Scale Smarter, Win the Talent War and Treat AI as a Journey

2026 Commercial Insights for Biotech and Pharma Leaders

If you lead commercial at a Fortune 1000 biotech or pharma company, 2026 can be a very good year, provided you place the right bets now. Despite macro noise (rates, reimbursement, tariffs), specialty pharma and biotech continue to expand. New therapeutics and advanced diagnostics are launching daily and the leaders we speak with are doubling down on commercial excellence.

The Growth Picture: Strong (If You Choose the Right Path to Scale)

The sector has moved beyond the initial shock of higher interest rates and constrained investment, particularly in biotech. Medicare Part D changes are real, with one large-cap company publicly flagging a potential $2B earnings impact, but demand for innovative therapies remains robust. Specialty pharma and biotech are growing at roughly 13%, a far cry from the “gloom and doom” narrative. The practical challenge is picking the right growth vector for a company’s current stage: license, acquire or commercialize. Each can work; the right answer depends on where you are on the scaling curve.

Leaders planning for 2026 expect commercial investment to increase because it consistently delivers strong ROI when it’s matched to lifecycle reality. Entering 2026 with clarity on where your assets sit on the maturity curve, and funding accordingly, is nonnegotiable.

Your Commercial Model Must Evolve Beyond “More Reps”

At launch, most U.S. models remain sales rep-heavy and concentrate on the highest value markets (think “NFL cities”). As products mature, the winning organizations pivot from a rep-centric model to a multirole engine that includes key accounts, patient education, reimbursement support, case management and nurse education. Alongside this, medical science liaisons (MSLs) expand in parallel (while not “commercial,” they are critical to clinician support). Over time, the share of commercial spend dedicated to traditional sellers typically falls from ~80–90% to ~40% as the broader team scales.

Outside the U.S., heterogeneity matters. Europe’s fragmented reimbursement and health systems require bespoke sequencing and role mix, so what works in the U.S. won’t map 1:1 to France or Germany. Building the field the same way everywhere is a costly mistake.

Policy and Tariffs: Manageable Headwinds, Not Strategy-Setters

Commercial leaders are not reporting major strategy pivots due to tariffs. While 43% of firms expected impacts >5%, the day-to-day commercial implications have been muted so far. Medicare and other policy shifts warrant vigilance, but most pharma and biotech commercial teams are focused elsewhere. This means that research tools suppliers serving academia have felt more pressure.

AI in 2026: Early, Real and Most Impactful in Marketing First

AI is not going away…and it’s already creating value. Roughly 75% of companies (across industries) report AI investment, though pharma and biotech commercial adoption lags at ~20% (given regulatory scrutiny). Expect AI to reshape marketing first through faster research, scalable content creation and smarter omnichannel. Then, sales is next to see AI improvement as conversation capture and real-time coaching mature. With all of this in mind, leaders should treat AI like the early Internet/CRM era. AI benefits compound over a 10 to20 year arc, vendors will overpromise and there’s no silver bullet. Start learning by experimenting now, or you’ll be behind when the tools eventually stabilize.

The 2026 Reality: Therapeutic Focus + Talent Scarcity

Rare disease, oncology, precision medicine and inflammatory disorders will continue to dominate specialty pharma; in parallel with the GLP1 wave transforming obesity. That mix has triggered a war for commercial talent. Relationships still matter and experienced sellers and field resources are getting poached. Leaders can navigate this by guarding the high-impact roles with competitive packages, clear career paths and mission-rich portfolios.

Don’t Skip the Hard but High Leverage Work: Incentives and Lifecycle Fit

Over 90% of companies will change sales compensation programs—a reminder that incentives are one of your most powerful levers to align behavior with evolving models (e.g., team-based roles, access constraints and omnichannel motion). Considering this, leaders should ensure that 2026 comp designs reward the outcomes you actually need at the asset’s stage; launch intensity, account expansion or adherence supporting services.

A Five-Point Agenda for Commercial Leaders Entering 2026

1. Diagnose your lifecycle stage and pick a scale path. Be explicit about whether licensing, M&A, or commercialization creates the fastest, least risky route to value for each asset.
2. Rebalance your resource mix. Shift from rep-dominant to the right blend of key accounts, patient/case/nurse education, reimbursement support and expanding MSLs—with market-by-market tailoring outside the U.S.
3. Invest in AI pragmatically. Prioritize near-term marketing use cases (e.g., research acceleration, content ops, next best engagement) while piloting seller assist tools where compliant. During this process, be sure to build governance early.
4. Fortify your talent moat. In rare/oncology/precision/inflammatory markets—and GLP1 adjacencies—protect critical commercial roles from attrition with differentiated development, recognition and purpose.
5. Tune incentives for 2026 realities. If you’re among the ~90% revising comp, align measures with desired outcomes (such as access, account depth or persistence) and with expanded team constructs.