Navigating the future of commercial in biopharma

A prescription for future success: reimagine engagement, leverage tech, and boost agility to meet evolving demands amid market pressures and tech advancements

Jonathan Fox

United States

Natasha Elsner

United States

The biopharmaceutical industry’s commercial model has been essential to each company’s success, but the current capabilities and strategies are unlikely to suffice for future complexities and demands. Rapidly evolving market forces and technological advancements demand that pharma companies reimagine customer engagement, expand their roles within the health care ecosystem, automate for greater efficiency, and enhance agility. Today, the question is not whether to change, but how quickly and extensively.

To evaluate the industry’s readiness for change over the next five years, the Deloitte Center for Health Solutions conducted a survey in November 2024 of 100 biopharma industry leaders in sales, marketing, patient services, market access, and field medical affairs roles, and interviewed 12 executives across these subfunctions. 

Based on this research and our market analysis, we’ve identified five elements of transformation for sustained success through 2030 that focus on customer engagement, operational resilience, and long-term value:

  1. Elevate engagement with an integrated customer model
  2. Meet empowered consumers’ needs with innovative models
  3. Deliver greater holistic value through an expanded ecosystem role
  4. Rewire commercial operations for increased efficiency
  5. Increase financial agility to achieve greater ROI

An increasing imperative to transform biopharma’s commercial model

The impact of market, customer, and competitive forces is changing rapidly, demanding great attention. For example, evolving government policies such as the Inflation Reduction Act are expected to impact industry margins, with some estimates suggesting cumulative revenue reductions between $237 billion and $455 billion from 2022 to 2032.1 At the same time, technological advancements have brought large language models into the mainstream, with some platforms reaching 100 million active users within just two months of launch2 and 100 million weekly users a year later.3 Subsequently, AI-powered searches have become a notable source of online retail traffic, challenging the dominance of traditional web searches.4 These trends highlight the acceleration and impact of these technological changes.

56% of survey respondents said the entire commercial function needs to change significantly or transform fully, and 89% said at least one subfunction requires change.

While the current commercial model may meet today’s business needs, it’s unlikely to do so in the future without major changes. Insights from the survey show this equivocation: 69% of respondents agreed or strongly agreed that their commercial organization meets today’s business needs. However, 56% of survey respondents said the entire commercial function needs to change significantly or transform fully, and 89% said at least one subfunction requires change (figure 1).

Despite recognizing the need for change, respondents admitted they aren’t well prepared. Only 30% felt their commercial organization is well prepared to respond to market trends. But what does this mean for the industry? Based on Deloitte analysis, we anticipate the following key developments shaping the biopharma industry by 2030:

  • Government reshapes the health care ecosystem with rapidly increasing pressure on net revenue.
  • Continued health care provider consolidation and concentration of decision-making drives the transformation in pharma’s go-to-market model.
  • An increasingly strained ecosystem with complex policies around care access and navigation demands innovative solutions to simplify patients’ care experience.
  • Changes in rebate revenue among payers and pharmacy benefits managers call for new collaboration models between pharma and payers.
  • Accelerated advancements in AI and digital capabilities transform ways of working and create the need for a new operating model.

In light of these anticipated changes by 2030, we propose a five-part strategy to position pharma’s commercial organizations for future success.

1.    Elevate engagement with an integrated customer model

Health care practitioners (HCPs) remain a key customer group for pharma today. However, several studies indicate that HCPs are dissatisfied with their engagement with pharma companies.5 They struggle to stay updated with medical knowledge, and up to 80% are skeptical about the scientific validity of pharma communications.6  Additionally, about half experience content fatigue.7

At the same time, the influence of HCPs on treatment decisions has diminished, prompting pharma organizations to shift their models to target C-suite executives and population health decision-makers who drive formulary and purchasing decisions.8 But today’s interactions between pharma’s customer-facing teams and decision makers at various levels of the customer organizations are often disconnected. Different pharma teams have their own objectives, which can result in fragmented messages and suboptimal customer’s experiences.9

The evolving needs and definitions of customers require a new engagement model. A fully integrated field model10 can help commercial organizations optimize their customer-facing teams—sales representatives, medical science liaisons, key account managers, and field reimbursement specialists—to deliver coordinated, personalized, and data-driven interactions with HCPs and population health decision-makers. These decision-makers influence purchasing and clinical guidelines at integrated delivery networks (IDNs) and payer organizations.

By adopting this model, pharma can develop a solution-oriented approach, matching the right expertise to customer needs and orchestrating a cohesive set of touchpoints. This model requires a “quarterback” to evaluate which relationships to target, plan engagement strategies, and determine appropriate messaging. The quarterback doesn’t handle every customer interaction but helps to ensure that each fits into a broader, well-executed game plan. They act as the central point of contact for internal stakeholders, such as marketing, sales, market access, and medical affairs. They also understand the full picture of a customer account, including decision-makers, influencers, and operational stakeholders, and most importantly, are empowered to make decisions across commercial subfunctions.

Implementing the integrated customer model comes with challenges, such as integrating data at an account level, driving organizational changes that create new roles and incentives, and fostering new behaviors required for success. Despite these challenges, moving to an integrated field model is essential for pharma and its customers.

Helping customer organizations achieve their population health goals

In the evolving pharma commercial model, the way pharma engages with customers should meet customer needs at multiple levels. For instance, it may involve IDN-wide population health objectives, hospital-specific quality goals and metrics, and helping individual HCPs better care for each patient and their entire patient panel. A cardiologist might exemplify this shift while navigating a new clinical decision support tool integrated into the organization’s electronic health record system. The tool provides a brand-agnostic, evidence-based summary of heart failure treatments, curated from multiple trusted sources to address the health system’s challenges in reducing ER visits and repeat hospital stays.

 

The health system has adopted a novel approach, moving beyond traditional formularies. Physicians are encouraged to prescribe treatments that best manage patients’ conditions, supported by outcome-based contracts with drug manufacturers. This collaborative effort involves developing clinical guidelines and educating frontline clinicians, enabling them to tailor treatments to individual patient needs.

 

The cardiologist benefits from personalized clinical insights, dynamically tailored to their specialty and patient demographics. The platform offers direct consultations with the IDN’s clinical pharmacists and options to request additional information from manufacturers, enhancing the decision-making process. Through instant messaging, the cardiologist coordinates a consultation with a pharmacist and a medical science liaison, gaining confidence in prescribing new therapies backed by real-world evidence.

 

This model exemplifies the future of pharma's commercial approach, where customer engagement is strengthened through continuous support and access to the latest evidence. By fostering multi-stakeholder collaboration, pharma companies can ensure that HCPs have the tools and knowledge needed to optimize patient outcomes and help the IDN improve population health.

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2.    Meet empowered consumers’ needs with innovative models

With rising consumer expectations for convenience, cost-effectiveness, and control over their health, their patience for frictions in the system—difficult access to care, high out-of-pocket costs, insurance delays, bouncing between specialists in search of diagnosis and treatment—is wearing thin.11

In response, consumers are increasingly bypassing traditional health care barriers altogether,12 seeking services and providers that meet their needs,13 or adopting do-it-yourself approaches.14 We expect the pharma industry to adapt to this consumer empowerment by embracing direct-to-patient (DTP) models. These models aim to enhance the patient experience by streamlining access to treatments, expediting access to physician consultations for diagnosis and prescriptions, simplifying insurance processes, and supporting adherence to therapy. Notable initiatives like PfizerForAll and LillyDirect offering multiple brands have gained attention, though manufacturers have used the DTP model for single brands for several years, such as AbbVie’s Synthroid Delivers Program.15

DTP models are commercially attractive due to their higher conversion and persistency rates. However, their longer-term strategic value lies in fostering deeper patient engagement and leveraging insights from first-party data. When patients consent to data sharing, manufacturers can leverage this data to understand patient behavior more precisely, develop refined segmentation models, and improve care coordination and service delivery.

Manufacturers should consider costs, regulatory compliance, platform development—whether in-house or through third parties—and maintaining relationships with existing customers and vendors.16 Despite these challenges, the DTP model holds promise for future products with strong consumer and patient orientation.17

3.    Deliver greater holistic value through an expanded ecosystem role

Traditionally, the pharma commercial model has focused on generating written prescriptions from HCPs. While this approach has often achieved its intended results, it does not fully address the comprehensive needs of patients throughout their health care journey. With the advent of more complex treatments and the growing set of requirements for therapy initiation, patients now need greater support, presenting a potential opportunity for the pharma industry.18

At the same time, new complex therapies have increased challenges for both patients and HCPs, such as navigating care, improving health literacy, and managing treatment costs.19 To help alleviate friction points in the patient journey, future commercial strategies should go beyond demand generation and emphasize support both before and after the prescription is written.

Additionally, pharma companies can play a more significant role in addressing barriers to care, enabling earlier diagnoses, designing a broader range of affordability programs, and providing more tailored disease management tools. Looking ahead to the next three to five years and beyond, we anticipate innovative screening programs, AI-driven diagnostics, greater investment in care coordination—such as becoming covered entities and industry partnerships—could address gaps in health care delivery.

In addition, the industry should create awareness and encourage adoption in the broader health care ecosystem of innovative financing models for novel treatments with curative potential. These could include supplemental risk pools, new insurance products like warranties and accelerated benefits, risk-sharing arrangements, and patient financing options. These models would aim to create mutually beneficial collaborations among employers, insurers, and financial service companies, while addressing the increasing cost burdens faced by patients, employers, and government payers.

The question is not whether these new programs, capabilities, and tools will exist in the future, but who will provide them. For the pharma industry, this presents an opportunity to play a greater role in orchestrating the health care ecosystem.

Building trust to expand pharma’s role in the health care ecosystem

Expanding the pharma industry’s roles as an orchestrator within the health care ecosystem could present challenges. Historically, legal, regulatory, and compliance concerns have constrained this expansion.20 Another challenge is that many pharma companies lack the brand permission to operate beyond traditional boundaries.

 

The key is to earn customer trust—a prerequisite for brand permission. Despite the potential for pharma to excel in certain areas, public trust remains low.21 According to the Deloitte Center for Health Solutions’ 2024 Health Care Consumer Survey, only 13% of consumers trust pharma companies as reliable sources of information on effective and safe treatments. This trust deficit extends to other stakeholders, too.22

 

Building trust involves addressing the needs of customers and stakeholders by demonstrating that your organization is capable, reliable, human, and transparent. These factors may resonate differently across customer segments. For instance, the traits of capability and reliability might resonate more with health insurers and pharmacy benefits managers, distributors, or for-profit health systems. On the other hand, humanity and transparency might attract consumers, nonprofits, employers, and HCPs.23

 

By measuring and understanding specific trust-building actions, pharma organizations can effectively manage and grow trust with their customers. This trust is likely to be important for earning the right to play a greater role in the health care ecosystem.

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4.    Rewire commercial operations for greater efficiency

The proliferation of health care data presents immense opportunities for pharma commercial organizations. However, managing, integrating, and ensuring the quality of this data has become increasingly complex, time-consuming, and expensive.24 Despite rapid technological advancements, especially in AI, many organizations struggle to keep up with managing the complexity of data. The challenge now lies not in the technology itself, but in the organizational capacity and readiness to adopt it. Often, regulatory, compliance, and change management concerns present the biggest hurdles.

While leaders see AI as crucial for future commercial models, 76% are still hindered by siloed and outdated data infrastructures.

Organizations may hesitate to fully trust or invest in capabilities they haven’t yet seen in action. Believing in the transformative potential of AI, especially agentic AI, requires a shift in mindset. AI can unlock significant value—generative AI alone could create up to $7 billion over five years for a large pharma company, with 25% to 35% of that in commercial functions. Yet, the real challenge is preparing the business to embrace this technology. The survey shows that while leaders see AI as crucial for future commercial models, 76% are still hindered by siloed and outdated data infrastructures.

Agentic AI, which can autonomously learn and execute complex tasks, has the potential to reduce effort in areas like data management. Agentic AI can autonomously correct data quality issues, learn from interactions, and generate valuable insights, but only if organizations are ready to trust and act on those insights.

To mitigate risks, implementing agentic AI should include human-in-the-loop controls, where humans provide oversight and final judgment.25 This approach allows businesses to safely test and adopt the technology without full exposure. Over time, as AI becomes more capable and trustworthy, the balance may shift, raising important questions about the future human role.

Incorporating AI into work processes is not just about automation; it’s about reimagining how work is structured, how decisions are made, and who is responsible for what. AI can empower frontline teams with insights and autonomy, while AI agents may handle routine tasks. However, this shift calls for a deeper conversation around the future of human work. HR leaders should start rethinking job design, talent strategies, and organizational structures now.26 What will a person’s job look like in five years? The answer will likely shape not just workforce planning, but the long-term vision of the pharma commercial organization in an AI-driven world.

The road to realizing this value will take time. Foundational investments in data, technology, and AI training are necessary, but equally important is creating a culture of trust, adaptability, and forward-thinking leadership.

5.    Increase financial agility to achieve greater ROI

Pharma commercial organizations often operate with distinct roles, capabilities, and investment strategies within their subfunctions. While this specialization aligns with varying business objectives, it can lead to fragmented investments that tend to optimize return on investment at the subfunction level, often at the expense of the enterprise. This fragmentation prevents organizations from having a cohesive, enterprisewide view of financial returns. In today’s environment of mounting financial pressure, this vertical investment orientation could be a significant blind spot that, if addressed, could unlock considerable value.27

To generate greater return on investments, commercial organizations should adopt a horizontal investment mindset. This approach can allow organizations to evaluate opportunities and performance across subfunctions rather than within them. A cross-functional perspective can enable better strategic alignment, prioritize high-value investments, and reduce funding for less effective initiatives. Achieving this shift requires not only a mindset change but also increased financial agility and a new approach to performance measurement.

A key enabler of this shift is the adoption of script-level profitability. This method goes beyond traditional gross-to-net metrics28 by attributing the costs of marketing, sales, and other commercial activities to specific customers or transactions, allowing organizations to understand the true drivers of their profitability. By using a standardized method for evaluating ROI, organizations can better understand which efforts drive value and which do not, resulting in more informed investment decisions and greater adaptability to market conditions.

However, implementing script-level profitability presents challenges, including potential impacts on leaders’ budgets and profit and loss statements. A new above-function governance model can help ensure a unified view of investments and outcomes across the organization. This governance model should be supported by integrated data platforms and advanced analytics capable of automating the measurement and reporting of script-level key performance indicators. Furthermore, commercial organizations should reassess traditional department-level goals, incentives, and reporting structures and develop new approaches to cross-functional collaboration and performance measurement.

Leading the way forward

The biopharmaceutical industry stands on the brink of a significant transformation that will redefine customer engagement, ways of working, and the role pharma plays in the broader health care ecosystem. As outlined, the future commercial model is likely to be characterized by solution-oriented customer interactions, the strategic use of AI, and greater agility and efficiency.

While envisioning this future is relatively straightforward, achieving it is far more challenging. That said, the potential value for both pharma and its customers could be significant, making inaction not an option. Each company is different and should chart its own course based on its current capabilities, future portfolio, and realistic pace of transformation. Pharma organizations realize they can benefit from bold initiatives, such as reimagining the field model, modernizing their customer relationship management systems, and innovating their patient programs, which should raise the standard for competitiveness for the entire industry.

The future isn’t waiting—and the organizations that anticipate and prepare for these changes will lead the transformation. 

Appendix: About the study

The study included a survey and qualitative interviews. Conducted in November 2024, the survey gathered responses from 100 commercial leaders representing small, mid-sized, and large pharmaceutical organizations in the United States, with a total of 77 unique companies represented. Respondents came from various functions and subfunctions, including commercial, sales, marketing, patient services, market access, and field medical affairs. Additionally, we conducted interviews with 12 leaders from commercial and field medical affairs across these subfunctions.

Select firmographic information of the survey sample:

  1. Revenue distribution: 37% of survey respondents belong to organizations with revenue of more than $20 billion.
  2. Company types: 73% of respondents come from traditional pharma companies that develop and make patented drugs,15% come from biotechnology companies that develop specialty therapies, and 12% are from biosimilar manufacturers.
  3. Functional distribution: The distribution of functions among respondents shows some overlap, reflecting matrixed structures of commercial organizations. Specifically, 63% work in the overall commercial function, 51% in market access, 48% in marketing, 46% in commercial operations, 44% in field medical affairs, 34% in commercial analytics, 31% in patient services, 24% in brand franchise, and 21% in sales. 

by

Jonathan Fox

United States

Natasha Elsner

United States

Endnotes

  1. Congressional budget office, How CBO Estimated the Budgetary Impact of Key Prescription Drug Provisions in the 2022 Reconciliation Act, February 2023; Miryam Frieder, Megan West, Rebecca Yip, Massey Whorley, and Rundell Douglas, “Drug pricing bill could reduce manufacturer revenue by over $450B,” Avalere Health, July 27, 2022.

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  2. Fabio Duarte, “Number of ChatGPT users (March 2025),” Exploding topics, April 23, 2025; Krystal Hu, “ChatGPT sets record for fastest-growing user base - analyst note,” Reuters, February 2, 2023; Shubham Singh “ChatGPT statistics (2025): DAU & MAU data worldwide,” DemandSage, May 19, 2025.

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  3. Bernard Marr, “10 mind-blowing generative AI stats everyone should know about,” Forbes, Jan. 29, 2024.

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  4. Vivek Pandya, “Adobe analytics: Traffic to U.S. retail websites from generative AI sources jumps 1,200 percent,” Adobe Blog, March 17, 2025.

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  5. Akosua Mireku, “Pharma’s engagement with healthcare providers has slipped in recent years,” Pharmaceutical Technology, Nov. 30, 2023; Ann Poorboy, “Trust matters: Healthcare providers changing preferences in pharma engagement,” Policy Reporter, Oct. 2, 2023.

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  6. Dave Rosner and Kate White Walters, “How are challenges in the pharma market leading toward future engagement models?,” Deloitte, Oct. 18, 2024; Ruud Kooi, “The state of Omnichannel in Biopharma 2023 global trends report,” Across Health, Feb. 15, 2024.

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  7. Ibid.

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  8. Rita Numerof, “Pharma executives are awakening to a new reality: Embrace the future of the commercial model now or else,” Forbes, Oct. 26, 2022.

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  9. Julie Walker, “Elevating patient experiences by breaking down internal silos,” PM360, Oct. 22, 2024.

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  10. Rosner and Walters, “How are challenges in the pharma market leading toward future engagement models?

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  11. Mark Newman, “Simplifying healthcare: Why complexity is failing patients and providers,” Health Data Management, April 17, 2025; American Medical Association, “2024 AMA prior authorization physician survey,” February 2025.

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  12. Tori Marsh, “Insurance hurdles delay care and force tough choices,” GoodRx, April 22, 2025.

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  13. Tegria, “Why people consider breaking up with their doctor,” press release, Feb. 15, 2022; Anwesha Dutta, Urvi Shah, Heather Nelson, and Leslie Korenda, “Consumer demand is outpacing virtual health availability,” WSJ CMO Today, Dec. 2, 2024.

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  14. Tina Reed, “DIY medicine draws frustrated patients to online forums,” Axios, Sept. 16, 2024; Bradley Burman, “The DIY medicine movement,” WHYY, June 14, 2024.

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  15. Amy Baxter, “Pfizer and Lilly are elbowing into the direct-to-consumer market. Will it work?BioPharma Dive, May 22, 2024; American Association of Clinical Endocrinology, New Direct-to-Patient Pharmacy Program Helps Abbvie Provide Thyroid Patients Better Access to Synthroid, August 26, 2020.

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  16. Lecia Bushak, “RFK Jr. confirmed as HHS Secretary: Here’s how pharma might be impacted,” Medical Marketing + Media, Feb. 13, 2025; Drew Wilkins and Clarissa Crain, “Can pharma make drugs more accessible while still complying with regs?” Deloitte, March 4, 2025.

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  17. Jordan Armstrong, “Direct-to-consumer models: Why they’re expanding and where they deliver the most impact,” Drug Channels, March 14, 2025.”New Direct-to-Patient Pharmacy Program Helps Abbvie Provide Thyroid Patients Better Access to Synthroid,” AACE, August 26, 2020.

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  18. Annie Bhattacharjee and Shayma Ali, “The patient as your guide: Thriving in new commercial models,” IQVIA, February 2025.

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  19. John Tozzi, “A plan to access cheap drugs backfires, leaving patient with $250,000 bill,” Bloomberg, April 22, 2025; Kimberly Westrich, Lisabeth Buelt, Arjun Narain, and, John Michael O’Brien, “Copay accumulator and maximizer programs: Stakes rise for patients as federal rulemaking lags,” Health Affairs, March 18, 2025.

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  20. US Department of Health and Human Services, “Health Insurance Portability and Accountability Act of 1996,” August 20, 1996; Wilkins and Crain, “Can pharma make drugs more accessible while still complying with regs?

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  21. Caroline Pearson, “Surveys of trust in the U.S. health care system,” NORC at the University of Chicago, May 21, 2021; Poorboy, “Trust matters.”

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  22. Deloitte Center for Health Solutions, 2024 Health Care Consumer Survey, fielded in July 2024. Sample included 2,014 US consumers. Unpublished data.

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  23. Greg Reh, Hanno Ronte, Leena Gupta, and Hemnabh Varia, “Overcoming biopharma's trust deficit,” Deloitte Insights, May 6, 2021.

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  24. Verix, “AI and commercial biopharma: A state of the industry report 2024,” March 2024.

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  25. Prakul Sharma et al., “The Cognitive leap: How to reimagine work with AI agents,” Deloitte, December 2024.

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  26. Sue Cantrell, Lauren Kirby, Nic Scoble-Williams, Joan Goodwin, and Andy Bayiates, “Is there still value in the role of managers?Deloitte Insights, March 24, 2025; David Mallon, Sue Cantrell, and John Forsythe, “Closing the experience gap,” Deloitte Insights, March 24, 2025.

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  27. Karen Taylor, Márcia Costa, and Emily May, “End-to-end transformation of pharma’s commercial activities,” Deloitte, Oct. 10, 2024.

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  28. Gross-to-net optimization refers to the process of measuring and optimizing the difference between a product’s initial gross sales and its net revenue after sales deductions and adjustments. This process evaluates the actual economic impact of a pharma company’s offerings by taking all price deductions into account, including discounts, rebates, clawbacks, and free goods. See: Christian Rebholz, Joshua Siow, and Tim Kohtes, “Driving profitable growth through Gross-to-Net in pharma,” Simon Kucher, July 8, 2024.

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Acknowledgments

The authors would like to thank Brian Corvino, Thomas Schram, David Figueroa, and Joe Milosh from the project team who contributed industry expertise and strategic analysis in developing and structuring the manuscript, and Leena Gupta and Apoorva Singh who provided crucial help with the survey design, analysis, and draft reviews.

They also thank Alex Blair, Tom Yang, Kevin Hershey, Sherilyn Tuthill, Andrea Cusano, Holly Darov, Drew Wilkins, Greg Szwartz, Ryan Hoffmeister, Neal Batra, Dave Rosner, Ryan Myers, Mike Flaherty, Jordan Baney, Alessandro Ucci, Adam Giblin, Karthika Nair, and Namrita Negi who lent their ideas and expertise and Jay Bhatt, Andy Davis, Rob Jacoby, and Debra Pielack (Asay) who provided valuable feedback that helped shape this paper.

Additionally, the authors thank Tatiana Blue Dixon, Rebecca Knutsen, Prodyut Ranjan Borah, Christina Giambrone, Jessica Overman, Komal Sapra, and many others who contributed to this project.

Lastly, this study would not have been possible without our research participants, who were generous with their time and insights.

Cover image by: Jim Slatton; Adobe Stock

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