News and Insights
Media Pulse: Digiday Programmatic Marketing Summit Reflections
December 22, 2025
The Digiday Programmatic Marketing Summit earlier this month made one thing obvious: The ground is moving beneath us faster than teams are reorganizing to keep up. Everywhere I turned, leaders were asking the same questions: How do we keep control? Where does AI actually help? Are we finally reaching the limits of complexity?
Here are the three themes that rose above the noise.
Trend 1: Health care programmatic has officially outgrown ‘niche’ status
One topic that really stood out was how much the healthcare programmatic conversation has evolved. What used to be a small, highly specialized part of the industry is now one of the most advanced proving grounds for how targeting, optimization, and platform decision-making actually work.
The growth hasn’t been quiet. Teams are staffing up and expanding into CTV, audio, DOOH — channels that pharma avoided for years due to complexity and compliance risks.
Health care teams are now designing systems that separate HCP and consumer pathways, relying on NPI-level ID matching for professionals and carefully modeled, regulation-compliant audiences for consumers.
What’s more, DSPs are redesigning their algorithms specifically for healthcare outcomes. Bids can now adjust based on how likely someone is to have a particular condition, using audience quality as a signal for whether media is reaching the right people, not just more people. It’s one of the clearest examples of a single industry pushing the technology forward for everyone else.
💓 The Pulse
- Regulation drives innovation: The constraints of HIPAA and state-by-state privacy laws are forcing more thoughtful data design than other verticals.
- HCP identity is a strategic advantage: NPI-based matching gives health care a targeting precision most categories no longer have.
- AI is becoming a copilot: DSPs are using condition-likelihood models to adjust bids, reflecting a meaningful shift from generic optimization.
OUR TAKE
Health care isn’t playing catch-up anymore. Instead, it’s a preview of the future. Brands in all categories should pay attention to how health care teams handle identity loss, model quality and compliance-first targeting. It’s where the next generation of best practices will come from.
Trend 2: AI is quickly becoming a key operating layer of the programmatic landscape
Conversations about AI surfaced in every Digiday session, but what matters isn’t the hype — it’s the pattern. And the pattern shows that teams aren’t replacing people; they’re restructuring work to prepare for AI.
Across DSPs and agency ops teams, AI is starting to take on elements of planning and campaign management, including audience research, media mix modeling, pacing, nomenclature verification, supply and budget QA, and bid strategy adjustments. While that list may sound like what teams work on day to day, it isn’t meant to raise concern that AI is here to take our jobs. Instead, teams are leveraging AI where AI works best — in tasks that require precision and specific outcomes. This frees up our teams to focus on more dynamic tasks rooted in complex decision-making, which AI agents are not currently capable of due to their propensity for error and hallucination.
Regardless of the application of AI agents, one point of emphasis was clear. A nonnegotiable prerequisite is clean, standardized data before any AI can deliver value.
But the strongest takeaway? AI’s value is real, but only when paired with human skepticism to prevent overreliance on AI’s evolving technology.
💓 The Pulse
- AI is emerging as an operational accelerant, not a strategic replacement: Teams are using agents for pacing, QA and campaign hygiene before handing it real optimization power.
- Machine learning improves efficiency; AI improves direction: Machine learning can be used to refine how to reach audiences, while AI can be used to shape optimization logic and insight creation.
- Data quality is the rate limiter: AI cannot compensate for inconsistent nomenclature, poor logs or fragmented supply. A sturdy foundation is the key to success.
OUR TAKE
AI won’t replace activation teams, but it will upskill them. The shift we’re really preparing for is programmatic traders becoming system architects, who will design clean data environments, validate model output and direct AI agents rather than manually pushing buttons.
Trend 3: Platform power plays are reshaping how agencies stay independent
If last year was about evaluating DSP features, this year was about understanding DSP behavior. The tone at the Summit was unmistakable: Platforms are no longer passive partners. They are active power centers shaping agency strategy, client relationships and even operational models. Amazon, The Trade Desk, DV360 and Yahoo each showed their cards in different ways, and together they signaled a new era where independence must be earned, not assumed.
Amazon’s assertiveness was the headline. Its DSP is now aggressively courting non-endemic advertisers with deep discounts and low fees, pushing banks, financial services and other unexpected verticals into Amazon’s ecosystem for the first time.
But low fees come with low transparency, which is a tension that agencies feel acutely. Meanwhile, The Trade Desk’s long-standing refusal to offer non-competes or protect agency accounts has become a strategic liability, pushing independent agencies to run formal RFPs, test emerging competitors like Viant and Adform, and even explore meta-DSP layers like TDI to regain leverage.
On the other end of the spectrum, DV360 is quietly re-earning trust with stronger support, more competitive economics and growing influence in retail and CTV pipelines, which is a notable shift from the days when teams avoided the platform entirely.
And Yahoo, long dismissed as legacy tech, appears to be having a resurgence. In-house leaders publicly praised it as their primary DSP due to cost efficiency, newly modernized tech and hands-on service.
This unexpected redistribution of power from incumbents to challengers signals a landscape where agencies can’t simply default to “the Big Three.”
💓 The Pulse
- Amazon is shifting the market economics: Discounts + non-endemic expansion = scale with strings attached.
- The Trade Desk is losing its automatic first-choice status: Refusal to offer protections is driving formal RFPs and diversification.
- Second-wave DSPs are gaining momentum: Yahoo’s cost-performance ratio and Viant’s identity graph are challenging old assumptions.
OUR TAKE
Agencies need a renewed stance on platform independence. Not the old version where independence meant agnostic, but a modern one that prioritizes leverage, transparency and the ability to walk away. The power has shifted. The smartest teams won’t just evaluate DSPs on their capabilities. They’ll look at their intentions, their incentives and the degree to which they protect (or undermine) the agency–client relationship.
About the author
Nikki D’Amato is Partner on FINN’s Paid Media, our global team of experts who live and breathe today’s fast-paced and fast-changing media landscape. The team delivers a full suite of services, including omnichannel planning and buying, performance media strategy and management, and comprehensive measurement, resulting in award-winning campaigns that drive client success.
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