Beyond the vision: Is a 'cultural undertow' drowning your biopharma transformation?

Biopharma thrives on innovation – pouring billions into R&D to bring transformative therapies to life. Yet, a persistent question remains, a quiet hum of frustration beneath the surface of impressive pipeline charts and launch metrics: Why do so many drugs miss expectations? Some promising therapies never gain traction after launch, despite compelling clinical data. Others launch strong, only to plateau prematurely, failing to capture their full potential. Perhaps the problem isn't just science, or the market, but something deeper.

I've been in the transformation and launch trenches of biopharma for years. I’ve witnessed C-suite leaders launch ambitious initiatives, fuelled by genuine vision and significant investment, all aimed at navigating the future of healthcare. We chart these bold strategies – perhaps a new R&D operating model driven by AI, an updated therapeutic areas or platform focus, or a digital health integration strategy. We then redesign new operating models, restructure teams, and rally the troops for change.

In a previous discussion, we explored the 'legacy pull' – the outdated processes and strategies hindering specific late-phase initiatives like fragmented clinical trial execution or manual supply chain management. Today, I want to delve into a significant, often underestimated, component of this resistance: the "cultural undertow." This undertow is a powerful collection of invisible but immensely powerful habits, assumptions, and unspoken rules that prevent biopharma organisations from truly embracing “future-proof strategies” and ultimately sabotage even the most well-intentioned transformations.

The 'cultural undertow': An invisible force holding us back

No matter how hard we push for strategic shifts – implementing agile methodologies, advocating for a patient-centric commercial model, or investing in sustainable manufacturing – a powerful force often keeps pulling us back to the familiar shoreline of "how things have always been done" in biopharma.

This is the cultural undertow. It’s not a line item on a budget or a box on an org chart; it’s the invisible but immensely powerful sum total of ingrained habits, unspoken rules, deep-seated assumptions, and outdated hierarchies. It's the collective muscle memory that reinforces the operational legacy pull we see derailing progress – things like the automatic preference for traditional regulatory dossiers, a reliance on conservative and limited trial designs, and adherence to outdated methodologies for building position statements, etc.

Mapping the subtle currents: Where the undertow pulls

This undertow manifests subtly but effectively, creating fertile ground for the legacy pull to thrive and preventing true strategic pivots. Here are some key currents to watch for:

• Old habits die hard: Ingrained routines (like retrospective analysis or siloed communication), once efficient, now hinder agility needed for future-proof thinking and perpetuate outdated operational models.
• The bottleneck of authority: Decision-making defaults upwards, stifling initiative and slowing critical responses, reinforcing slow processes in clinical development pivots or market access strategy adjustments.
• The "not invented here" syndrome: Resistance to new ideas or stakeholders (like giants entering the health space) fuels over-reliance on traditional KOLs, hindering innovative commercial models.
• Risk aversion as a default: Fear of mistakes outweighs innovation rewards, directly leading to risk aversion in commercial model innovation and unwillingness to experiment with novel Future-Proof approaches.
• Siloed loyalties: Departmental allegiance trumps broader collaborative needs, ensuring siloed, sequential go-to-market planning remains the norm despite inefficiencies.
• Passive Resistance: Quiet foot-dragging, endless "valid concerns," and subtle reversion to old ways derail progress. Think of reviews of out-of-the-box solutions, delayed resource alignment, or lack of enthusiasm for new tools. This makes dismantling legacy pull an uphill battle.

Why good strategies get stuck: The undertow's power

The cultural undertow doesn't just slow biopharma transformation; it actively works to neutralise it by perpetuating the very operational inefficiencies of the legacy pull. It makes future-proof thinking – with its emphasis on adaptability, external scanning, and bold pivots – seem alien and unachievable. It erodes enthusiasm for change, breeds cynicism about leadership initiatives, and ultimately pulls well-intentioned efforts back into the depths of the status quo. It makes true, sustainable change feel almost impossible because we're fighting against the very essence of who we currently are as an organisation – our ingrained habits, assumptions, and hierarchies.

Swimming against the tide: How to reshape your culture

So, if this potent cultural undertow is at play in biopharma, hindering our ability to adapt to exponential change and limiting the real-world value of our innovations – what must we, as leaders, do differently to not just swim against it, but to change its very direction?

1. Make the invisible visible: Map your biopharma undertow

The trap: Ignoring the specific cultural currents of your R&D, manufacturing, commercial, or support function team, assuming they'll change just because new processes are implemented.

The shift: Actively diagnose and discuss specific elements of your Cultural Undertow within your functions. Use targeted surveys, cross-functional workshops, and honest, facilitated conversations to surface hidden dynamics and address specific cultural barriers hindering transformation.

Ask yourself: What specific cultural norms, habits, or beliefs within R&D, commercial, or manufacturing, are pulling us back from our transformation goals and hindering future-proof thinking?

2. Champion psychological safety: Create safe waters for biopharma change

The trap: Expecting teams to embrace new behaviours – experimenting with digital health pilots, proposing novel clinical trial designs, exploring disruptive commercial models – when they fear negative repercussions.

The shift: Transformation requires trying new things and making mistakes. If the cultural undertow punishes vulnerability, no one will swim differently. Leaders must visibly create and protect an environment where learning from experimentation is valued over perfect execution. Celebrate learnings from failed pilots and support teams taking calculated risks.

Ask yourself: Does our current culture make it safe for people to challenge the status quo and experiment with new approaches, and even fail without fear of blame or career repercussions?

3. Cultivate new currents: Empower biopharma change agents deep within

• The trap: Relying solely on top-down mandates from the C-suite to shift culture or drive future-proof thinking in biopharma functions.
• The shift: Identify and empower internal influencers, early adopters, and champions across all levels and functions – a forward-thinking lab scientist, an agile regulatory affairs expert, a digitally savvy market access manager. Support them, give them visibility, and let their influence organically spread, modelling new behaviours and inspiring others to embrace future-proof thinking.
• Ask yourself: Who are our informal cultural leaders and innovators across various organisations, and how can we empower them to drive the behavioural shifts we need?

4. Redefine the shoreline: Align incentives & recognition with new biopharma behaviours

The trap: Talking about new values like collaboration and agility while still rewarding old actions – individual sales volume, meeting traditional trial timelines, or staying within siloed budgets – which reinforce the operational legacy pull.

The shift: Cultural Undertow is influenced by what gets measured, rewarded, and celebrated. Align performance management, compensation, and recognition systems explicitly with collaborative, agile, and innovative behaviours required for transformation. Make the "new way" the path to success and recognition.

Ask yourself: Do our current systems for reward and recognition reinforce our Cultural Undertow by rewarding old behaviours, or do they actively encourage the new culture and future-proof thinking we want to build?

5. Lead by swimming differently: Model the desired culture from the biopharma top

• The trap: The C-suite espouses transformation and future-proof thinking but continues to operate within old biopharma cultural norms – remaining in silos, demanding excessive control, or being risk-averse.
• The shift: Leaders' behaviours create the strongest currents. Consciously and visibly embody the new cultural attributes. If you want collaboration, break down your own C-suite silos. If you want risk-taking, share learnings from failures. Your actions will either reinforce the Cultural Undertow or begin to change its flow across the entire organisation.
• Ask yourself: Are my daily behaviours, decisions, and communication style as a leader actively fighting against the Cultural Undertow and modelling the future state, or am I inadvertently strengthening the very legacy pull we need to overcome?

Breaking free: Forging a future beyond the undertow

Changing a cultural undertow is one of the hardest leadership challenges in any industry, and perhaps even more so in the complex, mostly risk-averse world of biopharma. It requires more than just new strategies or technologies; it demands a profound and sustained focus on reshaping the human dynamics of your organisation.

Overcoming this internal cultural undertow is foundational for any hope of truly adopting future-proof thinking and successfully navigating the external complexities of our non-linear healthcare ecosystem, which requires an even more sophisticated strategic apparatus – a topic for our next discussion. By acknowledging the undertow's power and tackling it head-on, leaders can move from being pulled back by the past to truly forging a new direction, one that aligns our internal culture with the exponential realities of the external world.