For Evan Lippman, previously the commercial leader for Nexium and now leader of the Crestor brand at AstraZeneca, the shifting tides of pharma don't change the goals of his team. "Leadership is about solving complex problems and delivering on business objectives," he says. "I can't think of any other industry that enables you to do that in a way that benefits people like pharma does. I don't know why you wouldn't want to be a part of that."

The benefits of being part of the industry weren't innately apparent to Lippman, however. He started his career as an investment banker, serving biotechnology and biopharmaceutical companies. Challenges such as those facing pharma today haven't dissuaded Lippman from jumping in—in fact, it's just these sort of high-pressure situations that drew him to the industry. "Pharma is very fast-changing, it's dynamic, and it presents a lot of complex problems that don't always have one clear answer," he explains. "So you've got to be comfortable taking risks ... Pharma is about taking inordinate risk in order to benefit a large group of people. And the impact you can have is tremendous."

Going forward, says Lippman, it's less important for pharma to change, and more important to be receptive to—and to embrace—change.

"I lead by trying to create a sense of ownership, an entrepreneurial spirit that helps people own their segment, and that can lead to accountability in decision making," says Lippman. "And when you have that, you can continue to deploy very efficiently—I won't say regardless of budget—but even within certain constraints. Because you can still be innovative."

Rob Etherington has been with Actelion for 11 years, and has seen the company grow from five employees to more than 300 in the US alone, and around 2,500 worldwide, in that time. In the past decade, revenues at Actelion have grown from zero to nearly $1 billion in annual sales. And Etherington has been there through it all.

But as a company grows, so does the responsibility of its leaders. When Etherington joined Actelion in 2000, he was its fifth employee. "The leadership has had to evolve immensely," he says. "This has been a test in resiliency. We didn't even know at the beginning where our next dollar was coming from."

As Etherington marvels at how far his career and his company have come, he acknowledges the value of the path that led him here. Though he had an MBA, his first taste of industry was as a sales rep at Parke-Davis. "Many of my fellow alumni were saying 'You went to business school to be a rep?'" he recalls.

But Etherington maintains that the insight he gained as a rep is the foundation for his success. "Regardless of how you come into this business, if you don't have a field-based opportunity, you'll have great difficulty really understanding how to drive success in pharma."

Having been part of Actelion from the ground up, Etherington knows a thing or two about success—and difficulty. "In the past six months alone, FDA has changed all of our labels, we've been embroiled in a court case with another pharma company, and we've been dealing with an activist shareholder who wants to shake up Actelion in unfortunate ways."

Despite such challenges, Etherington believes that good leadership means a contagiously optimistic viewpoint and innovative problem-solving skills. "The people you lead need to understand the vision of what's possible. They need to believe that by working together as a team, we'll be able to conquer whatever challenges are in front of us. And they need to know that leadership has their back, will support them, and will be there alongside them, helping them solve the problem."