Veeva and IQVIA dominate the conversation, but they are no longer the only two major players in the market. Since the breakdown of the long-standing partnership between Veeva and Salesforce in late 2022, the landscape has shifted to include at least four families of platforms.

Veeva has migrated its CRM to its own Vault architecture, which has already seen significant adoption more than 115 Vault CRM deployments in production and nine of the world’s top twenty biopharmaceutical companies committed to the platform, according to figures released by Veeva in the third quarter of its 2026 fiscal year.

Salesforce responded with Life Sciences Cloud co-developed with IQVIA’s OCE technology more than 70 life sciences customers were announced in early 2026, including Pfizer ,Takeda, Boehringer Ingelheim, and Fresenius Kabi.

Cegedim CRM (Cegedim Relationship Management) remains a long-standing player that is often underestimated outside of French-speaking Europe. With a presence in France, Switzerland, the United Kingdom, and French-speaking Africa, the group built its business on life sciences CRM starting in the 1990s and today maintains a leading position in the pharmacy and medical practice segments in Europe.

Oracle and SAP round out the landscape in the areas of data, real-world evidence, and supply chain, with a more peripheral CRM integration.

For a French-speaking European and African player, this landscape analysis is important content conversion isn’t limited to the Anglo-Saxon Veeva–IQVIA axis. It’s just as relevant for pharmaceutical companies migrating to or from the Cegedim ecosystem, which has a particularly strong presence in the markets that Pixels Health serves on a daily basis.

In practical terms,this incompatibility results in several weeks of production,high technical costs,delays in campaign launches,and additional regulatory approval cycles (MLR). On the ground,it also results in a temporary desynchronization of omnichannel orchestration “next best action” recommendations lose their relevance until the content is reclassified on the new platform sales representatives’ adoption time slows down their visit frequency and there is a gap in SFE management while dashboards resynchronize. For pharmaceutical groups operating in multiple markets,the problem becomes structural every market and every platform change triggers the same costs both commercial and technical.

We must address here what is rarely addressed,without claiming a level of objectivity that no one fully possesses in this debate including Pixels Health since Bridge AI is itself a commercial solution. The difficulty of switching from one ecosystem to another is not merely a technical issue proprietary formats and the lack of interoperability standards between platforms effectively function as exit barriers.

This is not unique to the pharmaceutical industry or healthcare software it is a recurring pattern in the history of enterprise software,documented well beyond this sector,as the parallel below illustrates. Pointing this out is not an accusation against Veeva,IQVIA,Cegedim,or Salesforce it is a rational business decision that these vendors share with virtually the entire enterprise software industry.

This unspoken reality was tenable as long as content conversion required rare expertise and considerable manual labor. It is becoming less and less so as artificial intelligence enables the automated analysis and reconstruction of proprietary structures. What used to be a project taking several weeks is now a simple process. Content portability thus ceases to be a matter for experts and becomes a criterion for selecting the platforms themselves.

When people try to argue that a closed ecosystem guarantees stability,Apple is the first example that comes to mind a single vendor that controls the chip,the operating system,and the apps delivers a quality of experience that a multi-vendor ecosystem sometimes struggles to match. The argument is valid,but it rests on a specific level of technical complexity Apple’s vertical integration manages real-time coordination between hardware and software an engineering challenge where openness comes at a measurable cost.

CLM content does not reach that level of complexity. Its underlying layer HTML,CSS,images,and video has been a mature standard for over twenty-five years and is natively interoperable. Therefore,it is not the stability of the content that would justify a closed architecture it is something else.

The right parallel isn’t found in hardware proprietary printer cartridges,for example,are subject to a commercial lock-in on a physical consumable,which has nothing to do with the stability of digital content. It’s found in a software layer very similar to that of CLMs the proprietary customization languages of marketing automation platforms.

In Salesforce Marketing Cloud, email content remains standard HTML,readable by any email client in the world. But Salesforce overlays it with AMPscript, a proprietary scripting language executed on its own servers to drive personalization and access to customer data. HubSpot does the same with HubL,a language built on Jinja an open-source templating engine that has been transformed into a proprietary,non-portable dialect. A recent independent audit of the platform explicitly notes that HubL templates remain proprietary and that extracting them requires significant effort. Adobe Marketo,for its part,combines personalization tokens and Velocity script blocks to achieve the same functionality.

Three different publishers,three different languages,a single common logic the core content is open and interoperable,but the customization and conditional logic layer the one that makes the content truly usable in production is proprietary and non-transferable. Migrating from AMPscript to HubL isn’t just a matter of converting HTML it involves manually rewriting every condition,every data call,and every dynamic block in an entirely different syntax to essentially do the exact same thing.

This is precisely the mechanism found in pharmaceutical CLM,which operates at a higher level of regulatory complexity. What makes a Veeva presentation incompatible with IQVIA is not the content,but the navigation,metadata,and tracking layer specific to each platform built on the same logic as AMPscript or HubL a proprietary syntax for controlling content that is otherwise universal.

This layer serves a real purpose in terms of engagement tracking,multichannel orchestration,and compliance functions that would not exist natively in pure HTML. But there was no reason it had to be non-portable technically,nothing prevents a vendor from documenting an open schema for this layer rather than a closed format. The decision to use a closed format was an economic choice,not an engineering necessity. A sign that the direction can change Salesforce is currently migrating some of its users from AMPscript to HML,a new layer built on the open-source Handlebars.js engine proof that the closed format was not a technical inevitability.