File sectionSelected leadership work

The strategic account changed when its hidden connections became visible.

38

Strategy colleagues

Five direct reports at October 2026; company workforce 1850

C$9.6 m

Delegated strategy expense

2026 function budget; no implied medical, regulatory or capital authority

37

Years in healthcare business strategy

Career began August 1989; board presentations since September 2017 are executive exposure

Case 01

The new therapeutic categories carried a familiar purchasing dependence

In 2023 we assessed an acquisition whose portfolio carried C$84 million in trailing annual revenue. Its therapeutic-area labels differed from much of our existing business, making the proposal attractive as a diversification story. The commercial review found that 45% of the proposed portfolio revenue was tied to the same institutional purchasing group already important to our own portfolio. The labels had broadened, but a substantial part of the buyer dependence had not. I wanted that distinction inside the acquisition decision rather than left as a qualification beneath it.

Marc Auvrenay, our fictional corporate development head, argued that the therapeutic breadth still had strategic value. He did not dispute the concentration; he believed the new categories justified accepting it. That was a serious alternative, not a careless enthusiasm for a transaction. I disagreed about the weight the proposal placed on diversification. The case needed to explain why the additional dependence was acceptable on its own terms, rather than imply that a different set of medicines automatically reduced the exposure we already carried.

I recommended declining the proposal after C$1.7 million in diligence expense. The responsible decision-makers accepted that recommendation. Specialist teams retained the assessment of the products, their quality, scientific evidence, permissions and contractual position. I did not interpret the commercial concentration as evidence that a medicine was unsuitable or that a purchasing relationship would fail. The strategic question was whether this transaction provided the kind of breadth we were seeking at that point in the portfolio's development.

We gave up access to the new categories and accepted that diligence expenditure would not lead to an acquisition. That consequence mattered. It would be easy to turn a declined transaction into a story in which nothing was lost because a risk had been discovered. Here the alternative retained genuine appeal, and the review cost remained real. I do not claim that the decision prevented a quantifiable future loss; the counterfactual is not available in this fictional record.

The case explains how I use a portfolio map. It should identify the mechanism through which a transaction changes the business, including the dependence it adds or leaves intact. A different category can still be worthwhile. It simply needs a reason more precise than the visual impression of another colour on the acquisition slide.

Case 02

Two proposed markets still relied on one distribution group

Our 2016 international expansion assessment covered two markets and modelled C$135 million in annual sales at maturity. The model attributed 56% to one proposed distribution group. The geographical presentation made the opportunity look spread across two settings, while the commercial route concentrated a substantial part of the undertaking in the same counterpart. I wanted the strategy discussion to retain both facts. The sales estimate was prospective, and no part of this case treats it as achieved revenue or evidence that product permissions were settled.

The expansion sponsors preferred preparing both markets together. They expected the joint approach to make the opportunity more meaningful to the distributor and reduce repeated preparation. I understood that argument: working through the same group could offer practical advantages as well as concentration. My concern was that geographical breadth had been used as a shorthand for greater independence. If the programme depended on one relationship for more than half the modelled sales, the institution needed to choose that dependence consciously.

I supported commercial preparation for one market first, with C$2.4 million in assessment and preparation expense. The second remained an option for later consideration. Local professional teams retained the medical, regulatory, contractual and operating assessments required for the actual business. My recommendation did not establish that either market could be entered or prescribe how a medicine should be supplied. It concerned the scale of commercial commitment we were ready to prepare while examining the proposed channel relationship more closely.

The choice gave up the simultaneous launch ambition and some of the simplicity of a combined negotiation. It also required us to explain why a smaller immediate undertaking could still fit a broader long-term direction. The sponsors' objection remained relevant; preparation in sequence could carry duplicated effort. I did not claim that the selected approach removed distributor dependence or proved that one market was intrinsically preferable. It made the initial undertaking proportionate to the evidence we were prepared to use.

For my public record, the useful distinction is between location and dependence. A map can show two countries correctly while saying little about the counterpart through which the business expects to reach them. I want a strategic account that allows both the attraction of the route and its concentration to survive the presentation.

Case 03

Fourteen initiatives were not fourteen equivalent portfolio positions

In 2021 our strategic portfolio summary placed fourteen initiatives in a single row of progress cards. Nine were early development activities and five concerned extensions of established medicines. The format made the collection easy to count and difficult to interpret. Readers could see breadth without seeing how much evidence sat behind each part. I did not want a convenient unit of presentation to imply that fourteen activities represented fourteen comparable products, revenue streams or prospects of success.

The programme sponsors worried that separating the groups would make the earlier work appear less valuable. Those activities represented possible future directions, and they wanted the corporate account to show the effort behind them. I agreed that early work deserved a place. The disagreement concerned what its place should mean. Treating different stages as equivalent did not respect the early activities; it asked them to support a claim they could not yet substantiate and obscured the established work's different responsibilities.

We spent C$1.3 million on portfolio analysis and revised the strategic description to show the nine early activities separately from the five established-medicine extensions. Scientific and medical teams retained their evidence assessments, with regulatory and financial colleagues responsible for their own conclusions. I did not assign clinical probabilities or convert the early activities into a valuation. The change made the institution's business account more precise about the type of work it was considering and the uncertainty that remained.

We gave up a simple fourteen-item headline. The new presentation took longer to explain and did not offer one aggregate measure that could be carried unchanged into every conversation. That was the cost of preserving an important distinction. It was still possible to discuss the portfolio as a whole, but the discussion had to make clear which conclusions concerned established activities and which concerned options under development. The count remained a count of initiatives, not a substitute for their evidence.

The outcome I can claim is a clearer strategic account. This fictional case does not report a product approval, clinical result or subsequent commercial success. It shows how a CSO can help a decision-maker interpret the collection without assuming the authority of the specialists who determine what each activity can responsibly claim.

Case 04

I counted nine brands before examining their shared buying route

In 2008 I endorsed a portfolio description that used nine brand names as evidence of diversification. I had examined the differences between the categories but had not given equal attention to the route through which institutions purchased them. A later review found that six relied on one procurement route. The original account was not arithmetically wrong: there were nine names. It was strategically incomplete because I had allowed that count to stand in for a more demanding explanation of independent commercial exposure.

Camille Dervelune, our fictional portfolio research lead, challenged the classification. Colleagues responsible for the brands argued that their different histories, uses and market positions should not disappear into one concentration measure. They were right about the need to preserve those differences. My response was to retain the product distinctions while withdrawing the inference that each name represented a separate buying dependence. The correction concerned our business description, not an assessment of whether the medicines were appropriate or valuable.

I supported C$620,000 in additional research and reclassification. The work brought the common procurement route into the strategic discussion and changed the way we explained the nine-brand portfolio. Commercial and professional owners retained their respective assessments. We did not prescribe a clinical substitution, alter a product claim or assume that a shared route meant an inevitable loss. The evidence established a connection that my earlier account had overlooked, not a prediction of what the counterpart would do.

The correction cost money and made my earlier recommendation less persuasive. It also disappointed colleagues who had used the breadth story in their own planning. I could not ask them to accept the revised interpretation while presenting myself as the person who had discovered a problem belonging entirely to someone else. The original classification was mine to challenge before I supported it. Keeping that responsibility visible is part of why the case belongs in this record.

I learned to ask which differences matter to the decision at hand. Product distinctions can be real while a commercial dependency remains shared. A useful portfolio account needs room for both. The lesson was not to distrust every count, but to avoid letting a count answer a question that requires an explanation of relationships.

Case 05

The smaller portfolio still needed a complete support account

A 2025 review considered a smaller established portfolio with C$26 million in annual revenue. Its annual support-cost estimate was C$4.2 million. Because the portfolio attracted less growth attention, the initial strategy discussion treated that support work as a secondary issue while considering longer-term options. I wanted it brought into the main account. Relative size did not remove the work required to maintain the business, and a possible future transaction did not by itself change present responsibilities.

Some colleagues wanted to focus immediately on disposal options. They argued that management attention spent examining a small portfolio would delay the larger strategic choices. I accepted that attention was limited and that ownership options deserved examination. My concern was the implicit assumption that the current support undertaking could be made residual while those options remained unresolved. The commercial direction and the existing work had to be considered together, with the relevant professional owners explaining what the latter required.

I supported keeping the C$4.2 million annual support estimate visible in planning while the long-term options were reviewed. This was not a margin calculation formed by subtracting that amount from C$26 million revenue: the estimate did not represent all costs or a complete accounting period analysis. Medical, quality, safety, regulatory, operational and contractual judgements remained with qualified owners. My contribution was to prevent the strategic description from implying that a smaller revenue line had become a negligible institutional undertaking.

The choice retained management work that the disposal argument hoped to reduce. It did not settle the eventual ownership question, and it did not promise uninterrupted supply or a particular transaction outcome. We kept planning for the responsibilities that existed while examining what might change them. That required a more patient account than a simple decision to prioritise growth assets and move on. The smaller portfolio's needs had to remain visible even when they were not the centre of the company's ambition.

I use the case to explain that a strategy includes the activities whose future is still being decided. A portfolio review should show the cost and attention attached to that interval. Otherwise an option in the future can be mistaken for a change that has already released the institution from work in the present.

In the words of others

Endorsements

Raphael accepted that our nine-brand description had given the names too much weight. The correction made the shared purchasing route visible without turning it into a judgement about the medicines.
Camille DerveluneFictional portfolio research lead; colleague on the 2008 classification review
I supported the acquisition’s wider therapeutic reach. Raphael kept the institutional buyer concentration in the decision, including the cost of declining after diligence.
Marc AuvrenayFictional corporate development head; counterpart in the 2023 acquisition assessment