Use the languages required by your active markets and regulatory obligations. Adding a language that the organisation cannot maintain and review can create a stale or non-compliant version.
The limiting factor is rarely translation cost, it is ongoing review capacity: every language version needs to go through the same medical and regulatory review as the primary one, indefinitely, every time content changes. A language you cannot sustain reviewing becomes a liability, not an asset.
Start from where you have real commercial or regulatory presence and genuine capacity to maintain review in that language, rather than adding every market you might someday enter. See multilingual websites for how we structure the content model to support adding languages later without a rebuild.
Languages added faster than they can be maintained are the most common cause of the content divergence we get called in to fix — see multilingual content architecture for what that looks like once it has already happened.
Launching in every language at once is rarely necessary and adds risk to the timeline, since each language multiplies the review and translation workload. See global website rollout for why a sequenced launch, starting with priority markets, usually delivers a stronger result than trying to go live everywhere simultaneously.
Yes, additional languages can be added later without a rebuild, provided the content model was structured for multilingual support from the start. See WPML and translation for how that structure works in practice, since retrofitting translation support onto a site not built for it is far more disruptive.
More languages only help search visibility if each version is maintained and correctly targeted to its market, including local terminology and regulatory nuance. A poorly maintained extra language, left stale after launch, can hurt overall site credibility more than simply not offering that language at all.
This decision usually sits with regional or global marketing leadership, based on market size, regulatory priority and where the organisation already has commercial presence. Input from local affiliate teams matters too, since they often have the clearest view of whether local-language content will meaningfully change how the site is used.
Tell us your markets and review capacity and we will tell you a realistic language count.