Following the IQVIA Commercial Strategy Summit in March, senior IQVIA leaders convened to discuss what matters most for life sciences manufacturers operating in a more compressed market. Across approximately 60 pharmaceutical leaders, the signal was consistent. Commercial leaders face a simple but uncomfortable reality: less time, same or higher expectations, and different pressures. Leaders are looking for practical solutions to execute toward access, engagement, and ultimately, overall performance.

This roundtable extended that conversation, bringing together perspectives on strategy, evidence, and launch execution. The discussion surfaced themes on how leaders are evaluating trade-offs, prioritization, and decision speed as conditions become more constrained and expectations continue to rise.

This blog presents a summary narrative of the roundtable discussion.

Who was at the table

• Daniel Luft, managing principal for IQVIA’s Commercial Strategy & Transformation Center of Excellence, focuses on evidence, benchmarks, and executive decision support.
• Adam Sohn, IQVIA’s V.P. of Advisory Services, provides a cross-industry view from strategic advisory work with senior leaders across company sizes and therapy areas.
• Nadine Vangelov, senior principal for IQVIA’s U.S. Launch Center of Excellence, brings a launch execution lens, focusing on readiness, friction points, and the practical decisions that shape adoption.
• Luke Greenwalt, who leads IQVIA U.S. Thought Leadership & Innovation, served as roundtable moderator and has helped translate the discussion into a clear narrative.

Theme 1: Economic compression is today’s current reality

Luke: We opened with a straightforward idea: commercialization is compressing across the lifecycle, not in one isolated place. The pressure is showing up across launches, in-market brands, pricing, policy, access, and customer attention. As constraints stack up, teams have fewer levers and less time to pull them.

Adam: Over the past year, the same concerns are showing up in nearly every executive conversation. Sales are harder to sustain, launch windows are tighter, and products must perform earlier. At the same time, pricing, policy uncertainty, and engagement model changes are making planning more difficult. It all adds up to a compression of choices in which leaders have potentially fewer levers and certainly less time to act. That said, it’s not hopeless. Teams can still win, but it takes sharper prioritization, clearer investment choices, and tighter alignment across commercial, medical, and access. When those basics are in place, you can still build momentum, even in a more constrained market.

Daniel: The theme resonated because it put simple language to patterns and symptoms manufacturers have been experiencing in more fragmented ways. But recognition alone isn’t enough—leaders need a point of view they can stand behind. When discussions are grounded in evidence, not just intuition, it creates the confidence to act. That’s why a lot of the content we presented throughout the day resonated with our audience. It provided evidence for what they had already recognized anecdotally.

Luke: The bar for evidence in executive discussions is higher, and teams must be more explicit about where they place bets. Teams need to be clearer on which signals matter and align early on what actions they trigger.

Theme 2: Launches are under more pressure, earlier in the curve

Luke: We’re seeing launch performance hinge more on early decisions than on in-market adjustments. Teams need to make more explicit choices on targeting, engagement, and access before they have full market feedback, with less time to recalibrate. That makes readiness and alignment more critical than before.

Nadine: Launch pressure begins well before a product reaches the market. There is an increasing need for companies to have a visceral understanding of their stakeholders, to lay the appropriate groundwork, and to craft strategies and tactics that will mitigate barriers to uptake well in advance of product availability. Teams can have a strong brand story and still be unprepared for frictions that slow adoption. The focus has to be on decisions that remove friction early. That starts with being clear on priority customers, engagement built around their preferences, and a strong understanding of how to smooth the path to access and affordability.

Operating rhythm is another pressure point. Launch teams often measure too many metrics, making it harder to identify and respond quickly to those that really matter. The goal is a shorter loop between market feedback and operational response. When early signals show when a key, and I mean key, indicator is lagging, understanding why and responding quickly are critical, whether it’s a targeted adjustment in message, channel, access support, or field focus.

Adam: I connect launch pressure back to the broader compression story. When pricing, access, and engagement are all under strain, a launch has fewer clean paths to scale.

Daniel: When I look at the brands that win anyway, they enter the market with sharper choices, stronger cross functional alignment, and a plan to learn and adapt quickly once reality shows up.

Theme 3: In-market brands are fighting for durability, not just growth

Luke: Economic compression does not only target new products. It changes the calculus for established brands. In many categories, the question is no longer how to maximize peak. It is how to protect durability while you continue to invest in the next wave of growth.

Adam: I see this pressure forcing uncomfortable portfolio tradeoffs. Brands feel pressure from competition, payer controls, and changing care pathways, leading teams to spread investment too thin. Lifecycle strategy needs explicit choices. Be clear on where you still have headroom, which segments you can defend, and which proof points strengthen your value story. Then simplify the plan enough that the organization can execute it consistently.

Daniel: I bring it back to how decisions get made in real companies. If a team is trying to defend investment in an in-market brand, they need more than a story. They need benchmarks, scenario-based assumptions, and a measurement plan that shows whether the strategy is working.

Luke: Lifecycle performance depends more on repeatable capability than on one set of strategic choices. Teams that adjust early, using leading indicators and staying aligned with access realities, are able to sustain performance. When that capability is not in place, the gaps tend to show up faster.

Theme 4: Pricing, policy, and access uncertainty is shaping commercial choices

Luke: Pricing and policy shaped many of the choices leaders discussed. Even without immediate disruption, uncertainty changes behavior and influences launch sequencing, claims strategy, investment posture, and how value is communicated across stakeholders.

Adam: The uncertainty is showing up in delays, in second guessing, and in teams waiting for perfect information that never arrives. My recommendation is to plan with scenarios that reflect real constraints. Define the access conditions you are most likely to face and the value messages you can defend in each scenario. Then build operating plans that can flex without forcing a full redesign. That reduces surprises, and it helps leaders move with more confidence when policy signals change.

Daniel: I do not think access strategy can live in a separate lane from brand strategy. When evidence needs to shift, the commercial narrative has to shift with it. That requires tighter linkage between the clinical and real-world evidence plan, the payer value story, and what the field and digital channels actually say. For me, evidence-based alignment reduces rework. It prevents teams from having to reconcile conflicting messages after they have already hit the market.

Theme 5: Customer engagement is shifting, and the old playbook is aging out

Luke: Most organizations accept that engagement is changing. The next challenge is making the current model work more effectively. The lens here is simple: starting point has to be customer reality, which means teams need to align channel mix, field roles, and content to how customers actually engage.

Adam: That shows up as a consistent frustration. Even strong teams can struggle to engage customers where they actually are. The issue is not effort, it is fit. When the model does not reflect how customers want to interact, activity increases while impact plateaus. The starting point has to be customer reality, and from there the channel mix, field roles, and content approach are built to match. That is what turns omnichannel from a concept into an operating system.

Nadine: Coordination is where many teams get stuck, not just on coverage. Engagement only works when field and digital motion are aligned, not competing with different messages and timing. There also needs to be more simplicity in how customer journeys are designed so teams can execute consistently. When journeys get overly complex, organizations often fall back to one-size-fits-all activity, or worse, each team or function “doing their own thing”. That’s when both execution and the customer experience falter.

Daniel: I connect engagement to the quality of what we put in front of customers. Better targeting without better content still wastes attention. I think content has to give the customer a clear reason to engage. That means fewer, stronger points supported by credible evidence, delivered in formats that match how different stakeholders learn and decide. When content is strong, channels work harder. When content is weak, channels only amplify the weakness.

Luke: What that translates to in practice is a simpler discipline. It starts with how customers engage, not how we expect them to. From there, teams need to line up channel mix, field roles, and content around that reality. If the model does not reflect how customers want to interact, adding more activity is not going to improve performance.

Theme 6: Decision speed depends on faster signal-to-action cycles

Luke: Let’s turn to decision speed for a moment. The constraint is no longer access to data, but how quickly teams can act on it. In many organizations, planning cycles, reporting cycles, and internal handoffs still create lag, even when the signal is clear.

Nadine: You cannot manage a launch or an in-market brand with a dashboard that only tells you what already happened. The goal is earlier signals tied to specific decisions, not more metrics. If adoption lags in a priority segment, what are you willing to change? If access friction is rising, where can you step in with targeted support? And if a channel is not performing, what do you stop so you can reinvest with discipline?

Daniel: I focus on the decision system behind the metrics. The biggest risk is not that teams lack data. It is that they lack agreement on what data will trigger action. I advocate for measurement plans that support executive decisions, not just reporting. That means defining a small set of leading indicators, tying them to hypotheses, and agreeing on what will change when the indicators move.

Luke: That kind of clarity also reduces internal drag. When functions agree on what matters and what actions follow, the organization spends less time debating and more time executing. Over time, that becomes a real capability, not just a one-off improvement.

Theme 7: Content excellence raises decision confidence

Luke: One piece of feedback kept coming back throughout the Summit: leaders want content that is clear, defensible, and usable in decision making. It sounds straightforward, but it has become harder to deliver as the environment gets more demanding.

Daniel: I think content excellence is the combination of compelling insight and credible support. A point of view is only useful if it’s grounded in evidence leaders can use in executive discussions. That’s what creates the confidence to act.

Luke: And that’s where the bar has clearly moved. A broad perspective is not enough; executive teams expect evidence they can act on.

Adam: I agree. When the challenges are framed clearly and backed with data, it makes the uncertainty more tangible. It helps leaders see what they are navigating and where there is a path forward.

Nadine: And most of the time, it’s not a silver bullet or a “new” idea. It is doing the basics extremely well, better than anyone else. The difference comes down to alignment, discipline, and following through with excellence.

Daniel: When content connects insight to benchmarks, market context, and clear logic about what to do next, it holds attention in crowded calendars. It also becomes something teams can reuse across stakeholders, which is exactly what you need when time is limited.

Luke: You need strong content that people can find and use. Fewer, stronger points grounded in evidence, and content that teams can access and apply in decision making. Otherwise, even the best thinking doesn’t make it into the conversation.

Theme 8: What leaders can do now, even before the next planning cycle

Luke: I’d like to wrap with decisions and actions that are concrete enough to use. No team can change everything all at once, but most can identify a few small sets of moves now to reduce friction and increase decision speed inside current constraints. Where do you actually need to tighten, where can you simplify, and what could you put into motion now instead of waiting for the next planning cycle?

Adam: I would start by tightening prioritization. Compression punishes broad strategies. Make sharper choices about which patients, providers, and accounts matter most, and ensure investment matches those priorities. Then revisit cross functional alignment. If commercial, medical, and access are not aligned on the same value narrative and target segments, the market will expose the seams quickly. And given the level of policy and access uncertainty, adopting a more structured, scenario-based approach becomes critical so the organization is not forced into last-minute pivots.

Nadine: I would add operating cadence. This is where teams either gain time or lose time. A faster cadence starts with agreeing on the early signals that matter and tying them directly to the adjustments you are willing to make. It also means simplifying customer journeys so teams can execute consistently across channels, and as importantly, treating readiness as a cross-functional discipline, not a checklist. When readiness is strong and those learning loops are short, teams can correct course without losing unnecessary time.

Daniel: That points to a broader expectation around how decisions get made. Leaders need to raise the bar on what they call insight. It’s not enough to have a perspective. It has to be an evidence-based point of view that clearly connects market dynamics to specific decisions. That includes having measurement plans in place that are designed to trigger action, not just report on performance. When the narrative is defensible and there is alignment on the indicators that matter, decisions become clearer and execution accelerates.

Luke’s Closing Comments: The pressure is real, and the path forward is practical

I’d like to thank the panelists for their time today. The discussion highlighted where perspectives aligned and what actions follow. Let me recap what I heard as the main highlights and what they suggest for action.

Economic compression is the environment teams are operating in right now. The most useful parts of the conversation were grounded in choices and tradeoffs, not general observations. In practice, that starts with being clear on what matters most, making deliberate decisions on where to invest and where to stop, and aligning across functions so those choices hold up in execution.

There is also a clear shift in expectations around how quickly teams respond to the market. The challenge is not access to data, but how quickly the organization can turn signal into action. When that cycle is long, small gaps compound. When it is short, teams can adjust earlier and stay aligned with how the market is evolving.

Focus on the decisions that create leverage, align on the signals that matter, and be explicit about what changes when those signals move. Over time, that’s what builds the capability to respond consistently as the market shifts.