I love my work with biotech companies; they are among the most energetic and ambitious organisations in healthcare. Built around breakthrough ideas and bold science, their tenacity to bring something new and important into the world is thrilling to be around, and their contribution to the pipeline of innovation is significant, particularly in areas that larger organisations may not prioritise. Working closely with these organisations also reveals patterns. There are familiar challenges that come up time and again as companies grow and progress their research.
These challenges reflect the realities of building something highly specialised, often with limited resources and huge scientific ambition. They also represent opportunities to strengthen the path forward.
In the earliest phases, every resource is channelled into the science. It’s common for individuals to wear several hats – leading scientific strategy while also trying to manage grant applications, clinical protocols, publication planning or investor demands. This agility fuels momentum, but as the company grows, it can leave blind spots in future key functions like regulatory translational research, medical affairs or programme management underdeveloped. Too often, these areas are only addressed when a critical need arises, and when timelines are tight, decisions are urgent, and the consequences of delay become real.
The same can happen with external input. As consultants, we are often brought in after pressure has already built, when the opportunity for proactive shaping is more limited. In contrast, we’ve seen the impact when teams engage early. Whether it’s aligning on asset strategy, refining the clinical approach, or simply helping internal teams communicate more effectively, outside perspective can bring clarity and help surface decisions that might otherwise stall or be overlooked. Sometimes, the most valuable contribution is offering a different lens.
Many of these organisations are built around a single, bold idea. That deep focus creates energy and cohesion, but it can also narrow the field of vision. We’ve worked with teams where the science was solid, but the context around them had shifted – a competitor moved faster, regulatory guidance evolved, or technologies changed. In these moments, stepping back is essential. Not because the team lacks expertise, but because they’ve been immersed in one approach for so long that other possibilities become harder to see.
This close connection to a founding idea often stems from the leadership itself. Many biotechs are led by their founders, generally scientists or academics whose vision shaped the company. Their clarity and drive are essential in the early days, but the leadership circle they form often mirrors their own expertise. As the organisation matures, this can limit perspective. Functions like commercial operations, development planning or communications may not get the voice they need in strategy conversations, and groupthink can creep in unnoticed. Where we’ve seen this countered effectively, it’s been through conscious steps to diversify input, to bring in people who think differently and have experience beyond the bench.
There’s a similar tipping point when it comes to structure. At the start, things move fast because they can. Decisions happen in the moment. Everyone knows what’s going on. But as teams grow and stakes increase, any lack of clarity can become a drag. We’ve seen critical decisions delayed because no one was quite sure who had the authority to make them, or effort duplicated because no one kept track of what was already agreed. Introducing a light framework: some clear roles and basic governance can free people up to focus rather than slow them down. The right organisational structure can do wonders for momentum.
Perhaps the most demanding shift is the transition from a research-led organisation to a development stage or even a commercial company. At this point, you are reframing the company’s purpose, and this shift can feel uncomfortable. People who were essential in the beginning may feel less clear on their place in the new landscape. The focus widens. Scientific ambition now shares space with operational delivery, stakeholder expectations, and the need for consistency. The teams that manage this best tend to be the ones that start preparing early, that invest in leadership thinking, and that allow the company’s identity to evolve rather than trying to preserve it unchanged.
These observations come from experience working with biotech companies at different stages of their journey. Each one is different, but the themes are familiar. Progress in this sector relies on an organisation’s ability to adapt, to build the right support around the science, and to manage key transitions with intent. Although these are not simple tasks, they are achievable, especially when approached with curiosity and openness.
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