Why cost per lead misleads
A £20 lead sounds better than a £60 lead. But if the £20 leads rarely book and the £60 leads book a consult more often and start treatment, the expensive lead is the cheaper patient.
Aligner patients take time to decide. They compare prices, read reviews and ask about finance. A campaign that only looks at cost per lead will drift toward cheap, curious enquiries and away from people ready to start.
The four numbers that matter
To judge an Invisalign campaign properly, track every stage from spend to start:
- Cost per lead: what you pay for each enquiry
- Cost per booked consult: what you pay for each consult in the diary
- Cost per attended consult: no-shows cost chair time, so count who actually arrives
- Cost per start: what you pay for each patient who accepts treatment
A worked example
Illustrative figures only. Say you spend £3,000 in a month and get 100 leads: £30 per lead. If 30 book a consult, that’s £100 per consult. If 24 attend and 8 start treatment, your cost per start is £375.
Now compare that to the revenue from each start, minus lab and clinical costs. That margin is the real ceiling on what you can afford to pay for a patient, and it’s usually far higher than practices expect.
The question isn’t “how cheap are our leads?” It’s “how much can we afford to pay for a start, and are we under that?”
What pushes the cost up
- Slow follow-up: aligner enquiries go cold within hours
- No finance messaging (kept compliant on your own website)
- Generic stock creative instead of your own clinicians and patients
- Landing pages that don’t answer price and process questions
- No feedback from your CRM back into the ad platforms
How to bring it down
Track every stage, ideally through to your PMS. Feed booked and started patients back to Google and Meta so they find more people like them. Film your own clinicians explaining the process. And respond to every enquiry within minutes.
This is exactly what the VRM System is built to do: show cost per start by campaign, so budget moves to what’s actually producing patients.
A note on compliance
Finance offers are financial promotions under FCA rules, and claims about results need substantiation under the CAP Code. Keep finance details on your practice website in approved wording, and make sure any “from £X” price is genuinely available.