Align Medical and Commercial Teams to Stay Agile in Unpredictable Markets

One launch metric change reveals why alignment programs succeed or quietly collapse

The industry has spent a decade diagnosing its alignment problem. The diagnosis is correct. The treatments haven't worked.

At Pharma 2026, moderator Gaetano Pellitteri, VP Field Medical Affairs Europe at Syneos Health, opened by separating two categories of failure that organizations routinely conflate: "We have all seen fantastic drugs with fantastic science behind them failing when we are launching them... the issue is that the internal engines, medical and commercial, were probably not working through the same track." Leaders from Sanofi, Novartis, and AMIFE discussed why those engines keep diverging and what, structurally, would actually stop them.

The answer that emerged is uncomfortable. Pharma has been applying communication remedies to a design problem. Functions are built to diverge. Medical optimizes for caution, commercial for growth, regulatory for compliance, market access for reimbursement thresholds. No volume of collaboration workshops repairs this if each function is still evaluated against a different definition of what a successful launch looks like. The misalignment isn't interpersonal. It's architectural.