Large pharmaceutical companies are repeating Kodak's fatal error of treating a disruptive technology (AI) as an add-on to optimize existing processes, rather than rebuilding their foundation around it. This incremental approach will lead to them being overtaken by AI-native startups.
The catastrophic failure rate in drug development isn't just bad luck; it's a structural problem. It originates from the very first decision: researchers, biased by existing literature and simplistic models, fixate on a single biochemical target, ignoring the body's complex, multi-faceted nature.
Breakthroughs aren't single 'aha' moments. For Viagra, an unexpected side effect was only actionable because of five converging factors: a safe molecule, a known massive market (from a previously rejected proposal), a new scientific paper explaining the mechanism, and the right team to connect the dots instantly.
Contrary to common belief, rising to the top of a large organization drastically reduces control over one's own schedule. Senior leaders' time is consumed by reactive, last-minute demands from investors, press, and internal crises, while mid-level managers have more autonomy to focus on deliverables.
R&D efforts often fail because leaders don't understand the 'S-curve' of technology. New tech has a long, costly 'induction phase' (15-25 years, or 75 for AI) where it's not yet productive. Adopting too early is a resource drain, while adopting too late means you're already behind.
A drug that is proven safe in humans but fails to show efficacy for its initial target is not a total loss. It's a de-risked asset with a known safety profile, making it a prime, low-risk candidate for repurposing into a new disease area, especially for rare diseases with orphan drug protections.
When Viagra's fate hung in the balance, its champion secured crucial funding by physically closing his boss's office door and refusing to leave without the money. This act of calculated defiance shows that conviction sometimes requires breaking corporate norms to prevent a breakthrough from dying.
After the Viagra project was saved and initial trials proved incredibly effective (9 out of 10 men responding), the team's findings were rejected by The Lancet. The top medical journal deemed the results 'too good to be true,' showing how deep-seated skepticism persists even in the face of strong positive data.
According to former Glaxo CEO Sir Richard Sykes, people reach the top of large companies for two reasons: being good at their job or being good at internal politics. This creates an environment where 'power people' can thrive through backstabbing, hindering innovation and frustrating mission-driven employees.