A CEO's primary role differs fundamentally based on company type. In an asset-centric biotech, the CEO must act as a hands-on program manager, micromanaging execution. In a platform company, the CEO must be deeply embedded in the science to predict and leverage the technology's long-term trajectory.

Successful biotech leadership requires a clear decision-making hierarchy. Dr. Bahija Jallal advocates for a framework where patient welfare is paramount, followed by scientific rigor. Financial success is treated as a byproduct of excelling in the first two areas, not the primary goal.

At the VP or C-level, a leader's primary role shifts from managing their function to driving overall business success. Their focus becomes more external—customers, market, revenue—and their success is measured by their end-to-end impact on the company, not just their team's performance.

Recognizing that business leaders—not scientists—often set research priorities, Jonathan Steckbeck intentionally earned an MBA before his PhD. This nontraditional path gave him the commercial acumen to found a company where he could direct both the scientific and business strategy from day one.

The transition from a resource-rich environment like Novartis to an early-stage biotech reveals a stark contrast. The unlimited access to a global organization is replaced by a total reliance on a small, nimble team where everyone must be multi-skilled and hands-on, a change even experienced executives find jarring.

Luba Greenwood argues that unlike in tech, many biotech CEOs lack P&L experience. In today's cash-constrained market, CEOs need to be able to build financial models and understand finance deeply to be effective, a skill she personally developed after transitioning from law and science.

Investor preference for CEOs has shifted dramatically. While 2019-2021 favored scientific founder-CEOs, today’s tough market demands leaders with prior CEO experience. The ideal candidate has a "matrix organization" background, understanding all business functions, not just the science.

While success is celebrated publicly, some of the best leadership happens privately when a CEO makes the tough, candid call to shut down a program or company due to unfavorable data. This "truth-seeking" decision, often against their personal interest, is a hallmark of excellence.

The CEO of Peptilogics boils down leadership in the unpredictable, long-haul life sciences industry to three traits. Leaders must adapt to rapid changes, maintain a steady hand for the decade-plus development cycles, and provide a clear, guiding vision throughout.