How to manage multiple domains on international healthcare sites

19th Nov 2024

• Do you need a separate website for each region where you have a presence? 
• Would it be best to have siloed areas for your HCP and patient-facing content? 
• Should you create new sites for individual drugs, molecules and disease areas? 
• Alternatively, should all your content be hosted together, regardless of location, audience or intention?
• If you do need to create content silos, should these be individual websites, separate subdomains or separate subfolders? 

Unfortunately, there is no hard and fast rule when it comes to multiple domains. The best solution will depend entirely on what you are trying to achieve with your websites, how much content you have, as well as the health regulations you are working alongside. However, there are certain considerations to weigh up. Below we detail 8 items to take into account when considering a multi-domain strategy for healthcare websites:

1.  Healthcare Compliance

As we know, rules and regulations around pharmaceutical marketing vary from region to region. There are frequently also different compliance considerations for content aimed at patients as opposed to HCPs. Often, the easiest way to ensure your content is compliant is to separate it entirely for each targeted location and audience. Yet, whilst this may be simplest from a regulatory point of view, keeping numerous separate websites up to date and correct can be difficult in practice. An alternative approach would be to use subdomains or subfolders within a main website to host this different content, and use interstitials (pop ups) to direct specific audiences to the content that is relevant to them, with users needing to click to confirm their background and location before they can access certain information.

2.  Staggered Website Launches

It is widely acknowledged within the healthcare industry that the FDA often approves drugs at higher levels and in quicker time frames than European counterparts. In practice, this often means for pharmaceutical companies that US websites are launched first, with content for other regions following months or even years later. What are the implications for a multinational strategy if this is the case? From an SEO perspective, this can mean that Google and other search engines accept the US version of a website as the established, global version of the content – and that when additional content is launched for other geographical locations this can find itself in competition with the established US version. There is even the danger that Google will consider similar content launched later to target different regions as a duplicated or copied version of the US content, and therefore penalise this seeming ‘knock off’ copy content. A single, global domain can help to avoid this complication, but whatever approach you take it will be essential to have a watertight hreflang and canonical strategy.

3. Correct Hreflang and Canonicalisation Implementation

Whenever duplicate or near-duplicate content is published online, specific coding is required to help search engines understand the relationship between each page. Regardless of whether you have multiple domains, separate subfolders, or subdomains targeting different locations, each page can be tagged with hreflang coding to tell Google which language and location it is aimed at. Canonical tags must also be used, and these must not contradict your use of hreflang tags. For more detail on the correct technical implementation to use here, take a look at our advice on local SEO for healthcare and pharmaceutical companies.

4. Maintenance and Longevity

Once a website is up and running, it needs to be actively maintained. Content must be updated to ensure it is always correct and relevant, broken links must be found and fixed, and constant optimisation should be part of your marketing strategy to iteratively improve web performance. Using multiple domains can make this process messy or difficult to manage; as teams change and evolve, domains can end up without an owner or different teams may lack regular direct communication. It is important that any strategy for an international healthcare website works not only at launch, but will continue to work in two or five years time. Choosing to combine your domains at a later date can be difficult and can lead to the disruption or destruction of your established traffic. In 2024, Varn Health was awarded a Gold Award at the PM Society Digital Awards for helping to avoid just this. Our client Roche had multiple separate domains focusing on specific disease areas that they wanted to pull together onto a single, central location.  Aware of the dangers of losing established Organic Search rankings if this was not done carefully, we worked closely with Roche to ensure a seamless transition to the new domain. In the end, not only was performance protected, we saw an improvement in SERP clicks of more than 100%. So whilst it is always possible to successfully combine multi-domain content in the future, this does take time and effort.

5. Use of Pop-Ups and Interstitials

As already mentioned, interstitials can be used to help ensure your content is compliant, even when all located on a single domain. For example, a pop-up can interrupt the user’s access to the site until they confirm that they are a HCP; if they are not, they can be redirected to relevant patient-facing content. However, it is very important that interstitials are used with care, and that these enhance rather than undermining the user experience. Google has specific guidelines on how to avoid intrusive interstitials which should be followed to avoid them having a negative impact on your Organic Search performance.

6. Localisation (or Localization?)

The very basic requirement for launching content in different locations is that copy should be translated into the relevant language for the target audience. However, localisation takes things a few steps further and is essential for international pharmaceutical websites. First and foremost, localisation will take into account the specifics of how language is used in the relevant region, not only by differentiating between things such as UK spellings like ‘localisation’ and US spellings like ‘localization’, but by only using the sayings, idioms and turns-of-phrase that would be most familiar to the target audience. Furthermore, localisation should take into account cultural context and regulations. For healthcare sites, for instance, content must correctly reflect how healthcare provisions are put in place in the relevant region in order to provide readers with the most relevant information.

7. Cross-Domain Tracking

Implementing correct tracking on any website is essential. Monitoring and evaluating your website’s traffic, acquisition channels, and onsite user behaviours will give you vital insights into issues to be fixed and opportunities to be taken up. When considering a multi-domain strategy for your website, thought should be given to how cross-domain tracking can be implemented; this will be essential to track user journeys between your sites which will be particularly beneficial if it reveals that users are regularly arriving on content that is not intended for them, and having to navigate to other content areas.

8. Diluted Backlink Profiles

Good-quality backlinks are an essential part of a successful SEO strategy. Links from relevant, high-quality websites to your content provide context to Google, as well as acting as a vote of confidence for your website. It is generally easier to build up a rich and influential backlink profile for a single website hosting a fair amount of content, as opposed to attempting to create similarly strong individual backlink profiles for multiple separate domains. Focusing your offpage efforts on a single domain can have more of an impact, and avoids diluting the strength of your backlink profile across more than one separate website. Consolidating your content on a single domain is therefore more compelling if you are intending to implement an off-page SEO strategy for your content (you can read up on why backlinks are important to healthcare SEO if you’re not already convinced)

Still unsure about how to create a strategy for an international healthcare website? Get in touch with our expert team to find out how we can support you to implement strategies and tactics for SEO success.