When Medical Affairs, Commercial, and Market Access teams are misaligned, the diagnosis almost always points to people. The actual cause, however, is usually the absence of an appropriate structure.
Biopharma organizations are full of talented, well-intentioned people working in systems that were never expertly designed to encourage, facilitate, and produce cross-functional alignment. The conditions that reliably produce dysfunction are structural, not personal, and include:
- Goals being defined at the function level rather than at the account level
- Lack of a shared planning process across Medical Affairs, Commercial, and Market Access
- Unclear role boundaries and confusion over who owns the customer relationship
- No single accountable individual for ensuring integrated execution
What the problem looks like
Field teams calling on the same accounts from different functional perspectives without shared objectives, shared information, or a shared account strategy produce exactly what you would expect: duplicated effort, inconsistent customer experiences, diluted account outcomes, and occasional outright conflict over who owns the relationship. The customer sees three different organizations wearing the same logo and often experiences disjointed engagement interactions. Certainly, not a recipe to achieve ‘trusted partner’ status.
The instinct is to diagnose this as a culture problem or an interpersonal one. However, when you look at the structure underneath it, the dysfunction is almost always predictable from the design (or lack of). Simply put, employees typically default to what a system incentivizes. If the system rewards functional performance and provides no enforceable mechanism for shared accountability, most people will optimize for their function regardless of how much they hear talk of collaboration from leadership and in the network of conversation.
Structure and capability have to change together
Organizations that catch this early don’t wait for the breakdown. They design and codify the coordination mechanisms through Strategic Account Management frameworks and Ways of Working principals before conflict surfaces. For high-performing cross-functional or matrix teams, this is manifested through shared account objectives, clear roles in the account engagement strategy, structured processes for sharing information compliantly, and leaders who can coach and reward collaborative behavior.
It is imperative that structural design and capability development happen simultaneously. Redefining roles without training people for those roles produces confusion, not alignment. At the same time, training people to collaborate without redesigning the structures that govern their incentives produces only temporary behavior change. There will be no pull-through.
For CCOs and CMOs, this points to a specific intervention: design and implement the coordination mechanisms before the dysfunction becomes visible. Examine your top accounts and ask whether Medical Affairs, Commercial, and Market Access are operating from a shared strategy, with clear roles or swim lanes, and with the benefit of processes that incent best-in-class matrix team collaboration.
WLH’s 3C’s of Collaboration, Coordination, and Communication workshop addresses cross-functional breakdown at its source — not through team building, but through the structural clarity and shared planning processes that make alignment sustainable. Reach us at wlhconsulting.com.
