By Ronn Torossian

I have never worked inside a pharmaceutical company. I have advised them, pitched them, watched them navigate crises no other sector faces, and read every one of their earnings calls I could get my hands on. And when we finished measuring how the AI engines actually render eighteen pharma CEOs, I sat with the numbers for a long time.

The pharma cohort tells a very different story than any sector we have measured before.

David Ricks at Eli Lilly composites 82 — the highest score in the pharma cohort and among the highest across our entire eleven-study franchise. The engines do not render Ricks as the CEO of Lilly. They render him as the personification of GLP-1. Mounjaro. Zepbound. Kisunla in Alzheimer's. Trulicity underneath. He is the category inside the machine. That is a different reputation asset than anything I have ever seen a communications team build. And it is not accidental — it took fifteen years of category-defining approvals inside one Indianapolis institution to get there.

Then Stéphane Bancel at Moderna composites 34 — the lowest score in the pharma cohort, and one of the lowest we have ever measured in the entire Index. The engines still index the 2020–2021 pandemic-hero narrative. They also index the ninety percent share price decline from the 2021 peak. They index the sustained executive departures across the CFO, CMO, and R&D chief roles. And they do not know how to reconcile any of it. The two indexed narratives are dimensionally incompatible — pandemic hero, post-pandemic reversion — and the engines just hold both at once. That is what a portrait looks like when the product cycle ends and there is no successor commercial franchise to replace it.

The finding that shook me most was cross-portrait contamination. The GLP-1 category advance now writes eighteen pharma-CEO portraits simultaneously. All at once. Doustdar at Novo Nordisk inherited a damaged portrait ten months into his tenure because of what Ricks built. Bradway at Amgen is now indexed against MariTide as his category-entry anchor. Bourla at Pfizer bought Metsera in 2025 partially so the engines would stop indexing Pfizer against the absence of a GLP-1 pipeline. No other sector we have measured produces this. When one player defines the category, every competitor gets rewritten.

I want to also flag Reshma Kewalramani at Vertex. Composite 63. Biggest overperformer against peer-adjusted baseline. Vertex is smaller than every US Big Pharma — but Casgevy, the first-ever CRISPR gene therapy, produced an engine portrait that reads like a top-tier institution. The lesson is important: category dominance is not the only path to the top of the Index. Scientific firsts also work. Kewalramani proves it.

And Emma Walmsley at GSK deserves credit that I do not think the industry has given her yet. Composite 68. Third-place finish. The Zantac litigation cycle from 2019 through 2024 should have destroyed her portrait. GSK-the-institution absorbed the cycle across five years of sustained financial-reporting infrastructure. Individual response did not do that work. The institution did.

Here is what boards should be taking away. Every therapeutic-area investment decision now carries an engine-portrait consequence alongside the commercial consequence. And every category loss — Novo's, Moderna's, Biogen's — gets attributed to the sitting CEO, not to whoever was in the seat when the loss actually happened. That is worth measuring. Every quarter.

The full study is live: Pharma CEOs — The 5W Reputation Index. Eighteen chief executives. Six proprietary sub-indices, including two we built specifically for pharma. Ten other studies at 5wpr.com/reputation-index.

Ronn Torossian is the founder and chairman of 5W AI Communications, the AI Communications Firm. He is the publisher of Everything-PR and the author of two best-selling editions of For Immediate Release.