Five Things the Best-Performing Pharma Launches Have in Common

Most pharma launches do not meet expectations. The number has been remarkably consistent across two decades of industry research. McKinsey has reported that around two-thirds of new drugs fall short of pre-launch sales forecasts in their first year. Deloitte’s Rethinking Market Access report attributes 57% of launch failures to limited market access. ZS’s 2025 study of 340 launches found that one-third of clinically differentiated products still miss expectations three years after launch.

The pattern is not random. The pattern shows up.

When we look across two decades of launch research from McKinsey, ZS, Deloitte, IQVIA, and Guidehouse, the top-performing launches share a small number of operating beliefs. Not tactics. Beliefs that shape every tactic. Five of them show up consistently.

1. They treat launch as a system, not a moment

Most launches are organized around Day One. Top-performing launches are organized around the system that operates before, during, and long after Day One.

ZS’s 2025 launch research makes this explicit. The top 15 pharma manufacturers are now spending an average of $350 million per launch per year, and the firm’s analysis argues that the leaders are redesigning launch as an agile system rather than a fixed plan: investing earlier in reusable infrastructure, later in asset-specific spend, and using analytics to keep options open through approval. The launches that overperform are run by organizations that have built repeatable systems where each new launch inherits the capabilities of the last. The launches that underperform are run by organizations starting from zero every time.

For brand teams, this changes what the launch plan should actually look like. The plan is no longer a single document with a fixed sequence of activations. The plan is a system of pre-built capabilities, decision points, and contingency plays, ready to flex against whatever the market does.

2. They commit beyond clinical differentiation

The ZS 2025 study uncovered what the firm calls the differentiation paradox. Once a therapy meets a clinical threshold, the factors that actually drive launch performance are not the clinical profile itself. ZS attributes 29% of post-threshold performance to people (medical science liaisons and field reps who resolve practice-level friction), another 29% to support services (patient access programs, education, adherence tools), and 18% to reputation and the manufacturer’s perceived commitment to the therapeutic area.

The math gets sharper at the top of the curve. Clinical differentiation alone tops out at roughly five times analyst consensus. Add organizational commitment and overperformance reaches ten times. That is the difference between a $2 billion asset and a $4 billion asset in the same drug class.

Top-performing brand teams know this and act on it. They invest in the work that signals commitment to the disease area long before approval, long after launch, and across every audience that touches the therapy.

3. They invest in the audience long before approval

Guidehouse’s analysis of recent biotech launches found that companies investing 18 to 24 months in pre-launch market development achieved roughly 40% higher peak sales on average. Deloitte’s data on launch trajectories shows that around 70% of products that miss expectations at launch continue to miss them in subsequent years.

The trajectory of a launch gets set well before the trajectory begins. The top performers know this and start building brand equity, disease state education, and audience familiarity 18 months before Day One, sometimes longer. By the time approval comes, the HCP audience has been learning from the company for one, two, sometimes three years. The brand is not introducing itself at launch. The brand is converting a relationship that has already been built.

4. They build the value story across HCP, payer, and patient in parallel

The traditional launch sequence had the brand team build with HCPs first, the DTC team build with patients second, and market access translate the brand into payer language third. Top-performing launches no longer work that way.

Deloitte’s Rethinking Market Access research attributes 57% of US drug launch failures to limited market access, more than any other single factor. Inadequate market understanding ranks second at 47%. Poor product differentiation ranks third at 41%. The implication for brand teams is that the value story has to be developed and stress-tested across HCP, patient, and payer audiences in parallel, with the same level of investment and creative ambition.

The brands gaining ground are the ones whose HCP message, patient communication, and payer value framework share a through-line built deliberately from the start. The brands losing ground are the ones whose three audiences are getting three different stories from three different teams.

5. They build with patients, not just for them

The 2025 Edelman Trust Barometer found that 59% of people believe industry leaders make claims about health they know to be false or grossly exaggerated. Two-thirds of respondents said a health expert’s understanding of “people like me” matters as much as credentials. In October 2025, the FDA finalized the third of its four Patient-Focused Drug Development guidances, formally codifying patient experience data as a regulatory input.

Top-performing launches treat this as a structural commitment rather than a content tactic. Patients are involved in brand strategy, not brought in late to validate. Patient-led content is commissioned with creative authorship, not extracted as testimonial. The brand team’s brief is co-written with the patient community it is meant to serve.

That commitment shows up in the work, and audiences feel it immediately.

The through-line

The top-performing pharma launches share an operating belief that runs underneath all five of these characteristics. They believe that launch is a function of everything the organization does in the 24 months before approval and the 24 months after it. There is no launch magic, no single message that lands, no week of activation that rescues a brand the organization has not committed to. What works is a system, built early, committed to over time, and integrated across every audience that has to say yes for the therapy to reach the patient.

Brand teams running launches in 2026 and beyond have less room for error than the teams that ran launches in 2020. The launches that will outperform are already being designed today, by teams operating on these five beliefs.

If your brand team is in the planning window for an upcoming launch and rethinking how the work should be built, that is a conversation we would welcome.