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Latest Executive Roundtables

Asembia 2025 

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Sales and Marketing

1rem

 podcast episode, UpScriptHealth founder and CEO Peter Ax discusses:

The impact of tariffs on the pharmaceutical industry, highlighting branded and generics medications

How tariffs could lead to strategic supply chain changes, including potential US manufacturing shifts

How digital health platforms can help potentially offset tariff impacts

The importance of telehealth in ensuring medication availability

Strategic partnerships between digital health platforms and pharma companies to improve patient care and access

Podcasts

Peter Ax, founder & CEO of UpScriptHealth, discusses the impact of tariffs on the pharmaceutical industry and how digital health platforms could potentially help offset them.

Tariffs and Drug Prices: Understanding the Impact on Pharmaceuticals

 Podcast, CEO and Founder of Sooth, Ian Baer, is back to discuss:

Why people trust friends and influencers over companies

Ian Baer, Founder and CEO of Sooth, discusses how the growing distrust in social media will impact industry marketing strategies and the relationships between pharmaceutical companies and the patients they aim to serve. He also explains dark social, how to combat misinformation, closing the trust gap, and more.

Navigating Distrust: Pharma in the Age of Social Media

In this episode of the Pharmaceutical Executive podcast, Bill Grambley, CEO of AllazoHealth, explores:

How AI can potentially revolutionize patient engagement and adherence

Utilizing patient-level data and predictive modeling

How AI can identify individual needs and preferences

The importance of ethical considerations and data privacy when leveraging AI in healthcare

Bill Grambley, CEO of AllazoHealth, delves into the potential of AI to revolutionize patient engagement and adherence.

Revolutionizing Patient Adherence: Leveraging AI for Personalized Engagement

Companies that have broken ground or begun construction on US manufacturing sites will be exempt from these tariffs.

President Trump Announces 100% Tariffs on Branded or Patented Pharmaceuticals

FDA approves Eli Lilly’s Inluriyo (imlunestrant) for adults with ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer that has progressed after endocrine therapy.

FDA Approves Lilly’s Inluriyo Oral Therapy for ESR1-Mutated Metastatic Breast Cancer

In order to enforce MFN, regulatory agencies must navigate the complex process of determining a drug’s true value.

The Complications of Determining a Drug’s Value

The President announced FDA will no longer recommend the use of the common painkiller during pregnancy, despite a casual link between the medication and autism not being established.

President Trump Claims Tylenol Increases Risk of Autism, Medical Community Pushes Back

The FDA has expanded the indication of Incyte’s Opzelura (ruxolitinib) cream to include children aged two to 11 years with mild to moderate atopic dermatitis, making it the first steroid-free topical treatment option for this age group.

FDA Expands Opzelura Approval to Children as Young as Two With Atopic Dermatitis

What Could the Global Impact of the MFN Order Be?

Peter Rubin, executive director of No Patient Left Behind, spoke with 

 about President Trump’s Most-Favored Nation (MFN) order and the widespread impact it could have on the industry. While the order seeks to reduce drug costs in the United States by enforcing a rule based on foreign prices, it’s likely that this rule could force pharma companies, large and small, to adjust the way they approach innovation. According to Rubin, the ruling is likely to impact more than just pricing. He also believes that it will be hard to even find a fair price for the drugs using the MFN order as determining a drug’s true value is more difficult that it first appears.

Pharmaceutical Executive: How can the pharma industry prepare for enforcement of the MFN order?

 When you think about the biopharma industry, it’s important to think about it as an entire ecosystem. You have the specialist investors that fund seed stage and small bio-pharmas that comprise two-thirds of the drugs before FDA. There’s the large pharmas that are very successful at bringing new drugs to market successfully.

The industry is not a monolith, it’s an ecosystem where everybody plays an important role. Specialist investors and small bio-pharmas have done a good job of raising their hands and warning of the impact of imposing foreign price controls based on ex-US health technology entities that’s going to impact US competitiveness and impact our ability to bring new drugs to market five to 10 years from now.

As we talk to people over the course of the year, I’ve told people is that this is really a 16-quarter presidency. Each quarter will have its own volatility and you should expect that. Just because deal with MFN in the first quarter doesn’t mean that it’s not going to pop up in a whole new way in the second quarter. Even if you resolve it in the third, it’s going pop up between now and the rest of the 16 quarters. It’s hard to get a sense of what’s actually going to happen.

PE: How is oncology R&D already being impacted by existing regulatory concerns?

 It’s a one-two-punch with MFN and the Inflation Reduction Act (IRA) with the small molecule penalty. That’s already caused a lot of retreat in the small molecule oncology. Prior to the IRA’s passage, half of the molecules that were approved in oncology were small molecules. As of the IRA and the pill penalty, a lot of investors, large pharmas, and everybody inbetween switching to large molecule solutions. Unfortunately, small and large molecules are just as difficult to innovate, but small molecules are easier and less expensive to manufacture. They don’t require physician administration (in most cases), they’re interchangeable at the pharmacy, and they’re easily genericized.

Many of the large molecules aren’t covered by the IRA’s $2,000 out-of-pocket cap. It’s really only Part D drugs, which are primarily small molecule drugs in most instances. From a societal and environmental perspective, oncology and small molecule drugs have been severely impacted by the IRA’s pill penalty. If you throw imposing foreign price controls (via the MFN process) on top of that, you’re going to see another negative impact on oncology R&D for both small and large molecules.

Videos

Aside from pricing changes, the impacts that MFN could have on the US market could have global reverberations.

How is Oncology R&D Already Being Impacted by Existing Regulatory Concerns?

Alongside regulations from the IRA, oncology R&D is set to face unique challenges when MFN is enforced.

How Can the Pharma Industry Prepare for Enforcement of the MFN Order?

Peter Rubin discusses how the industry is an ecosystem and each of the parts will feel the impact differently.

Advancing Innovative Medicines Through Global Regulatory and Academic Partnerships

, Rob Abbott, CEO of ISPOR, discussed how health economics and outcomes research (HEOR) is transforming the way health systems and governments around the world address rising drug prices. Abbott highlighted the growing importance of real-world evidence, patient-centered approaches, and artificial intelligence in shaping value-based healthcare decisions. He also emphasized the critical role of cross-sector collaboration among regulators, payers, academia, and industry in advancing evidence-based policies and improving patient access to innovative therapies.

Pharmaceutical Executive: What collaborations or partnerships are most critical right now—across government, academia, or industry—to advance evidence-based health policy and access globally?

Let me start with ISPOR, because it’s central to how I think about this question. Healthcare is incredibly complex—it’s an ecosystem with many stakeholders, and we have to understand how those players interact.

ISPOR is the global society for health economics and outcomes research, with more than 20,000 members in over 100 countries. Our members represent academia, government, patient groups, NGOs such as the Institute for Clinical and Economic Review in the United States, as well as investors and payers. What’s most important is the dynamic interaction among these groups.

We’ve found it crucial to bring regulators, payers, and health technology assessment (HTA) agencies together. In fact, we’re launching a pilot project in Europe this fall to do exactly that. We chose Europe intentionally, given that the European Union’s new HTA regulation—officially in effect this year—has the potential to be a real game changer for patient access to innovative medicines.

The key is not to operate in silos. Collaboration across the ecosystem is essential. At ISPOR, we are working closely with the FDA, the European Medicines Agency, and leading academic institutions worldwide. These partnerships ensure we have access to cutting-edge thought leadership on where healthcare is heading, and how health economics and outcomes research can guide that path.

At the end of the day, collaboration and cooperation are vital if we want to navigate the maze of complexity, costs, and challenges in healthcare.

 Health economics and outcomes research (HEOR) is increasingly shaping how health systems and governments address rising drug prices. HEOR integrates clinical trial results, real-world data, patient experiences, and economic analysis to evaluate medical interventions. By assessing a treatment’s cost-effectiveness and real-world value, HEOR informs value-based pricing and decision-making, going beyond traditional clinical trial data to determine how drugs perform in everyday patient care.

A key trend highlighted in ISPOR’s 2024–2025 Top 10 Trends report is the growing importance of real-world evidence. Unlike clinical trials, real-world evidence captures patient outcomes, side effects, and overall cost-effectiveness after drugs enter the market, making it critical for both policy and clinical decisions. Another transformative trend is the accelerated adoption of artificial intelligence (AI) and digital health tools. AI is being used to synthesize literature, analyze complex data sets, and tailor treatment protocols efficiently. However, experts caution that while AI offers significant potential, human oversight remains essential to ensure patient-centered care.

From a global perspective, US healthcare excels in certain areas, such as cancer screening, vaccination rates, and advanced medical technology, but faces challenges including high per-capita costs, lack of universal coverage, and suboptimal outcomes in chronic disease and life expectancy. These issues highlight the universal challenge of managing rising costs amid increasing complexity.

Collaboration across government, academia, and industry is critical to advance evidence-based health policy and patient access. Organizations like ISPOR, with its global membership spanning regulators, payers, patient organizations, and academics, are fostering these partnerships. Initiatives, such as pilot projects aligning regulators and health technology assessment agencies in Europe, illustrate how coordinated efforts can improve patient access to innovative therapies while navigating the complexities of cost, efficacy, and healthcare delivery.

Overall, HEOR, real-world evidence, AI, and multi-stakeholder collaboration are central to shaping efficient, patient-centered, and cost-conscious healthcare systems worldwide.

Rob Abbott, CEO, ISPOR, highlights how uniting regulators, payers, and academic leaders worldwide can accelerate access to innovative treatments and strengthen evidence-based healthcare.

Video Series

Why Court Battles Could Alter the Path of Emergency Use Authorizations for Vaccines

, Ron Lanton, partner, Lanton Law, discussed the unprecedented legal and policy challenges emerging from recent changes to federal vaccine recommendations under Robert F. Kennedy Jr’s leadership at HHS. Lanton explained that while federal law has long guaranteed access to vaccines through programs such as the Affordable Care Act and the Vaccines for Children initiative, recent shifts raise complex questions about coverage, regulatory authority, and the future of vaccine policy in the United States.

Pharmaceutical Executive: How might lawsuits like this impact the regulatory environment for vaccine approvals and emergency use authorizations in the future?

Vaccine approvals and emergency use authorizations are handled by the FDA, not the CDC, so any lawsuits would focus on how broader vaccine policy affects public health. If the FDA were to adopt similar policies in the future, additional legal challenges would almost certainly follow. We haven’t seen that yet, but that doesn’t mean it couldn’t happen. The longer this plays out, the more coordinated the messaging from the executive branch appears to be on vaccine issues. If the FDA ultimately moves in that same direction, it would be a real game changer.

From a legal standpoint, recent shifts in federal vaccine policy under RFK Jr. raise unprecedented challenges. Historically, vaccine access in the U.S. has been anchored by recommendations from the Advisory Committee on Immunization Practices (ACIP). Since 1994, ACIP-recommended vaccines have been required to be fully covered by Medicare, Medicaid, and private insurance under the Affordable Care Act (ACA). Similarly, the Vaccines for Children program has ensured free access to ACIP- and CDC-approved vaccines for low-income children. These frameworks were designed to protect universal access regardless of political changes.

However, if ACIP’s role has already been weakened or “gutted” under RFK Jr.’s tenure, the system faces a novel legal and regulatory crisis. Because the new CDC director only recently assumed office, responsibility for these changes appears to rest solely with RFK Jr. This creates an unprecedented situation in which longstanding vaccine recommendations were altered or limited at the federal level, potentially undermining established protections under the ACA and other federal programs. Reversing such changes will almost certainly require extensive litigation across multiple fronts, involving stakeholders throughout the healthcare and insurance supply chains.

Another open question is how these lawsuits might affect the broader regulatory environment for vaccines. While the CDC shapes recommendations, vaccine approvals and emergency use authorizations fall under the FDA. At present, the FDA has not signaled a policy shift, but if it were to align with restrictive approaches, the impact would be transformative. Such coordination from the executive branch could reshape not only access to existing vaccines but also the approval pathway for future ones. Stakeholders should therefore prepare for a protracted legal battle and remain alert to possible ripple effects on both public health policy and the vaccine market.

Ron Lanton, partner, Lanton Law, warns that ongoing lawsuits targeting vaccine policy could create ripple effects across FDA decision-making and reshape how future emergency use authorizations are granted.

Embrelis Approval Highlights FDA Confidence in ADC Oncology Treatments

, Neha Anand, Analyst, Biopharma Intelligence Services, Citeline, discussed how AbbVie’s newly approved antibody-drug conjugate (ADC), Emrelis, differentiates itself in a rapidly evolving oncology landscape. With rising competition in the ADC field—particularly in solid tumors—Anand highlighted Emrelis’ unique target, mechanism of action, and strategic positioning as key factors that set it apart. She also provided insight into what the approval signals about the FDA’s current regulatory posture, the potential impact on investor interest, and what a successful Phase III trial could mean for AbbVie’s long-term growth in precision oncology.

Pharmaceutical Executive: What does this approval signal about the FDA’s current posture toward emerging ADC therapies in oncology, especially for solid tumors?

The approval of Emrelis definitely signals that the FDA is very supportive of ADC therapies, particularly in oncology and for solid tumors with defined biomarkers. It also demonstrates the FDA’s willingness to grant accelerated approvals for ADCs targeting novel proteins, addressing clear unmet needs in specific patient subgroups. This aligns with the FDA’s broader trend of encouraging precision medicine approaches that match therapies to biomarker-driven populations. Additionally, this decision indicates that the FDA is now more confident about the safety and efficacy profiles of ADC platforms, paving the way for continued innovation in this field and potentially faster regulatory pathways for ADCs in the future.

 Emrelis stands out in the crowded antibody-drug conjugate (ADC) space by targeting a highly specific biomarker—C-MET overexpression in non-small cell lung cancer (NSCLC)—rather than pursuing broader tumor indications. Unlike ADCs such as those targeting HER2 or TROP2, which are used in breast or gastric cancers, Emrelis is designed for a niche patient subgroup with high C-MET protein levels but without MET gene mutations, a population with limited treatment options. This precision-targeting approach, combined with the use of the MMAE payload via a cleavable linker (which disrupts microtubules rather than causing DNA damage like some other ADCs), sets Emrelis apart both clinically and mechanistically.

The FDA’s accelerated approval of Emrelis signals a growing willingness to support biomarker-driven ADCs in solid tumors, particularly when addressing unmet needs. It reflects confidence in ADC safety and efficacy profiles and aligns with broader trends favoring precision medicine.

Emrelis is especially well-positioned to serve NSCLC patients representing roughly 25% of EGFR wild-type cases who overexpress C-MET but lack actionable mutations. While NSCLC remains the primary focus, success here could pave the way for expansion into other C-MET–driven solid tumors.

From an industry perspective, Emrelis’ approval is likely to fuel both investor enthusiasm and R&D momentum. For large pharmaceutical companies, it offers a blueprint to diversify oncology pipelines beyond traditional small molecules or immunotherapies. For biotechs, it validates the potential of novel ADC designs targeting underexplored antigens.

If Phase III trials meet their endpoints, Emrelis could become a new standard of care in C-MET high NSCLC and mark a strategic shift for AbbVie, establishing its credibility in solid tumor oncology and reinforcing its in-house ADC capabilities amidst rising competition from companies like Daiichi Sankyo and ImmunoGen.

Neha Anand, Analyst, Biopharma Intelligence Services, Citeline, explains how the approval of Emrelis marks a pivotal moment for ADC therapies in oncology, reflecting the FDA’s growing confidence in their safety and efficacy and accelerating the shift toward precision medicine in cancer treatment.

Emrelis Approval Highlights FDA Confidence in ADC Oncology Treatments

Marcel Botha, CEO of 10XBeta, explore the role collaboration between private industry, government agencies, and research institutions plays in strengthening pandemic preparedness and ensuring medical device resiliency.

Strengthening Pandemic Preparedness Through Collaboration

 video interview, Marcel Botha, CEO of 10XBeta, discusses shortcomings in the US' emergency plans for rapid innovation and manufacturing during public health crises, highlighting the need for innovation pipelines, supply chain resilience, and regulatory clarity. He also emphasizes the importance of localized manufacturing, public-private partnerships, and advanced manufacturing techniques like AI and additive manufacturing. Botha notes the success of the Spiro Wave project in reducing ventilator size and the need for better coordination and funding structures. He also advocates for a more agile and collaborative approach to ensure rapid response in future emergencies.

Pharmaceutical Executive: What role does collaboration between private industry, government agencies, and research institutions play in strengthening pandemic preparedness and ensuring medical device resiliency?

Collaboration is critical. Consumer level or civilian-led companies do not have the same access and reach as a government agency or research institution. If I take MIT, the city and state of New York, and what we did during the during the pandemic—we all responded as a collective to the pandemic response, specifically the ventilator rapid response here in New York. Making sure that we had a stockpile of our own ventilators should we run out. That project could not have been successful without that consortium of research institution, government agency, and private sector.

That said it was completely under the radar, because at that moment in time it was frowned upon for anybody from MIT to even be on campus. While Moderna and the biotech cluster around MIT was highly active, MIT was hesitant to offer approval at that moment in time to support things that weren't guaranteed.

They definitely doubled down on everything in the biotech space, but it is essential that all parts of society to come together to make sure that we can offer a seamless response and bring different perspectives. Politicians, government agencies, and bursaries open routes for engagement with the publicly funded health sectors, the military, and others. Research institutions crossover with both military and civilian tech and see a lot of early-stage innovation that we cannot see as the civilian population on a daily basis. Then we bring together a very agile commercial sector approach to commercializing products, so that we can effectively guarantee the cost basis. You can't make everything on a Cost Plus [Drugs] basis and not be held accountable for how you bring innovation to market. 

How we as the private sector show up when it comes to government or public private interactions or contracts to do our best and to be held accountable is very much in the crosshairs in DC right now.

Marcel Botha, CEO of 10XBeta, discusses lessons from The Spiro Wave project that can be applied in creating more agile and responsive systems for future public health emergencies.

Creating More Agile Systems for Future Public Health Emergencies

Pharmaceutical Executive: The Spiro Wave project demonstrated the potential for rapid development and deployment of critical medical devices. What key lessons from that experience can be applied to creating more agile and responsive systems for future public health emergencies?

It's very important to do a postmortem of how we responded,  what worked, and what failed during the first pandemic and then build pre-approved emergency innovation frameworks of how one might respond to the next disaster. Regardless of whether it is a natural, man-made, or viral disaster—they all have different outcomes and costs of human life. The challenge remains clear, we as a society need to have clear, actionable steps that we can follow when we want to have impact in record time, without the level of waste we saw during the pandemic because of all the wheel spinning and inertia to get going.

In line with bringing manufacturing stateside, building ecosystems, and relying on advanced manufacturing, we need to think about manufacturing similarly to how we think about products. Can we build modern, modular, distributed networks of manufacturing? Can we do it in a way where we build a system of resilience and reliance, where the economic framework for collaboration between everyday competitors is clear and actionable for when we go into emergency mode?

It's fine to be competing on the battlefield, very much like a game of rugby, but afterwards, let's have a drink together. If we have to get on the same page for the collective good, we do that, and then we can trash talk each other next week's game. To make society work, we need to understand when we're competing, when we're collaborating, and when we are celebrating. There needs to be healthy constructs to do all of those things in our society. It can't just be compete, compete, compete; and fail the rest of the time.

We see more of the public private partnerships now, but it’s still not fast enough. There were some rapid response innovation consortia set up between us and the city during the pandemic, but we want to see more of that. We want to go back to the product typologies, more open sourcing, and rapid prototyping ecosystems in place that we can leverage for fast manufacturing. Additive manufacturing, which we have been following since grad school days, has evolved to the point where we can now make metal, plastic, electronics, wire, harness, installations, everything using additive techniques.

There's no reason why we can't leverage these different technologies during a mission-critical or disaster relief response. However, there's always the cost benefit analysis that you have to take of the technology, time it takes to execute, and the response that you have to adhere by.

Matthew Yelovich, Partner at Cleary Gottlieb, discusses the appeal of Elizabeth Holmes and Ramesh "Sunny" Balwani, who were convicted of fraud and the Ninth Circuit's recent affirmation of their convictions.

Analyzing the Theranos Appeals

 video interview, Matthew Yelovich, partner at Cleary Gottlieb, discusses the appeals of both Theranos founder Elizabeth Holmes and the company’s COO, Ramesh “Sunny” Balwani. The Ninth Circuit recently affirmed the duo’s convictions after considering questions about expert and lay testimony. Yelovich emphasizes the importance of careful vetting of statements to investors and the public, especially in tech-driven companies. The conversation also explores the complexities of sentencing in fraud cases, the importance of corporate governance and accountability, and his transition in late-2024 from federal prosecutor to a role at Cleary Gottlieb.

Pharmaceutical Executive: Can you discuss the history of this case and the specific issues involved in the appeal that you handled?


 Theranos founder Elizabeth Holmes and her COO Ramesh “Sunny” Balwani were indicted by the United States’ Attorney’s office in San Francisco for fraud related to statements they made to investors and patients about their technology’s capabilities. They were convicted in separate trials and both appealed, where they raised a number of evidentiary challenges to their convictions, as well as some sentencing claims.

In a published opinion, the Ninth Circuit rejected those claims and affirmed the convictions and sentences.

PE: Having handled the government's response to the appeal, what were some of the most challenging legal arguments you encountered?


 The Ninth Circuit’s opinion reflects that the court found the difference between expert and lay testimony to be a difficult line. Many courts have struggled to navigate that line across the country. This opinion shows a careful parsing of what the court viewed as expert and lay testimony, and when lay testimony may veer into expert testimony.

In this case, those differences didn’t alter the outcome of the trial. As the court said, the evidence was overwhelming, so any errors there were harmless to the conviction. In future cases, courts could take a more specific line on when a percipient or lay witness can talk about highly technical subjects. That’s what the majority of the court’s opinion focuses on.

PE: Holmes and Balwani have each served roughly two years of their sentences. In your opinion, what are the key legal and ethical considerations that arise when evaluating the proportionality of sentences in complex fraud cases like this?


 Speaking broadly (and not these particular sentences), there are two key legal considerations in sentencings like this one. The first is that the court must calculate the advisory United States Sentencing Guidelines, which vary depending on the offense. In complex fraud cases, they’re driven largely by the amount that the fraud cost the victims, which dictates to a large extent what the monthly range will be for the prison sentence that the court must consider.

There’s also a federal law called Section 3553 which says the court must consider a range of different characteristics, including the nature & seriousness of the offense, the history & characteristics of the defendant, and principles of deterrence.

All of that is put together into a sentencing hearing where there is advocacy for both sides, and the court comes up with a proportional sentence that is not greater than necessary to achieve the purposes that are in that law.

Matthew Yelovich, partner at Cleary Gottlieb, discusses the appeals of Elizabeth Holmes and Ramesh "Sunny" Balwani and the Ninth Circuit's recent affirmation of their convictions.

Marcel Botha, CEO of 10XBeta, discusses shortcomings in the US's emergency plans for rapid innovation and manufacturing during public health crises, highlighting the need for innovation pipelines, supply chain resilience, and regulatory clarity.

Critical Shortcomings in the US's Public Health Crisis Plans

Pharmaceutical Executive: It's been five years since the COVID-19 pandemic. Given your experience with the Spiro Wave project, what do you believe are the most critical shortcomings in the US' emergency plans for rapid deployment of innovation and manufacturing during a public health crisis?

 It was an honor to be part of the ventilator crisis response for New York and to work with MIT on open-source technology that was shared globally. However, it was also alarming to realize how unprepared we were—not just at that moment, but in general—for responding to critical challenges quickly. Despite living in a world where disaster scenarios dominate our media and climate-driven and man-made emergencies frequently remind us of our vulnerabilities, we remain in a state of unpreparedness.

Our responses during the pandemic were ad hoc and disorganized, unavoidable due to the lack of established innovation pipelines and a clear framework for emergency responses. We figured things out quickly, with the Emergency Use Authorization process being a prime example. The FDA did a commendable job keeping pace with the speed at which innovators and community members mobilized. Still, the agency was never designed to engage with so many stakeholders simultaneously. This lack of a structured process slowed critical decision-making and introduced uncertainty around whether efforts to help would result in real impact.

Supply chain vulnerabilities were another major issue. During the pandemic, we solved this by vertically integrating everything into one facility. But this level of agility was only possible because we cashed in every favor and pulled together resources creatively. Future responses cannot rely on such improvisation. We need a more resilient and decentralized supply chain that can withstand geopolitical threats and component shortages without collapsing.

Fragmentation between the public and private sectors also hindered an effective, unified response. The pandemic response became politicized, and competition for limited resources created a hierarchy where some groups believed they should be prioritized over others. Private sector involvement filled the gaps, but that shouldn’t be the default response. We need better public-private collaboration to ensure a more cohesive approach in future crises.

High-speed innovation is expensive, and the lack of clear funding and accountability structures made rapid action even riskier. During the pandemic, it became evident that investing in solutions without a clear customer or funding model could be a costly gamble. Future disaster responses need transparent communication around funding, contracting, and vetting to prevent fraud and ensure that resources are used efficiently.

Finally, while vertical integration allowed us to meet the ventilator demand during COVID-19, future responses should not rely solely on centralized systems. We need flexible, scalable manufacturing and supply chain systems that can adapt quickly to evolving needs. Without these improvements, we risk repeating the same mistakes when the next crisis arises. The pandemic made it clear that we can no longer assume the government will step in to save us. Those capable of acting must do so, but we need a more structured framework to ensure those efforts are coordinated, effective, and sustainable.

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