Bluesky works in a similar way to X. People post short messages, follow others, and join in conversations, all in a familiar scrolling feed. But what makes Bluesky different is how it's built. It’s designed to be decentralised, which means no single company owns or controls everything. Instead, users have more power to choose the algorithms they want, control how their data is used, and even move their account between different services built on the same system.
Bluesky was started by Jack Dorsey, the co-founder of Twitter (now X), as a way to rethink how social media should work — more open, less controlled, and more focused on user choice. While it's not as big as established platforms like X or LinkedIn, as at July 2025 the platform had over 37.5 million registered users. According to the latest estimates, Bluesky has 4.1 million daily active users.
Bluesky was started by Jack Dorsey, the co-founder of Twitter (now X), as a way to rethink how social media should work — more open, less controlled, and more focused on user choice. While it's not as big as established platforms like X or LinkedIn, as at July 2025 the platform had over 37.5 million registered users. According to the latest estimates, Bluesky has 4.1 million daily active users.
Are HCPs using Bluesky?

Are pharma companies using Bluesky?
Right now, some of the big pharma companies (such as Amgen, Eli Lilly, Novartis, Bristol Myers Squibb and AstraZeneca) have accounts, but we are yet to see any actively and regularly posting. As an example, Eli Lilly have posted five posts on Bluesky in the last 4 months and continue to be more active on X. Amgen are yet to post on Bluesky and are likewise remaining active on X.
How can pharma marketers prepare for Bluesky?
While the platform is still in its early days, especially in healthcare, it offers a glimpse into what a decentralised, user-first social network could mean for digital engagement. For companies and brands that want to stay ahead of the curve, now is the time to observe, listen, and lay the groundwork. Here's how pharma can start preparing for Bluesky and monitor early signs of HCP activity.
1. Secure your handle early
2. Start listening
3. Map your digital KOLs
4. Monitor sentiment and gaps
Right now, Bluesky doesn’t support paid advertising or advanced targeting. For pharma marketers, the priority should be understanding the platform’s culture, tone, and the kinds of content that genuinely resonate.
For those ready to explore Bluesky, early adoption can pay off. With less competition, it's easier to gain organic reach and grow a following. As platforms mature, this gets harder without paid support. If the channel fits your strategy, consider starting by repurposing content you’re already creating for other platforms as a low investment way to get started.