Pharmaceutical Commercialization: A 2026 Outlook

2025 has been a dynamic year for pharma. Breakthroughs in AI-driven drug discovery and precision medicine have reshaped how treatments are developed and delivered, and major drug launches have further highlighted the industries’ efforts to serve unmet needs. This was also a year of significant regulatory shifts, which brought increased scrutiny on drug pricing, consumer advertising, evidence needs, and vaccine policy changes, among other issues.  Despite the breakthroughs, this year has been characterized by widespread uncertainty about the future. 

It is time for commercialization leaders to rethink market approaches and investments. We’re encouraging our clients to reexamine how they structure their organizations and deploy resources to respond to five major market trends.

DTC will evolve beyond promotion to personalization. 

Direct-to-consumer (DTC) spending is poised to rise, but not in the way we’ve seen before. The days of TV commercials as the centerpiece of DTC strategy are fading. In their place, direct patient engagement is taking center stage. Our perspective is that direct patient engagement will continue to evolve, with more services, more integration, and more personalized support. Hyper-personalized consumer engagement—delivering tailored experiences that meet unique needs—will become a powerful differentiator. 

Pharma firms must reclaim the patient relationship—not just to promote products, but to drive end-to-end care coordination. This includes promoting earlier diagnosis, better access to care, and offering personalized assistance to help patients start and stay on treatment. This shift demands new capabilities, new partnerships, and a new mindset. Technology will be a key enabler—but not the only answer. Digital health platforms will continue to play a key role  in engaging patients, but their real strength will be in facilitating dialogue between providers and patients. 

How to respond: Reimagine DTC as a service platform. Invest in tools that personalize engagement, educate patients, and facilitate shared decision making between providers and patients.

Delivering targeted therapies within a complex care ecosystem will demand greater agility. 

As pharma continues to advance scientific breakthroughs for specialty and rare conditions, leaders will need to think beyond traditional commercialization strategies to drive product growth. Conditions, treatments, and patient populations are becoming more precisely defined, and as a result, pharma will need to rethink their structure and growth strategies. Peak sales for personalized therapies are smaller, and the path to those peaks is largely uncharted.  

To remain competitive, manufacturers will need to take a more agile approach to pinpointing target audiences and engaging patients and providers. Patient identification will be a critical dimension of the go-to-market strategy, and it will increasingly define the success of launches and commercial execution. 

How to respond: Invest in flexible engagement platforms that can accommodate diverse provider settings and patient populations. Resist the temptation to engage in share-of-voice battles and instead focus on leveraging data and technology capabilities that allow leaders to better understand patients and tailor outreach.

Horizontal integration will increase as vertical integration recedes.

The vertical integration playbook is showing its limits. Companies that aggressively integrated vertically are slowly unwinding some of their businesses and, in many ways, going back to their roots.  Walgreens’ divestment of VillageMD and CVS Health’s divestment from Oak Street Health are high-profile examples, and many health systems have refined their payer plans to exit the marketplace.  

Many PBMs are also finding their business at risk as pharma–PBM tension continues to intensify. We predict that this tension will continue in 2026, especially for companies with late-stage assets in obesity, cardiology, and metabolic health. 

While vertical integration may slow down, we anticipate that horizontal integration and M&A activity among health systems will accelerate in 2026. Pharma has not yet fully matured its capabilities to support horizontally integrated provider organizations. These organizations operate across an expanding variety of care settings—inpatient, outpatient, ambulatory and home care. Going forward, it will be critical for pharma brands to better understand how these complex organizations operate, and how their structure effects prescribing behavior and adoption of innovative drugs.  

Targeting healthcare providers—who are increasingly employed by health systems—is no longer enough. Brands need to consider how they can best support non-hospital sites of care, especially as health systems increasingly funnel patients to their own advanced, multidisciplinary outpatient facilities, infusion centers, and at-home care. While some pharma brands have started to adapt to this shift, many brands have work to do.

How to respond: Reengineer market access, commercial and patient support functions to support a new normal of care delivery. Invest in future growth by building capabilities that help providers navigate system complexities and deliver better outcomes for patients.

Investments in AI will overshadow SG&A.

AI is no longer a buzzword—it’s now a budget line. It has passed the hype and prototype phase. In 2026, leading brands will spend more on AI-led innovation, often at the expense of traditional sales, general, and administrative expenses (SG&A). Pharma leaders are becoming increasingly comfortable with this shift and will need to align their teams with a new way of resourcing their functions. Brand-level leadership will need to reimagine how they think about staffing, using digital workers to complete repetitive, process-focused tasks and redirecting humans to address complex problem-solving. They also need to determine how AI can help with key brand management activities and reduce the overall cost of operations. 

In R&D, AI is already unlocking new possibilities. In commercial operations, it’s about efficiency—and that comes down to people and process. Brands will need to over-index on both to demystify the tech and make big bets in AI.  

How to respond: Move beyond quick wins. Fund AI initiatives that deliver measurable impact—even if that means optimizing a model over a longer timeframe. Invest in training for brand-level leadership to help them comprehend this monumental shift. Make embedding AI into business workflows a core KPI of management to accelerate adoption.

Data integration and evidence generation will become key differentiators.

Real-world evidence (RWE) will become essential to rising above competitors in 2026.   

As the already-crowded market for pharmaceuticals becomes more complex and personalized, pharma brands that can use real-world insights to inform strategy and demonstrate sustainable value will be better positioned to win in the market. We predict that successful companies will rethink their data and evidence generation strategies to drive success in RWE efforts, including collaboration with other firms and participation in data marketplaces. Future pharma data strategy needs to evolve beyond traditional claims, electronic medical record (EMR), and lab data to include social determinants of health, registries, patient-reported outcomes (PRO) and hospital resource utilization data. Pharma needs to accelerate efforts to integrate across these data sets, build data-mining capabilities, and generate more real-world evidence. 

How to respond: Lead the charge on data acquisition and integration. Use RWE to inform strategy, differentiate products, and deepen relationships across the healthcare ecosystem. Invest in RWE-driven digital tools and platforms that engage customers and uncover opportunities to collaborate with payers and providers—advancing population health outcomes while strengthening brand performance. 

The cost of inaction is rising

The pressures facing pharma leaders are converging—and accelerating. The complexity of the pipeline, the fragmentation of care delivery, and the expectations of increasingly diverse patient populations are not slowing down. Neither is the pace of technological change. 

What worked before may not work in the year ahead. Past successes and failures offer limited guidance in a landscape where the rules are being rewritten. Leaders must resist the temptation to follow familiar paths and instead embrace the discomfort of change and innovation.  

2026 will reward those who act with precision, who personalize with purpose, and who provoke change rather than react to it. The future of pharma will not be shaped by those who wait—it will be shaped by those who lead. 

This article was originally published in Pharmaceutical Executive.