European pharma’s next chapter will be defined by execution

European pharma leaders are operating in a more demanding environment. Innovation is migrating toward the United States and China, AI is moving faster than most organizations can absorb, and a tightening web of pricing and policy, sharpened by geopolitical strain, is weighing on the region’s competitiveness.

At the Reuters Pharma Europe 2026 conference, it was clear that much of the discussion had moved beyond describing these pressures. The focus was increasingly on what it will take to respond: how companies can build the capabilities, capacity, and leadership needed to act at pace.

Three themes surfaced most consistently: AI and data transformation, policy and pricing pressure, and co-creation with patients. Set against intensifying global competition, they illustrate where leaders are concentrating as they work to translate strategic intent into execution.

From AI pilots to execution

Unsurprisingly, AI was a frequent topic of conversation at the conference, but the most compelling examples came from organizations that had moved past experimentation. Instead, these organizations are building governed data foundations, enterprise-grade intelligence platforms, and AI operating models that change how commercial, medical, and market access teams work.

Rather than treating AI as a string of isolated experiments, companies leading in this space are standing up intelligence platforms, centers of excellence, and governance structures that sit close to the business. That distinction matters. Competitive advantage will increasingly depend on the ability to operationalize AI rather than continuing to experiment with it.

The foundation remains the hardest part. Leaders we spoke with repeatedly cited fragmented systems, weak data ownership, and poor interoperability across markets. Those problems point to the need for unified, governed platforms that treat data as a product. Use cases include everything from next-best-action tools to AI-enabled forecasting and unified customer data platforms, highlighting the shift from simply exploring what AI can do to now building the infrastructure, governance, and capabilities required to use it at scale. For many organizations, the real shortage is capacity and specialized skill sets—too few people combine data, AI, and commercial experience in ways that allow these tools to be embedded into everyday workflows.

Policy and pricing are reshaping access strategy

Next, policy and pricing pressures are redrawing the European landscape. Most-favored-nation (MFN) pricing proposals, the US Inflation Reduction Act (IRA), and the EU Joint Clinical Assessment (JCA)—the bloc's own move toward centralized clinical evaluation—are changing evidence requirements, commercial models, and launch sequencing, and in some cases delaying access in Europe.

Two of those forces originate in the United States, but their effects spread. Because international reference pricing links markets, and companies manage price as a global system, pressure on US prices is cascading into European launch sequencing and access, influencing when and at what price medicines reach European patients.

Recent client requests show that access strategy is moving upstream. Market access, pricing, and evidence planning are becoming tightly integrated much earlier in development as these forces reshape launch sequencing, evidence requirements, and pricing strategy. Teams that once weighed in late in launch planning now need to shape strategy in Phase 2 or early Phase 3. That shift will stretch current access functions, drawing them into the process sooner and asking them to stay central over a longer horizon—work existing teams were rarely sized to absorb.

As companies face growing pressure to plan earlier and more systematically in a tougher access environment, they will need to integrate these capabilities earlier while making sure their teams have the skills and capacity to keep pace.

Patient co-creation moves to the center

Finally, co-creation with patients and healthcare professionals is shifting from a supporting activity to a core capability—one tied directly to regulatory success, differentiation, and uptake. Across advisory boards, as well as in areas such as patient-reported outcomes, real-world evidence (RWE), and digital health and support programs, there is a growing expectation that patient and clinician input will shape endpoints, evidence packages, access strategies, and downstream engagement earlier and more deliberately.

Today, patient and clinician co-creation is moving from a stakeholder engagement exercise toward a genuine source of competitive advantage. As regulators, payers, and companies place greater weight on patient input, real-world evidence, and structured engagement, organizations with stronger capabilities in patient insights, RWE, and engagement strategy will be better positioned to support both access and uptake. But embedding that input this early, and this deliberately, demands specialist depth in patient engagement strategy, RWE, and insights—a mix of capabilities that few teams have in abundance and most were never built to carry alongside their existing remit.

Closing the gap between strategy and execution

While these learnings were central to Reuters Pharma EU 2026, they reflect a broader structural shift across the industry. As innovation, policy, technology, and patient expectations advance in parallel, organizations are operating in a sustained state of transformation where internal capacity alone is rarely enough to keep pace.

Across contexts—from post-acquisition integrations and portfolio shifts toward cell and gene therapies to omnichannel overhauls and launch sequencing in policy-sensitive markets—the recurring challenge is how to translate these dynamics into effective execution. Doing so requires organizations to quickly mobilize the right combination of leadership, specialist expertise, and execution support.

That is where interim talent is playing a practical role. In AI and data, interim leaders can help consolidate fragmented pilots into governed platforms, define operating models, and build adoption pathways that commercial, medical, and market access teams will actually use. In access, pricing, and evidence, they can help adapt launch strategies to a tougher policy and reimbursement environment while strengthening capabilities that endure beyond the immediate need. And in patient engagement, they can reinforce the advocacy, insight, and engagement capabilities needed to support more effective co-creation and downstream uptake.

Taken together, scaled AI, policy and pricing pressure, and the rise of genuine patient partnership—all set against intensifying global competition—make execution and organizational agility a competitive requirement. The differentiator for European leaders will be how quickly they can assemble the capabilities and talent required to deliver.

About the author

Anya Maksymenko (amaksymenko@heidrick.com) is a partner in the Healthcare & Life Sciences Practice focused on interim solutions; she is based in the London office.