US Pharma Marketing
Why launch success depends less on the number of resources around the table than on whether functions, markets, and supply teams align early enough to act.
Getting every function into the launch meeting was never the hard part. The bigger opportunity is turning that room into a team that shares one view of what must be true and can move together when that view changes. Cross-functional collaboration isn’t a milestone to check off before launch but a discipline to sustain through it.
The numbers make the case. A Deloitte analysis of 284 US drug launches (2012-2021) found midsize companies met or exceeded analyst forecasts 71% of the time, against 66% industry-wide and 61% for large companies—whose performance was also the most volatile of the three groups. Large organizations rarely lack expertise, budget, or data.1 The opportunity is getting the right expertise to the right asset without losing it between layers.
The real test was never who was in the launch meeting. It’s whether commercial, medical, access, supply, and local markets share one view of what must be true and can change course together when that view proves wrong. That includes markets whose launch is still a year or two away: a distant date is an assumption, not a certainty, and those teams need visibility into the plan well before it’s their turn to execute.
The Trajectory Is Set Early The first six months post-launch are best understood as a diagnostic window, not an execution phase. A third of the launches in Deloitte’s sample missed expectations outright1, and IQVIA’s more recent research shows that window has stretched: the full performance verdict on a launch now plays out over a 36-month horizon, as payer restrictions and slower uptake curves push the real verdict further out than it used to.2
“Large organizations rarely lack expertise, budget, or data.1 The opportunity is getting the right expertise to the right asset without losing it between layers.”
Sales and share numbers are lagging indicators. The signals that matter show up earlier, scattered across desks that don’t always talk to each other: diagnostic activity, referral patterns, payer and reimbursement decisions, HCP questions, site readiness, early discontinuation, and supply reliability. Commercial often catches a prescribing shift weeks before it shows up anywhere else and that insight can sit in a regional deck for a month before reaching someone with authority to act. Closing that gap is where the next wave of launch performance will come from. No single function sees the whole picture, yet the teams that win turn scattered signals into a fast, shared decision. AI-driven commercial intelligence tools can now help surface these signals in near real time, instead of next month’s deck.
The Gaps Sit Between Functions, Not Inside Them
Launches rarely miss their targets for reasons as clean as one function’s fault. Deloitte’s broader research points to market access issues, weak read on customer needs, and thin differentiation as recurring themes1 —each cutting across functions rather than one. Access depends on evidence, pricing, contracting, and payer process working together, while differentiation only holds up if it’s credible, evidence-backed, and said consistently.
Launch plans are still often built like a relay race: medical hands off an evidence plan, access a payer strategy, commercial a brand plan, supply preps inventory, and local markets execute the finished plan. Everything eventually gets stapled into one deck, and that stapling can look like collaboration without being it. By then, assumptions about patient numbers, access timing, or production volumes are already baked into budgets that are expensive to revisit. Recognizing that pattern early is an advantage in itself and the fix isn’t more functions in the room, but connecting the ones already there sooner.
Start With Shared Assumptions
The most useful question at the start of a launch usually isn’t “is the plan complete?” but “what has to be true for this to work?”—making that question explicit is one of the simplest changes a team can make.
Before functions finalize individual plans, the strongest teams name a short list of assumptions that carry real consequences if wrong: eligible population, diagnostic capacity, whether HCPs will change practice, payer restrictions, and manufacturing yield. Each gets an owner, supporting evidence, and a trigger for review. The step most teams skip is agreeing in advance what decision follows if the assumption breaks.
Bain’s research points to a structural fix: smaller, empowered teams—often 10 to 20 people spanning commercial, medical, supply, and access—reporting to one accountable leader who can make trade-off calls without convening the full organization.3
Consider a team convinced diagnosis is the main barrier to adoption. If referral capacity turns out to be the real constraint, no single function can solve that alone—resources need to move across the organization, and moving faster starts with naming that scenario ahead of time. A short list of owned assumptions does more for a launch than a long risk register as it ties uncertainty to a decision someone owns.
Alignment Has a Cost and a Return
None of this is free. Cross-functional alignment adds meetings and review cycles, and speed is exactly what a launch can’t afford to lose. That tension is real, and any credible launch model must account for it.
Governance works best aimed narrowly at the handful of assumptions with genuine cross-functional risk rather than spread across everything, with clear decision rights so alignment doesn’t collapse into consensus-seeking. Bain’s research points to a structural fix: smaller, empowered teams—often 10 to 20 people spanning commercial, medical, supply, and access—reporting to one accountable leader who can make trade-off calls without convening the full organization.3 Bain also cites Xarelto as a launch that succeeded without being the most clinically differentiated option: how it was organized mattered as much as the molecule (simpler once-daily dose against a twice-daily rival).3
Supply Readiness Is Launch Readiness
Commercial teams often treat approval as the launch date. Supply works toward a different one: the date when released inventory, packaging, and production can reliably meet demand. That gap is one of the most fixable sources of disruption today.
Wegovy is a case worth studying.
Formulary access built quickly after the June 2021 US launch, and demand outpaced supply almost immediately while a contract manufacturer’s compliance issue compounded the problem later that year. Novo Nordisk spent much of the following year managing a shortage that limited how many new patients could start treatment and deliberately staggered its European rollout market by market, partly to avoid repeating the same mismatch, even as reimbursement restrictions in several countries created a different kind of access bottleneck.5
The lesson isn’t that any company got it wrong but that commercial momentum can outrun supply confirmation even at the most capable organizations, which is why the two need to be planned together, market by market.
Manufacturing and quality issues have remained a persistent driver of US drug shortages—accounting for roughly a third of new shortages as recently as 20234 and that same supply risk travels with a product wherever it launches, even as European rollouts carry their own separate timeline risk through EMA and national reimbursement decisions. That’s why supply belongs inside launch governance from day one. The strongest launches create demand at the rate the organization can serve, not maximize day-one demand at any cost. That is a discipline that should extend to the launch date, only real once supply confirms it can hit it.
Make Decisions Visible
In large launch teams, friction usually has less to do with disagreement than with the same trade-off getting re-litigated meeting after meeting because it isn’t clear who’s empowered to decide. Distinguishing input, recommendation, and decision is a small change with an outsized payoff. A simple decision log: the choice, the evidence, the owner, the review date. It does more for alignment than another status update. Routine updates can move asynchronously, freeing meetings for exceptions: what changed, what’s the evidence, who decides.
Launch Day Begins the Test
Launch day isn’t the end of planning but when assumptions meet reality, and when alignment must hold up under pressure, not just at kick-off. The teams best positioned agree in advance, in writing, which signals they’ll monitor, what threshold earns a real conversation, and who’s authorized to act once it’s crossed. That clarity keeps early weeks focused on action instead of debating whether a shift is real.
Three questions are worth putting to any launch team before the plan is finalized:
1. What five or six assumptions, if wrong, would force a change of course and who owns each one?
2. What operational date has supply confirmed, and does every function’s plan work backward from that date rather than the ideal one?
3. What signal, at what threshold, triggers a cross-functional conversation in week one, week four, and month three, and who’s in the room?
The next frontier is sustaining alignment past kick-off: shared assumptions with named owners, decisions made once instead of re-argued, supply readiness built into governance from the start, and small, empowered teams with authority to change course while there’s still time to matter.