Growing Healthcare E-commerce from £6M to £20M+ with PPC

Overview

Between 2012 and 2018, I led the digital marketing strategy for Complete Care Shop, a UK healthcare and mobility aids e-commerce business. Through strategic PPC management, SEO, email marketing, and conversion optimisation, we grew their annual revenue from £6M to over £20M.

This case study shares the strategy, tactics, and lessons learned from scaling a healthcare business in a competitive market.

The Challenge

Industry: Healthcare and mobility aids - walking aids, wheelchairs, bathroom safety equipment, and daily living aids.

Starting point: £6M annual revenue, primarily from PPC advertising.

Key challenges:

1. Highly competitive market - Large competitors like Boots, Lloyds Pharmacy, and specialist healthcare retailers
2. High cost-per-click - Healthcare keywords are expensive (£2-5+ per click)
3. Complex product range - Thousands of SKUs across dozens of categories
4. Sensitive audience - People with disabilities, elderly customers, and their carers
5. Regulatory constraints - Healthcare advertising has strict rules
6. Seasonal patterns - Demand spikes (winter) and drops (summer)

Goal: Grow revenue while maintaining profitability and ROI.

The Strategy

We implemented a comprehensive multi-channel digital marketing strategy focused on:

1. PPC optimization - Smart campaign structure and bidding
2. SEO expansion - Organic traffic growth
3. Email marketing - Customer retention and repeat purchases
4. Conversion rate optimization - Better site performance
5. Data-driven decisions - Analytics and testing

1. PPC Strategy: The Growth Engine

PPC was the primary revenue driver, so we optimised aggressively.

Campaign Structure Overhaul

We rebuilt the account structure around product intent:

Brand campaigns - High-intent searches for specific product brands:
- "Drive wheelchair"
- "Rollator walking frame"
- Separate campaigns by brand for budget control

Generic product campaigns - Category-level searches:
- "Walking sticks for elderly"
- "Bathroom grab rails"
- "Mobility scooters"

Shopping campaigns - Product-level advertising:
- High-priority for best sellers
- Medium-priority for standard range
- Low-priority for long-tail products

Remarketing campaigns - Bringing back visitors:
- Cart abandoners (highest bids)
- Product viewers (medium bids)
- General visitors (lowest bids)

This structure gave us granular control over budgets and bids for different user intents.

Bidding Strategy

Early on, we used manual bidding. As Google's automation improved, we gradually shifted to smart bidding:

Brand campaigns: Target ROAS (return on ad spend) bidding
- High ROAS targets (600-800%) because brand searches convert well
- Protected brand traffic from competitors

Generic campaigns: Target CPA (cost per acquisition)
- Set CPA based on product margins
- Higher bids for high-margin products (wheelchairs, scooters)
- Lower bids for low-margin products (basic aids)

Shopping campaigns: Target ROAS
- Different targets by product category
- Adjusted seasonally (higher in winter)

Remarketing: Maximize conversion value
- Let Google optimise for highest-value conversions
- Worked well because remarketing users convert at 5-10x higher rates

Keyword Optimization

We obsessively managed keywords:

Negative keywords. We built extensive negative keyword lists:
- "Free" - People looking for NHS/charity support
- "Second hand" "used" - Low-value traffic
- "Repair" "parts" - Not product buyers
- "Jobs" "careers" - Wrong intent

This saved thousands per month in wasted clicks.

Match types. We used a tiered approach:
- Exact match for proven converters (highest bids)
- Phrase match for discovery (medium bids)
- Broad match with smart bidding for scale (lower bids)

Long-tail keywords. Healthcare has specific search patterns:
- "Walking stick for arthritis"
- "Lightweight wheelchair for narrow doorways"
- "Raised toilet seat for after hip surgery"

These converted better than generic terms because they showed clearer intent.

Ad Copy That Converts

Healthcare advertising requires empathy and clarity:

Key messages:
- Next day delivery (critical for urgent needs)
- NHS trusted supplier
- Expert advice available
- Wide range of products
- Free returns

Ad extensions we used:
- Sitelinks (wheelchairs, walking aids, bathroom safety, etc.)
- Callouts (Free UK delivery, NHS supplier, 30-day returns)
- Structured snippets (Brands: Drive, Invacare, Etac, etc.)
- Call extensions (phone orders for elderly customers)
- Location extensions (showroom visits)

Extensions improved click-through rates by 20-30%.

2. SEO: Building Organic Traffic

While PPC drove immediate revenue, SEO provided long-term growth.

Content Strategy

We created helpful content for customers:

Category pages optimised for search:
- "Mobility Scooters: Complete Buying Guide"
- "Walking Aids: How to Choose the Right One"
- Clear, jargon-free explanations

Product descriptions rewritten:
- Replaced manufacturer copy with helpful, benefit-focused content
- Explained who each product is ideal for
- Added customer reviews

Buying guides:
- "How to Choose a Walking Frame"
- "Wheelchair Sizing Guide"
- "Bathroom Safety Checklist"

This content:
- Ranked for informational searches
- Built trust with potential customers
- Reduced customer service questions

Technical SEO

We improved site structure:

Site speed: Faster loading reduced bounce rates and improved rankings.

Mobile optimization: Healthcare customers increasingly searched on mobile. We ensured the site worked perfectly on phones and tablets.

Schema markup: Added product schema, review schema, and breadcrumb markup to improve search appearance.

Internal linking: Connected related products and categories to spread authority.

URL structure: Clean, readable URLs like /mobility-scooters/drive-cobra/ instead of /product.php?id=12345.

Link Building

Healthcare is a natural industry for earning links:

• Partnered with NHS trusts (got links from their supplier pages)
• Reached out to disability charities
• Created shareable resources (wheelchair sizing calculator, etc.)
• Got featured in healthcare publications

We avoided sketchy link tactics. Healthcare requires trust, and dodgy SEO damages reputation.

3. Email Marketing: Retention & Repeat Purchases

Acquiring customers was expensive. Email helped us get more value from existing customers.

Welcome series: New customers got a series of helpful emails:
- Welcome email with product recommendations
- Guide to using their purchased product
- Related product suggestions
- Request for review after delivery

Abandoned cart emails:
- First email after 1 hour (reminder)
- Second email after 24 hours (with 5% discount)
- Third email after 48 hours (last chance)

Recovered 10-15% of abandoned carts.

Seasonal campaigns:
- Winter safety tips (sold ice grips, outdoor mobility aids)
- Spring mobility (sold lightweight wheelchairs, scooters for warmer weather)

Re-engagement:
- Identified customers who hadn't purchased in 12+ months
- Sent "We've missed you" emails with offers

Email drove 15-20% of revenue at mature stage.

4. Conversion Rate Optimization

Growing traffic is only valuable if visitors convert.

Site improvements:
- Simplified checkout (reduced from 4 steps to 2)
- Added trust signals (NHS supplier badge, customer reviews, secure payment icons)
- Improved product images (multiple angles, lifestyle photos)
- Added live chat (elderly customers often prefer to ask questions)
- Phone number prominent (many customers still prefer phone orders)

A/B testing:
- Tested different call-to-action buttons
- Tested delivery messaging
- Tested product page layouts

Small improvements added up. A 0.5% conversion rate increase at £10M revenue = £50k extra revenue.

5. Data & Analytics

We tracked everything:

Google Analytics:
- Revenue by channel
- Product performance
- Customer journeys

PPC dashboards:
- Daily performance by campaign
- ROAS by product category
- Wasted spend on poor keywords

Custom reports:
- Lifetime value by acquisition channel
- Profit margins by product
- Seasonal trends

This data guided every decision.

Key Tactics That Worked

Seasonal Bidding

Healthcare demand is seasonal:

Winter (Nov-Feb): High demand
- Increase bids 20-30%
- Expand budgets
- Add winter-specific keywords ("non-slip shoes", "ice grips")

Summer (Jun-Aug): Lower demand
- Reduce bids
- Focus on high-performers only
- Pause underperforming campaigns

This prevented wasted spend in slow periods.

Product Margin Bidding

Not all products have the same margin:

High margin (40%+): Mobility scooters, powerchairs
- Aggressive bidding
- Target CPA: £40-50

Medium margin (25-40%): Walking aids, wheelchairs
- Moderate bidding
- Target CPA: £20-30

Low margin (10-25%): Basic daily living aids
- Conservative bidding
- Target CPA: £10-15

This ensured profitability while maximising revenue.

Competitor Research

We monitored competitors constantly:

• Tracked their ad copy (what messages worked)
• Watched their promotions (matched when necessary)
• Analysed their product range (spotted gaps)
• Monitored their SEO (found keyword opportunities)

Competitive intelligence informed strategy.

Customer Feedback Loop

We systematically collected feedback:

• Post-purchase surveys
• Phone call insights (recorded and analysed)
• Live chat transcripts
• Product reviews

This revealed:
- Common questions (turned into FAQs and content)
- Product issues (fed back to suppliers)
- Delivery concerns (improved logistics)

The Results

Over the 6-year engagement:

Revenue growth: £6M → £20M+ annually (230%+ growth)

PPC performance:
- ROAS: 400-600% consistently
- CPA: Decreased 20% despite rising CPCs
- Conversion rate: Improved from 2.1% to 3.4%

SEO growth:
- Organic traffic: Tripled
- Ranking keywords: Increased from ~800 to 3,500+
- Organic revenue: Grew from 15% to 35% of total

Email marketing:
- List growth: From 12,000 to 80,000+
- Email revenue: 15-20% of total at mature stage
- Cart recovery rate: 12-15%

Customer metrics:
- Repeat purchase rate: Increased from 18% to 31%
- Average order value: Up 25%
- Customer lifetime value: Doubled

Why It Worked

Deep understanding of the customer. Healthcare customers need reassurance, clear information, and trustworthiness. We optimised for these, not just clicks.

Multi-channel approach. Relying only on PPC would have limited growth. SEO, email, and conversion optimization created sustainable growth.

Data-driven decisions. We tested constantly and let data guide strategy, not assumptions.

Long-term partnership. Six years allowed us to refine continuously. Quick wins in year one, compounding growth in years two through six.

Specialist focus. Healthcare marketing requires specific knowledge (regulations, terminology, customer needs). We developed genuine expertise.

Lessons Learned

1. Profitability matters more than growth. We could have grown faster by accepting lower ROI, but sustainable growth at healthy margins is better than unprofitable revenue.

2. Channel diversification reduces risk. When Google increased CPCs by 30% one year, SEO and email cushioned the impact.

3. Customer retention is cheaper than acquisition. Email marketing and customer service improvements had better ROI than acquiring new customers.

4. Healthcare requires empathy. Marketing that treats customers as numbers fails. Understanding their challenges builds trust.

5. Continuous optimization beats big campaigns. Hundreds of small improvements (better keywords, improved ad copy, faster site speed) created more impact than occasional big initiatives.

Key Metrics Summary

Looking to grow your e-commerce business? I offer consulting on PPC strategy, multi-channel marketing, and conversion optimization. With 20+ years managing digital marketing for retailers, I can help you develop a data-driven growth strategy. Get in touch to discuss your business.