Commercializing Innovation in Healthcare: Why “Think Commercial” Needs to Start on Day 1
Springboard Enterprises
Springboard is a network of entrepreneurs, investors, and advisors accelerating the success of women entrepreneurs.
When my father was diagnosed with a rare neurodegenerative disease known as frontotemporal dementia (FTD), I knew that breakthrough therapies can still leave patients stranded if access hurdles aren’t solved. I have seen it happen in my biopharma career more than once. Those experiences — and two decades of bringing pipeline assets to market at Pfizer, Genentech/Roche, Kite/Gilead, and Johnson & Johnson— taught me a simple lesson: scientific ingenuity is only half the job. Unless a biotech starts designing for customers, competitors, payers, regulators, and patients early, even an FDA approval can end in commercial disappointment. If you truly understand commercialization, you know that it is so much more than just “sales and marketing”.
⏰The Cost of Waiting
Drug launches are brutally unforgiving. Research has shown that roughly two-thirds of launches miss their first-year revenue targets. For first-time launchers the odds are worse: only 28 % beat analyst forecasts compared with nearly half for seasoned companies. Those misses are not the result of mediocre science; they’re usually the price of postponing commercial thinking until Phase III.
Consider Biogen’s Alzheimer’s drug Aduhelm – a space I know well. The antibody won accelerated approval in 2021, yet CMS confined coverage to clinical-trial settings because the evidence package failed to convince payers. The label sat on a shelf while the company re-ran studies to answer questions that could have been anticipated years earlier.
Or look at Bluebird bio’s $2.8 million gene therapy Zynteglo. A curative promise could not overcome sticker shock and fragmented reimbursement systems; three years later the company was forced into a take-private deal amid a cash crunch. The science worked. The go-to-market model did not.
❓Begin with the End Customers in Mind
There is no longer one decision maker in healthcare. There are several, as well as enablers and influencers on whether or not a patient will ultimately get a drug. This has evolved tremendously since I started in the industry 25 years ago when you had one customer, one value prop and one. Times have changed. “Customer” in healthcare is plural:
Mapping these questions in Phase I forces development teams to pick endpoints that resonate beyond the FDA and to build HEOR and real-world-evidence plans early. Done well, the dataset that earns approval is the same dataset that unlocks coverage, guideline inclusion, and physician confidence.
🏅Competitive Intelligence Is a Development Activity
In crowded indications more than 60 % of launches fall short of expectations. Yet competitive assessments often live in slide decks reviewed once a year. High-performing biotechs treat competitive intelligence as a real-time feed that shapes trial design, manufacturing choices, and even indication sequencing.
Questions to ask before the first patient is dosed:
By answering these early, dose selection and endpoint hierarchy become strategic weapons, not scientific afterthoughts.
📊Design for Data the Ecosystem Needs
Every metric you choose -- from primary endpoint to PRO (patient-reported outcomes) -- is a future line in a payer dossier or KOL slide. Three practical rules:
Failure here, as Aduhelm shows, can delay uptake by years.
🚂Build the Cross-Functional Engine Ahead of the Curve
Capitalize years Before FIH • Hire or contract a seasoned commercial strategist once you have credible pre-clinical data. The incremental salary is trivial compared with the burn rate of a failed launch.
Phase I • Formalize Target Product Profile v1.0 with input from market access, medical affairs, and analytics.
Phase II • Stand up customer-insights capability: iterative advisory boards, digital ethnography, claims-data mining. Use findings to lock the pivotal protocol and the value story.
Phase III & CMC • Add pricing & contracting, distribution ops, and patient-services leads so they can influence supply-chain design and hub architecture.
12–18 Months Pre-PDUFA • Execute unbranded disease education, field-medical deployment, and payer pre-positioning so launch day is a step-function, not a crawl.
Analysis of first-time launchers found that the most successful companies raised 2–3× more capital earlier to fund precisely these capabilities.
📚Practical Playbook for Founders & Boards
🏆Conclusion: Science and Strategy Save Lives
Healthcare innovation fails whenever brilliant science meets an unprepared market. By embedding commercial perspective from the first experiment, biotech founders honor the ultimate stakeholder…… the patient waiting at the end of the value chain.
My father didn’t get that chance; his disease progressed faster than the system could. Let’s ensure the next generation of therapies clear not only the regulatory bar but the real-world barriers that determine whether hope turns into health.
Begin with the End Customers in Mind
“Customer” in healthcare is plural:
About Deanna Angello, MBA :
Deanna Angello is a multidimensional biotech C-suite and board strategist who fuses Fortune-50 rigor with startup velocity to turn uncharted challenges into enterprise growth. Over 25 years at Pfizer, Genentech/Roche, Kite/Gilead, Johnson & Johnson, and most recently as Chief Commercial Officer at Cognito Therapeutics, she has tackled first-of-their-kind market, policy, and launch challenges, orchestrated growth for seven blockbuster franchises that exceed $7B in annual revenue, neutralized a $10B competitive threat, and held P&L responsibility up to $3B while directing capital allocation, pipeline prioritization, go/no-go calls, and critical launches.
As a Venture Partner at LongeVC, former Executive-in-Residence at Springboard Enterprises, startup board member, and mentor to 50+ founders who have raised $20M+, she channels a global network of investors, payers, regulators, and KOLs to accelerate access, reimbursement, and capital formation; she also invests through Portfolia’s Active Aging & Longevity Fund and advises accelerators including Springboard Enterprises, IGNITE, Creative Destruction Lab, and Innosphere Ventures. Therapeutically, her footprint spans Alzheimer’s, neurodegeneration, oncology, cell therapy, metabolic disease, women’s health, and health tech, with signature influence on several blockbusters: Lyrica®, Lipitor®, Aricept®, Herceptin®, Rituxan®, Yescarta®, Erleada®, and Carvykti®. Renowned for thriving in ambiguity and solving first-of-their-kind problems, Deanna unites R&D, investors, and payers and strategic operators around a common North Star—delivering transformative growth while advancing science that changes lives.