Why your brand plan can't see what's killing it

Most pharma launches fail for strategic reasons, not scientific ones. Here's the planning shift that changes the outcome.

The data should make every commercial leader uncomfortable. A Deloitte Center for Health Solutions analysis of 284 US drug launches spanning 2012 to 2021 found that about one-in-three new products missed launch-year forecasts and that the revenue gap rarely closes.¹ Separate research across 1,700 forecasts on 260 drugs puts pre-launch forecast error at an average of over 70%, with errors persisting as far as six years post-launch.² And a 2025 ZS Associates retrospective of 340 launches confirmed that even among clinically differentiated products, nearly a third still fail to meet expectations three years after launch.³

These aren't outliers. They are the baseline.

What's striking is where the failures actually originate. The Deloitte analysis identified six categories of underperformance. Limited market access topped the list at ~57% of failures but that number needs context.¹ When broken out by therapeutic archetype, market access as a primary failure driver drops sharply in competitive oncology settings, where inadequate clinical differentiation and poor understanding of market dynamics are the dominant culprits. In other words, payer rejection is frequently not the root problem. It is the consequence of a strategic problem that went undiagnosed earlier in the planning cycle.

The ATU trap

Most Annual Operating Plans are built on a familiar foundation: prior year assumptions, brand-level attribute tracking studies, and an inherited marketing mix. Awareness, Trial, and Usage (ATU) data tells a team where their brand stands relative to competitor perceptions. What it cannot tell them is what is actually driving prescribing behavior at the category level—the structural forces shaping the entire competitive landscape before any brand enters the frame.

This distinction matters more than most planning processes acknowledge. Brand-level data reveals how you are seen. Market-level driver analysis reveals what is moving the market: clinical, behavioral, operational, and access dynamics that exist independent of any single product's positioning.

The difference shows up in outcomes. Zaltrap (ziv-aflibercept) launched in colorectal cancer with legitimate clinical credentials but failed to quantify its differentiation in terms that were meaningful to payers and physicians. Faced with a list price roughly double that of the established standard of care, Sanofi ultimately halved Zaltrap's US price, a move that raised its own complications, as reimbursement remained tied to the original list price, affecting patient cost-sharing.⁴ The lesson: clinical merit alone does not constitute a value narrative.

Kymriah (tisagenlecleucel) pioneered the CAR-T category and changed the ceiling of what oncology could do. Yet five years after its 2017 launch, Kymriah achieved $230 million in sales against pre-launch year-five projections of nearly $497 million.⁵ The science was revolutionary. The planning process had not fully accounted for the logistical and behavioral realities of a therapy requiring patients' own cells to be extracted, cryopreserved, shipped, genetically reprogrammed, and reinfused within a critical window. According to provider surveys, this process presented at least two significant logistical obstacles at nearly every administrative stage. These are not scientific failures. They are strategic planning failures.

What rigorous planning actually looks like

High-performing commercial teams are rebuilding their AOP processes around market-level driver analysis: a quantified framework that maps the specific clinical, operational, and behavioral forces actually shaping prescribing at the category level, not just tracking how a brand is perceived within it.⁶

This approach enables planning teams to force-prioritize the clinical differentiators that will genuinely move share, build a marketing mix directly traceable to those imperatives, and produce forecasts with materially lower variance. It's also where the structure of the planning partner matters: Woven Health Collective is built as a unified blend of science, strategy, creative, and technology precisely because this kind of analysis can't be handed off across organizational seams. When every cost line is anchored to a logical chain of evidence—from clinical profile through market dynamics through tactical execution—the plan on paper is far more likely to perform in the field.

With hundreds of new product launches and microlaunches expected in the next five years, the competitive pressure on physician attention, formulary position, and patient access will only intensify. The brands that break through won't necessarily have the best molecules. They'll have the most rigorous plans behind them.

References

1. Deloitte Center for Health Solutions. Drug launches reflect overall company performance. Deloitte Insights. Published August 23, 2023. Accessed April 24, 2026. https://www.deloitte.com/us/en/insights/industry/health-care/key-factors-for-successful-drug-launch.html

2. Cha M, Rifai B, Sarraf P. Pharmaceutical forecasting: throwing darts? Nat Rev Drug Discov. 2013;12(10):737-739. doi:10.1038/nrd4127. https://pubmed.ncbi.nlm.nih.gov/24080692/

3. ZS. Why your best science is losing and what wins in pharma launches. ZS Insights. Published March 29, 2026. Accessed April 24, 2026. https://www.zs.com/insights/build-a-pharmaceutical-launch-strategy-and-operating-system

4. Sanofi halves the price of Zaltrap in response to criticism from oncologists. Pharmacy Times. Published January 3, 2022. Accessed April 24, 2026. https://www.pharmacytimes.com/view/sanofi-halves-the-price-of-zaltrap-in-response-to-criticism-from-oncologists

5. Brauner J. Biopharma product strategy: lessons from over- and under-performing launches. Recon Strategy. Published June 9, 2025. Accessed April 24, 2026. https://reconstrategy.com/2025/06/biopharma-product-strategy-lessons-from-over-and-under-performing-launches/

6. Woven Health Collective internal analysis, 2026.