The audience decided this audit, not the law
Osteoporosis is a disease of older adults. The average visitor to a patient information site about it is likely over 60, often dealing with weaker eyesight, sometimes recovering from a fall, sometimes reading the screen alongside a caregiver. That profile should drive every design decision a pharma brand makes for that channel. Often it doesn't.
We recently completed a WCAG 2.2 accessibility audit on osteoporosenews.be, an Amgen patient information site. Belgian law does not currently require pharma patient sites of this type to be WCAG compliant, which is part of why we did the audit in the first place. When compliance is voluntary, the audit becomes a clearer test of intent. The site scored 30 out of 100.
That number is not an outlier. Across the broader web, research from accessibility.build found that 94.8% of sites contain at least one detectable WCAG failure, and only 7% reach the 80-point threshold considered reasonably accessible. Healthcare specifically performs poorly. An AudioEye industry report found the average healthcare page contains 69.1 unique color contrast violations, the exact failure mode that punishes older users with reduced vision.
Why does accessibility matter for older patients in pharma digital communication
The business case for accessible patient communication is usually framed around legal risk. That framing misses the point for pharma. The point is engagement, and engagement drives outcomes.
Promedia's own patient engagement research shows that fewer than 45% of people searching for health information online find what they need without frustration. Patients who feel unheard disengage from their care entirely. The downstream effect is measurable: unengaged patients are twice as likely to delay care and three times more likely to have unmet medical needs. For a chronic condition like osteoporosis, where adherence to treatment and follow-up scans determines fracture risk over years, a disengaged patient is a clinical problem, not just a marketing one.
Now apply that to a 72-year-old reading medication information at home after a wrist fracture. If the text is small, the contrast is poor, and the tap targets are too tight for shaky fingers, that patient closes the tab. The brand has lost a touchpoint at exactly the moment the patient most needed reliable information. That is the quiet cost of inaccessible patient sites, and it shows up nowhere on a campaign dashboard.
How do you audit a pharma patient website for WCAG compliance
A WCAG audit is not a single automated scan. Automated tools catch perhaps a third of real accessibility issues. The rest require a trained reviewer to walk through the site the way a real user would, with a screen reader, with a keyboard only, with simulated low vision. For a pharma patient site, we structure the audit around the four WCAG principles: perceivable, operable, understandable, robust.
In practice, that means checking:
- Color contrast against WCAG Success Criterion 1.4.3, the most commonly failed criterion across the web, found on 79.1% of tested pages.
- Font size and line spacing at default zoom and at 200% zoom, which older readers routinely use.
- Tap target size, with a minimum of 24 by 24 CSS pixels under WCAG 2.2, and ideally larger for a patient audience with motor impairment.
- Keyboard-only navigation, since AudioEye recorded an average of 6.1 keyboard violations per healthcare page.
- Heading hierarchy, so screen readers can announce structure cleanly to users who cannot scan visually.
- Form labels, error messages, and link text that make sense out of context.
The audit produces a score, but the score is not the deliverable. The deliverable is a prioritized list of fixes ranked by user impact, with the cheap-and-high-impact items separated from the deep rebuild items. A brand team rarely has budget to fix everything at once. They need to know what to fix first.
What does a WCAG score of 30 out of 100 mean for a patient website
A score of 30 means the site fails the majority of automated and manual checks against WCAG 2.2 AA, the standard most regulators and procurement teams now reference. In practical terms, a patient with low vision will struggle to read large portions of the site. A patient using a screen reader will encounter unlabeled elements and broken navigation. A patient using only a keyboard, common among users with tremor or arthritis, will get trapped or skip past key information.
It is not catastrophic, and it is not unusual. It is roughly where most pharma patient sites land when no one has been asked to check. The work to move a 30 toward a 70 or 80 is mostly mechanical: contrast adjustments, semantic HTML cleanup, alt text, focus indicators. Moving from 80 toward 95 is harder and involves content strategy, plain language, and structural decisions.
For brand teams, the useful framing is this. A score below 50 means the site is actively excluding a meaningful share of its intended audience. A score between 50 and 70 means the site works for most users but creates friction for the ones who need it most. A score above 80 means the site is usable by the audience it claims to serve.
How to improve readability and usability of pharma patient websites
The fixes that matter most for an older patient audience are unglamorous and cheap. Increase body text to at least 18 pixels. Use a contrast ratio of 7:1 rather than the minimum 4.5:1. Make tap targets at least 44 by 44 pixels. Write in short sentences with one idea per paragraph. Use real headings, not bold text that looks like a heading. Test the site with a screen reader, then test it again at 200% zoom, then test it on a five-year-old Android phone over 4G.
None of this is technically difficult. What it requires is a brand team willing to treat the patient site as a clinical communication tool rather than a campaign asset. Promedia's patient engagement work consistently shows that the brands building digital tools tailored to actual patient needs are the ones earning trust and retention. Three out of four patients believe providers who offer accessible digital tools create a better care experience. That trust compounds across a chronic disease journey.
