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Global Pharma · 2024–2026 Evidence
WHY
LAUNCHES
FAIL.

The industry produces more drugs than ever. Commercial execution remains stubbornly broken. Here is the evidence — using only 2024, 2025, and 2026 data.

MARKET ACCESS · PRICING · OMNICHANNEL · HCP BEHAVIOR · PATIENT JOURNEY
2/3
of new drug launches miss first-year sales forecasts — and those that miss continue to underdeliver for the next two years
McKinsey Drug Launch Research (widely cited 2024–2025)
78
Novel active substances launched globally in 2024 — 5-year total: 394
IQVIA Global Use of Medicines Outlook, 2025
$1.7T
Global pharma market size in 2024 — record revenue, record underperformance
IQVIA / Statista, 2024
394
Novel substances launched globally across 2020–2024 — innovation is not the constraint
IQVIA, 2025
48
NAS launched in the US in 2024 alone — a 22% increase vs the prior 5-year period
IQVIA, 2025
Sources: McKinsey Drug Launch Research; IQVIA Global Use of Medicines Outlook 2025; Evaluate World Preview 2025; IQVIA/Statista Global Pharma Market 2024
SPEAKER NOTES [N]
02 / 15
Macro Context · Patent Cliff
The $300B Warning

Over $300 billion in branded drug sales face patent expiry by 2030 — arriving simultaneously with the most aggressive pricing reforms in pharma history.

  • IRA Medicare price negotiations first impact revenues in 2026 — avg 38% reduction on first 10 drugs
  • EU Pharma Reform (Council agreement March 2024) — first major revision in 20+ years
  • EU Joint Clinical Assessment live since January 2025 for oncology and ATMPs
  • Prescription drug sales projected to top $1.75T by 2030 — but only if launches execute
Evaluate World Preview, Dec 2025 · EU Pharma Reform Council 2024 · Remap Consulting 2025
Patent Cliff: Cumulative Sales at Risk ($B) — Illustrative Trend
$1.75T
Projected global prescription drug sales by 2030 — contingent on successful launches clearing the access and engagement barriers documented in this deck
Evaluate World Preview, December 2025
Sources: Evaluate World Preview Dec 2025; EU Council Pharma Reform Agreement Mar 2024; Remap Consulting PMA Review 2024 & 2025; IRA/CMS 2025
SPEAKER NOTES [N]
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Market Access · EU Timing
Market Access:
The New
Bottleneck
531
days — average EU time from regulatory approval to reimbursement in 2024
▲ 2.3% increase vs 2023 — highest value on record
EFPIA W.A.I.T. Survey, 5 January 2024
EMA-Approved Drugs (2021–2024): EU Reimbursement Status
Fully reimbursed Partially reimbursed Not assessed / not reimbursed
58%
of EMA-approved drugs (2021–2024) reimbursed in at least one EU market
GlobalData Price Intelligence, 2025
40%
of indications for 2021–2024 approved brands still have no HTA assessment
GlobalData, Pharma Technology Focus, Jul 2025
Sources: EFPIA W.A.I.T. Survey Jan 2024; GlobalData Price Intelligence POLI; Pharma Technology Focus Jul 2025; TRiBECA Knowledge Market Access Report 2024
SPEAKER NOTES [N]
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Market Access · EU Disparities
Europe's Access Fracture Map

% of EMA-approved brands (2021–2024) reimbursed per market. The 5EU reimburses 2.7× more products than the European average. Same regulatory approval. Radically different commercial reality.

Major Markets (5EU + UK)
Smaller EU Markets
2.7×
The 5EU reimburses 2.7× more products annually than the overall EU average. Pricing in low-access markets can contaminate cross-reference pricing in high-access markets — making launch sequence strategy commercially critical. GlobalData, Pharma Technology Focus Jul 2025
Sources: GlobalData Price Intelligence POLI; Pharma Technology Focus Jul 2025; European Market Access Lag 2021–2024 — GlobalData/NRI Digital Jul 2025
SPEAKER NOTES [N]
05 / 15
EU HTA Reform · January 2025
EU JCA Era:
Promise vs
Reality

The EU Joint Clinical Assessment launched January 2025 for oncology and ATMPs — the most significant HTA reform in a generation. But clinical harmonization is not the same as commercial access.

"What worked in 2020 no longer applies in 2025. Global access planning must become granular."

WLCUS Pharma Market Access Analysis, Jul 2025
What JCA delivers
  • Single clinical assessment replacing 27 national evaluations
  • Standardized HTA-IT platform — one dossier submission route
  • Reduced redundancy for applicants long-term
  • Expands to orphan drugs Jan 2028; all NAS by Jan 2030
What JCA does NOT deliver
  • Harmonized pricing — still 27 separate national decisions
  • Guaranteed reimbursement — national payers retain full control
  • Speed in the short term — adds complexity before reducing it
  • Certainty on outcomes for novel or real-world evidence
-18%
Positive HTA decisions across 5EU in Q1 2025 vs Q1 2024
GlobalData 5EU Analysis, May 2025
+22%
Neutral (restricted access) HTA decisions across 5EU in Q1 2025 vs Q1 2024
GlobalData 5EU Analysis, May 2025
Sources: EU HTA Regulation (2021/2282); GlobalData 5EU Q1 2024 vs 2025, May 2025; WLCUS Pharma Market Access Jul 2025; Remap EU Pharma Reform Jun 2025
SPEAKER NOTES [N]
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Pricing · US IRA + EU Cost Pressure
The IRA
Effect
-38%
avg price reduction for first 10 Medicare-negotiated drugs, effective 2026 vs 2023 list prices
Remap Consulting Market Access Check-In, December 2025
  • 15+ additional drugs incl. Ozempic entered IRA negotiations in 2025 for 2027 implementation
  • EU 2024: pricing focus shifted from value to cost-containment — post-COVID & Ukraine budget pressure
  • Industry Q3 2024 earnings: IRA creates R&D incentive distortions favoring biologics over small molecules
First 10 IRA-Negotiated Drugs: 2023 List Price vs 2026 Negotiated (Indexed = 100)
10
First batch of Medicare price-negotiated drugs — effective 2026
IRA / CMS 2025
15+
Additional drugs in 2025 negotiation round — Ozempic included — effective 2027
Remap Consulting, Dec 2025
Sources: Remap Consulting PMA Trends 2024 & Market Access Check-In Dec 2025; IRA / CMS; GlobalData Life Sciences Trends 2025; EU Pharma Reform 2025
SPEAKER NOTES [N]
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HCP Engagement · Omnichannel
The Engagement
Illusion

Most pharma companies have launched digital transformation programs. The results, measured from the HCP side, are sobering.

"The gap between omnichannel ambition and execution is vast — and the HCP is paying for it with wasted time."

Gurpinder Singh, VP Omnichannel Activation, Indegene · May 2025

Despite heavy investments in CRM, content platforms, and digital activation — the HCP experience has not materially improved. The signal is consistent across 2024 and 2025 research.

80%
of HCPs report receiving generic, impersonal communications
from pharmaceutical companies
Indegene Omnichannel Strategies Report, May 2025
<20%
of HCPs feel personally engaged by pharma companies despite digital investments
Indegene, 2025
84%
of physicians want to maintain or increase online pharma interactions — the demand is there
Viseven Analysis, 2025
Sources: Indegene Omnichannel Strategies Report May 2025; Indegene HCP Digital Affinity Report Nov 2024; Viseven 2025 Analysis; IntuitionLabs HCP Marketing Guide Feb 2026
SPEAKER NOTES [N]
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HCP Behavior · Real Data 2025
How HCPs
Actually
Engage

HCPs are clear: they want digital content on their terms. But they will not show up for low-value interactions — regardless of channel.

50%
of HCPs who register for pharma webinars never attend — wasting every investment made
SpotMe / Life Science Research, 2024
<2m
Duration of nearly 90% of rep–HCP interactions in 2025 — the average conversation is barely a minute
PharmExec Reinventing SFE, 2025
HCP Demand vs Pharma Delivery Quality by Channel (indicative, 2024–2025)
HCP demand Pharma delivery quality
Sources: Indegene HCP Digital Affinity 2024; Viseven 2025; IntuitionLabs Feb 2026
Sources: SpotMe/Life Science HCP Events Research 2024; PharmExec Reinventing SFE Mar 2025; Indegene Digital Affinity Report Nov 2024; Viseven 2025
SPEAKER NOTES [N]
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Sales Force · Effectiveness
The SFE
Gap

Despite massive investment in measuring sales force effectiveness, the foundational metrics are deeply unflattering — and have not materially improved.

$4M – $6M
spent annually per top pharma company on third-party SFE research — yet market share impact remains unclear to commercial executives
PharmExec Reinventing SFE, March 2025
  • Only 1 in 3 sales calls considered valuable by physicians (2025)
  • Over 20% of physicians now restrict rep access entirely
  • Reps who remove prescribing barriers outperform product-pushers on every measurable
PharmExec Reinventing SFE, March 2025
What HCPs Value from Reps — Ranked by Importance (2025)
Source: PharmExec Reinventing SFE, March 2025 — indicative ranking based on published HCP value drivers
Sources: PharmExec Reinventing SFE March 2025; Within3 Pharma Statistics 2024; Indegene HCP Digital Affinity 2024; IntuitionLabs HCP Marketing Guide Feb 2026
SPEAKER NOTES [N]
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Omnichannel · Execution Maturity
Multi-Channel ≠ Omnichannel

Most pharma companies believe they have an omnichannel strategy. What they actually have is siloed channel activation — without connected data, unified HCP profiles, or feedback loops.

01
Fragmented Tactics
Isolated emails, calls, posts. No connection between touchpoints. Pure broadcast.
Where most companies are stuck
02
Channel Activation
Multiple channels running in parallel — siloed, no unified data or shared learning loop.
Multi-channel, not omnichannel
03
Omnichannel Orchestration
Connected channels, unified HCP profiles, consistent messaging, behavioral feedback loops.
Minimum viable standard for 2025
04
AI-Driven Journeys
Real-time behavioral AI adapts content, timing, channel per HCP. ~50% more conversions (AI-based segmentation).
IntuitionLabs / AI HCP study, 2024
+53%
HCP engagement uplift — orchestrated omnichannel vs siloed campaigns. L.E.K. pharma case, 2024.
+46%
Email open rate uplift — rep-triggered omnichannel vs generic outreach. Veeva / L.E.K. case.
+30%
Campaign relevance uplift — companies using NLP and predictive analytics. IntuitionLabs, Feb 2026.
Sources: Indegene Omnichannel Strategies May 2025; L.E.K. Consulting Omnichannel Case Studies; IntuitionLabs HCP Marketing Guide Feb 2026; Tikamobile Pharma 2025 Guide
SPEAKER NOTES [N]
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Patient Journey · Access & Adherence
Broken at
Every Stage

The 2025 Medication Access Report synthesizes 180 qualitative interviews and 777 quantitative surveys. The findings reveal systemic failure — not isolated friction.

65%
of patients experience delays receiving their medications
CoverMyMeds 2025 Medication Access Report
1 in 5
patients modified their prescription because they could not afford it
CoverMyMeds Patient Survey 2023/2025
Specialty drugs = 56% of total drug spend but only 2% of prescriptions — access burden is concentrated and severe for the most innovative launches. CoverMyMeds 2025 / THL 2024
Patient Medication Access Barriers — % Affected (2025)
Sources: CoverMyMeds 2025 Medication Access Report; CoverMyMeds Patient Survey 2023; THL Specialty Drug Market May 2024; AMA 2024
Sources: CoverMyMeds 2025 Medication Access Report (180 qualitative interviews, 777 quantitative surveys); CoverMyMeds Patient Survey 2023; THL Specialty Drug 2024
SPEAKER NOTES [N]
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Patient Access · Prior Authorization
The Hidden
Launch Killer
94%
of physicians say the prior authorization process delays necessary patient care
American Medical Association, July 2024

PA is not just a bureaucratic friction — it is an active barrier between the prescribing moment and the dispensing reality. Physicians may avoid prescribing newly launched drugs entirely if PA friction is too high.

56%
of total US drug spending is specialty drugs — but they are only 2% of all prescriptions
CoverMyMeds 2025 / THL May 2024
54%
of patients cite drug cost as a major concern when accessing their prescribed therapy
CoverMyMeds Medication Access Report, 2025
Prior Authorization Impact Chain
Physician prescribes
PA required
Weeks of delay
Patient abandons
Research shows physicians sometimes avoid prescribing PA-required drugs even for clinically appropriate patients — removing demand before it is even expressed. AJMC, cited Guidehouse 2025
Prior authorizations delay care in up to 94% of cases — and this figure has remained consistent despite years of industry advocacy for reform. Pharma Patient Services / Courier Health citing AMA data, 2024
Sources: AMA Health Insurance Denials & Prior Authorization Report Jul 2024; CoverMyMeds 2025; Guidehouse PSP Trends Q1 2025; AJMC study on PA avoidance
SPEAKER NOTES [N]
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Patient Support Programs · Awareness
The Invisible
Infrastructure

Pharma invests over $5 billion annually building patient support programs. It then largely fails to tell patients or prescribers that they exist.

59%
of patients are unaware patient support programs exist for their therapy
CoverMyMeds 2025 Medication Access Report
42%
of prescribers are unaware of PSPs for drugs they regularly prescribe
CoverMyMeds 2025 Medication Access Report
$5B+
invested annually by pharma in PSPs — copay assistance, access programs, education
Fierce Pharma, cited by McKesson/CoverMyMeds
PSP Landscape — 2025 (% executives / patients)
  • 80% of PSP leaders say copay assistance is the most utilized program they offer (Guidehouse PSP Survey Q1 2025, n=35 executives)
  • 75% of 7,000+ drugs in development are specialty medications — access complexity will intensify (Courier Health 2025)
  • Digital tools, automated reminders, and telehealth with human support are the most impactful PSP investments (CoverMyMeds 2025)
Sources: CoverMyMeds 2025 Medication Access Report; Guidehouse PSP Trends Report Q1 2025 (n=35); Courier Health Patient Services 2025; Fierce Pharma / McKesson
SPEAKER NOTES [N]
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Synthesis · Five Failure Modes
The Anatomy of a Failed Launch

These five modes do not operate independently. Each amplifies the others. A launch that underperforms on access will underperform on every downstream metric.

01
Access Delay
531-day EU P&R lag. 40% of EU indications unassessed. Cyprus access at 7% of approved drugs.
02
Pricing Erosion
IRA cuts avg 38% from Medicare prices effective 2026. EU shifting from value to cost-containment as primary payer frame.
03
HCP Disengagement
80% of HCPs receive generic comms. <20% feel engaged. Only 1 in 3 calls valuable. 20%+ deny rep access.
04
Channel Fragmentation
Data siloed across sales, marketing, medical. Multichannel ≠ omnichannel. No unified HCP view or feedback loops.
05
Patient Abandonment
65% face delays. 1 in 5 can't afford therapy. 59% unaware help exists. PA blocks the prescription before dispensing.
2/3
of launches underperform in year one — and those that miss continue to underdeliver for the next two years. The window to correct a failed launch is narrow and expensive. Most failures originate in decisions made three to five years before the drug reaches a formulary. McKinsey Drug Launch Research; DrugPatentWatch, March 2025
Synthesis: McKinsey; IQVIA 2025; GlobalData; CoverMyMeds 2025; Indegene 2025; AMA Jul 2024; Remap Consulting 2025; PharmExec 2025; DrugPatentWatch 2025
SPEAKER NOTES [N]
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The Way Forward · 2026 Imperative
FROM
PRODUCT
LAUNCH TO
ECOSYSTEM
LAUNCH.

PwC Q4 2025 data signals the first pharma commercial outperformance after years of muted results. Companies breaking through are those integrating access, engagement, and patient support — before day one, not after it.

Evidence-First Access
Design clinical programs for HTA and payer — not just regulators. HEOR strategy starts at trial design.
True Omnichannel
Unified HCP data — connected journeys, not parallel campaigns. Behavior-driven, not calendar-driven.
Visible PSPs
Patient support programs both patients and prescribers know about — at the point of prescribing.
Value Storytelling
Payer narratives grounded in real-world evidence and comparative outcomes — not clinical trial data alone.

"Winning companies won't wait for certainty. They will experiment boldly, scale what works, and hardwire adaptability into their DNA."

PwC Future of Pharma — January 2026
www.leadership-house.com www.bluebarna.com All data: 2024–2026
Sources: PwC Future of Pharma Jan 2026; McKinsey Biopharma Dealmaking Jun 2025; IQVIA Global Use of Medicines 2025; DrugPatentWatch Drug Launch Playbook Mar 2025
SPEAKER NOTES [N]

Speaker Notes

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