There is no single path toward becoming a CEO. The job requires many different skills, often concurrently: sharp analytical capabilities, strategic thinking, clear communication with multiple audiences, curiosity and perseverance. It demands strong leadership but also humility, and a willingness to acknowledge mistakes and knowledge gaps.

Founder-CEOs do not typically remain at the helm as biotechs mature. Exceptions to that rule are multiplying, though, especially in Europe as companies aim directly for Nasdaq.

Merck & Co.’s Keytruda is already elbowing its way into the top ten best-selling drugs. But it, and its expanding cohort of competitors, could be much bigger. Companies and investors are scrambling to identify the technology or technologies that can unlock checkpoint inhibitors’ potential in the 70% or more of tumors where they do not currently work. That activity is reflected across 2018’s licensing deals, M&A and financings.

This month a handful of biosimilars of the world’s top-selling drug, Humira (adalimumab), are due to launch in Europe. They will not topple the $18 billion behemoth. But they will do some damage, as Europe’s cash-strapped payers ready themselves to embrace these cheaper lookalikes. 

Digital must become a core capability for pharma if it is to remain competitive. New technologies bring faster innovation cycles, but demand new kinds of expertise and partnerships that threaten traditional hierarchies and mindsets. The rewards, for pharma, are most likely to come from improved efficiency and stronger relationships with stakeholders, rather than from digital end-products.

Experiments are underway to solve pharma’s well-documented R&D productivity crisis. The industry is no longer focused only on buying new drugs via M&A, or on outsourcing discovery. Companies are also building new channels through which to access innovation, setting up different kinds of partnerships, and using new kinds of data. The shift involves re-thinking pharma’s place in healthcare.