Purpose This paper aims to investigate the moderating role of co-creation in the implementation of servitization strategies in the pharmaceutical industry in a business-to-business (B-to-B) context. More specifically, this investigation explores the impact of different levels of services (base, intermediate and advanced) on servitization and on performance by using co-creation as a moderating factor. Design/methodology/approach A research framework was developed and empirically tested in the pharmaceutical sector. Data collection was conducted through the online distribution of questionnaires. The final sample included 219 pharmacy stores, and the data were analysed using structural equation modelling. Findings Main findings suggest that when the level of co-creation of the design of services is high, there are significant effects of servitization on firm performance. The moderating effect of co-creation is illustrated in regard to intermediate and advanced services, but results referring to the impact of intermediate services on servitization appear non-significant with a low degree of co-creation. No significant effects could be found for the impact of base services on performance and servitization for both high and low degrees of co-creation. Findings show an impact of advanced services on performance through the mediating effect of servitization when the degree of co-creation is high. Originality/value Most research concerning servitization has been done from the perspective of manufacturers and service providers. This study adds value to the literature because it was designed from a customer’s perspective. Moreover, it contributes towards the conceptualization of the servitization research strategy and business models in a B2B context. This is accomplished through the investigation of the moderating effect of co-creation on the impact of the different levels of services on servitization and on performance.