Pharma growth depends on a reinvented CIO agenda—not just better IT or AI

The Inflation Reduction Act (IRA) of 2022, which allows CMS to negotiate prices for Medicare, the Trump tariffs of 2025, followed by the executive order to have the most-favored-nation price for prescription drugs and biologics, impacts of the canceling of US aid programs, the sunset of blockbusters, the increasing pressure to reshore manufacturing, and the advances in AI are just some of the things the pharma C-suite is attempting to address simultaneously. An industry generally financially comfortable in a global recession-proof economy is now in unknown territory.

As pharma leaders figure it out, they must collaborate with an actor that operates cross-functionally, across clinical, operations, and commercials. That will be the CIO. However, the attributes of the CIO must shift (see Exhibit 1) from the traditional IT firefighter to a technocrat who is also a pharma expert. The CIO could very well be the defining anchor of successful pharmas of the 21^st century.

Exhibit 1: The reinvented pharma CIO must have critical superpowers to be the secret weapon most have forgotten about

Source: HFS Research, 2025

Cost management must be meaningful and sustainable

Pharmaceuticals have a very sophisticated understanding of their costs (see Exhibit 2) and have managed it in the manner befitting an enterprise with very healthy and sustained revenues. In the context of softer revenues for the next generation, cost management must take a very different approach.

Exhibit 2: Increased automation and AI enablement can improve SG&A, COGS, and R&D costs

Source: HFS Research, 2025

In that context, CIOs must elevate their level of ownership of costs that they control across the spectrum of people, capital investments, technologies (infrastructure, software, applications), and innovation. They must embrace an enhanced level of discipline with robust cost-benefit analysis and manage their portfolios smartly. This must be less about tactical cost-cutting and more about strategic expense management.

Similarly, CIOs must have a bigger say in the costs they might influence in R&D, supply chain, and distribution.

CIO’s agenda is the growth agenda

Pharmaceutical growth will have to take a different path that will not be cushioned by government grants that underwrite R&D, lobbying dollars that make friendly policies, or bank on the revolving doors of regulatory agencies that will facilitate easy drug approvals. Instead, this will be an everyday knife fight in every geography the pharmaceutical chooses to address. In such a competitive landscape, the CIO will be the key warrior whose agenda will be foundational to growth (see Exhibit 3).

Exhibit 3: CIO agenda is core to pharmaceutical growth in an uncertain world

Source: HFS Research, 2025

The CIO’s agenda must address seven specific enterprise growth metrics:

• Market expansion: Enabling sophisticated and targeted HCP outreach and engagement in a very noisy channel will be the ultimate differentiator.
• Market access: An industry biased toward the disease conditions of Caucasian males must look beyond this focus as radical demographic shifts take place by leveraging equitable data and enhanced data governance.
• Innovation: Enabling and leading innovation, be it R&D, commercialization, or another, will be the difference between long-term growth and none in a market where the cycle time from drug discovery to market is rapidly shrinking.
• Pipeline: Developing and maintaining a high-compute environment to support R&D will give that edge in an uber-competitive global market.
• Speed to market: The enablement of technology to drive efficient, effective, and safe supply chains and manufacturing to accelerate products to consumers is key to disease management and, consequently, revenues.
• Stickiness: The faster a product can reach consumers, the higher the likelihood of disease management and cure. This critical attribute of consumer loyalty positively contributes to HCP engagement.
• Walletshare: CIOs must understand the need to take a portfolio management approach to support consumers who may consume multiple products from the same pharma. The data analytics, distribution management, and rewards programs are just some of the threads CIOs must take to the next level.

Innovation is central to new ideas and new cures

The only constant may be change but change without improving the status quo is a lost opportunity. Luckily, pharmaceutical companies have a target-rich environment globally supported by disease prevalence and aging. Climate change is likely going to make opportunities even more attractive. However, innovation is the key to addressing these opportunities in an uber-competitive market. The proliferation of AI will help take innovation to another level, as illustrated by Exhibit 4.

Exhibit 4: Pharma leaders claim to be all in on the AI revolution…are they really?

Sample: N = 19
Source: HFS Research, 2025

Pharma innovation has generally been seen through the lens of clinical R&D around the drug discovery process. However, innovation must be at the core of driving the business forward beyond just the clinical in an era marked by few to no blockbusters. The CIO’s agenda must create an enterprise innovation framework that identifies and addresses specific market differentiators over multiple time horizons. They must take ownership of the innovation budget and take a whole-of-company approach that includes processes, technologies, and products.

Other approaches that pharmas have taken have led to innovation in silos, which is characterized by a death by a thousand pilots, experiments that are akin to science projects, and have very little to show for the investments. CIOs must eliminate this wasted effort and consolidate and coordinate innovation to drive sustained differentiation.

Partnerships are all about bigger brains and bigger gains

The pace of technology change, evolving consumer and provider expectations, and a landscape of constant regulatory modification must dissuade pharmaceutical companies from wanting to build or develop everything independently. Instead, they must create and nurture an ecosystem (see Exhibit 4) that will allow them to address their changing environment nimbly and speedily, with lower total investment and at a far lower level of risk.

Exhibit 5: The HFS OneEcosystem says it all

Source: HFS Research, 2025

Exhibit 4 visualizes the OneEcosystem framework that CIOs must embrace as the keepers of partnerships. In this role, CIOs must identify diverse partners that transcend a spectrum, including enterprise platforms, hyperscalers, domain specialists, academic medical institutions, startups, industry associations, and other relevant experts. The idea for the ecosystem is to allow for the pharma to plug in partner(s) to address specific challenges at an optimal speed, cost, and risk. The ecosystem enables continuously infusing the enterprise with the latest thinking, technical advances, and innovations that are not at scale or commercialized, giving pharmaceuticals the edge and option to incorporate into their go-to-market. As with innovation, CIOs are at the pole position to be leaders in creating and managing an ecosystem that will accelerate the advancement of enterprise goals.

The Bottom Line: Embrace the revolutionary CIO agenda to navigate the multiple headwinds and emerge as a winner confidently.

CIOs who remain on their heels and are biased toward tactical firefighting will fail their organizations. However, those who lean into addressing enterprise objectives to grow, meet the needs of their consumers safely, and innovate to be ahead of the market will do justice to their roles. CIOs are at a fork in the road, and it is time to take the right one.