engine Land (2025). Why GEO is a reputation problem. https://searchengineland.com/geo-reputation-problem-475342
7. Pharma Marketing in the Age of AI Search, Olivier Gryson

Olivier Gryson, PharmD, MSc
25 years of experience in digital marketing in the pharmaceutical industry
Special focus on AI Search in Pharma Marketing