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ISE Investment Tips > Blog > Market > Pharma’s Execution Gap: Solved Through Systems, Not Spend
Market

Pharma’s Execution Gap: Solved Through Systems, Not Spend

Sam Hubbert
Last updated: April 9, 2025 10:00 am
Sam Hubbert
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6 Min Read
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When a pharmaceutical company receives FDA approval for a new therapy, it marks the culmination of years—often over a decade—of scientific research, clinical trials, and regulatory navigation. But the notion that this milestone signals the hard part is over is dangerously misleading. For commercial teams, approval is the starting gun, not the finish line.

Biopharma firms are now operating in a compressed commercial window. Pricing scrutiny is intensifying, regulatory environments are diverging across markets, and the clock to patent expiry starts ticking the moment approval is granted. In this context, what separates commercially successful launches from those that stall isn’t just the strength of the molecule or the size of the promotional budget—it’s the digital infrastructure built to support and scale the launch.

To explore how these systems work behind the scenes, we spoke with Venkata Nerusu, a commercial IT strategist whose work has underpinned launches at BridgeBio, Gilead, and Ascendis Pharma. Nerusu also serves on the editorial boards of the SARC Journal of Entrepreneurship and Business Management and the Journal of Medical Series, reflecting his roles as both a technical specialist, but also as a contributor to thought leadership at the intersection of healthcare innovation and commercial strategy.

The Commercial Bottleneck No One Talks About

According to Nerusu, many leadership teams misread the launch timeline by assuming commercialization starts post-approval. “There’s a tendency to over-index on regulatory approval as the go/no-go point,” he explains. “But, for example, if your CRM isn’t validated and your field content workflows aren’t aligned, then you’re not ready to commercialize, no matter what the FDA says.”

Key systems—including CRM platforms, regulatory content workflows, master data management, and payer response tools—should be operational no later than six months before the anticipated PDUFA date. That timeline becomes even more aggressive in global launches, where localization, metadata structures, and multi-jurisdictional compliance must be designed up front. “You can’t retrofit scale,” Nerusu notes. “Every delay after approval burns patent life—and investor confidence.”

Earnings calls or press releases shouldn’t be your pivot point. He emphasizes that the real launch bottlenecks appear when sales teams can’t access approved materials, when MSLs can’t report interactions in structured formats, or when payer objections can’t be answered with data.

Compliance Is A Systems Design Challenge

Biopharma companies often frame compliance as a constraint—something that slows down innovation. Nerusu takes the opposite view. “Treat compliance like a core design principle, not a bolt-on,” he advises. This reframing has real operational consequences.

Consider FDA 21 CFR Part 11, GDPR, HIPAA—all of which impose strict requirements on data management, access, and traceability. When infrastructure is built with these mandates in mind from day one, audit trails, user permissions, and version control become native features, not hurdles. This reduces regulatory risk and accelerates review cycles, especially in the tense lead-up to approval.

Compliance, says Nerusu, is about confidence. Confident medical teams deploy materials faster. Confident legal teams spend less time in back-and-forth. “If your infrastructure defaults to traceability,” Nerusu says, “you move faster, with fewer surprises.”

The Currency of Launch Is Integrated Data

A launch’s commercial trajectory hinges on a company’s ability to respond to a fragmented market—different payers, prescribers, regulators, and patient populations, each with their own expectations and metrics. Meeting those expectations requires more than compelling clinical data. It requires infrastructure that connects the dots.

Every team—MSLs, sales reps, market access, brand marketing—is generating data. But if those data streams aren’t integrated, companies lose coherence and speed. “You can’t build a value story if your insights are trapped in silos,” Nerusu warns.

He advocates for shared, structured data environments where field activity logs, payer interactions, formulary decisions, and medical education outcomes all feed into unified dashboards. These tools allow different teams to align around what’s working, where resistance is surfacing, and how to adapt messaging in real time.

There’s also an emerging opportunity for machine learning to synthesize patterns across large, disparate datasets. “AI is only as useful as your architecture allows,” he says. “It’s another point of leverage—if the groundwork is there.”

How Investors Can Spot a High-Functioning Launch Engine

For investors evaluating pre-commercial biotechs, Nerusu offers a diagnostic lens that goes beyond pipeline strength. “Ask about digital operations,” he suggests. “What systems are live? Who’s leading IT and commercial ops? Are those teams in sync with medical and market access?”

Warning signs include CRM environments still in setup mode close to the PDUFA date, or content workflows that haven’t yet passed regulatory scrutiny. Green flags, on the other hand, look like this: training modules localized by region, data systems validated and live, field teams practicing on production-ready tools.

In a capital-intensive industry where delays cost millions and first impressions set the tone with prescribers and payers, digital readiness is fast becoming a proxy for operational maturity. And maturity signals execution, not just aspiration.

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