Key takeaways:

• Future biopharma leadership will be defined not only by scientific innovation, but also by the ability to redesign care delivery around the patient.
• “Zero distance to the patient” is a strategic imperative: reducing friction, delay and fragmentation between patient need and patient outcome.
• Meaningful competitive advantage will come from eliminating barriers, breaking down silos and accelerating decision-making across the healthcare ecosystem.
• Leaders should move beyond incremental fixes and pursue system-level transformation that removes coordination burden from patients and improves outcomes at scale.

Leaders in the life sciences are being asked to do something that looks impossible: drive growth while reducing cost, move faster while staying compliant and adopt new technology while rethinking talent and ways of working, all at once, continuously and under pressure.

In moments like this, performance isn’t enough. What’s required is poise: the ability to hold opposing forces in balance and still move with clarity.

Elite athletes, like Olympic champion skater Alysa Liu, understand this well. In figure skating, what appears effortless is anything but. A skater glides across the ice with grace and control, but beneath that calm is constant tension; opposing muscles firing simultaneously to maintain balance on a surface with no friction. Stability isn’t something achieved once; it’s constantly maintained.

The principle in athletics is called “stillness through opposition.” That’s what leadership looks like now. How do we create that same poise and control in today’s uncertainty? And how do we envision a future that can sustain us in a consistent winning momentum through continuous evolution?

What do we mean by zero distance to the patient?

To answer this question, we start with our “why.” For most of us, the answer is clear: we do this to improve patient outcomes—to improve life and how it is lived.

Today, there remains a significant distance between when a person has a health need and how quickly they receive the right care. Closing that gap requires more than incremental improvement. It requires a different ambition: deliver zero distance to the patient.

Zero distance means eliminating the gap between a patient’s need and their outcome: no friction, no delay and no burden of coordination.

Because today, that burden is real.

How can biopharma reduce patient burden?

Consider a common moment in the patient’s journey: a patient receives a diagnosis and leaves with a prescription and a plan. The intent is to start on therapy according to that plan. In reality, that is when the real work begins—prior authorizations, pharmacy calls, reentering information, calling insurance, calling the office, waiting and wondering what happens next. Every handoff creates friction.

And here’s the brutal part. In this system, the patient becomes the project manager, coordinating across institutions, systems, pharmacies and payers at what is often a life-changing moment. They’re doing this not by choice, but by necessity.

Across our work, we consistently see the consequences of this fragmentation. More than one-third of U.S. respondents to a 2023 poll said they haven’t filled a prescription because of its cost, and sometimes this number is far higher. This is the consequence of a system that depends on patients doing the work it should be doing for them.

A zero-distance experience looks fundamentally different: the coverage decision is triggered when the prescription is written and confirmed immediately, fulfillment timing and costs are visible, support is activated before confusion sets in and next best actions are clear. The patient no longer carries the coordination burden.

More than patient engagement: A pharma transformation

It’s time to redesign the system for zero distance. And pharma—like all the other stakeholders in healthcare—has a critical role in getting there.

This means challenging a core assumption in pharma today: We are innovators in science. Not architects of care. That assumption worked w hen the system reliably carried innovation forward. It breaks down when the system itself becomes the barrier. According to ZS’s Future of Health research, 44% of U.S. respondents don’t engage with the system until they are already sick. They avoid it because of hassle, cost and time. When healthcare feels hard, people wait. When people wait, outcomes worsen.

Zero distance requires more than participation in the system, it requires wading into the messy middle—often between the moments in the journey we spend most of our energy on—and designing a zero-friction approach.

This isn’t an incremental change. Zero distance requires us to take on the system itself, not just improving activity, but redesigning progression so the right actions happen seamlessly without placing the burden on the patient. It’s a design choice and a leadership decision.

Zero barriers, zero silos, zero waste

At ZS, we see a tangible path to zero distance—our stillness through opposition—built on three principles: zero barriers, zero silos and zero waste. These are not slogans. They are leadership moves.

Zero barriers

Barriers don’t exist in isolation—they live in context. The patient has context. The physician has context. The system has context. Taken together, it’s no surprise that most health outcomes are shaped by behavioral and environmental factors.

Barriers-driven engagement^TM is the solution. ZS has found that while organizations have made progress identifying barriers, most activity still focuses on clinical ones while the greatest friction often sits in operational and systemic barriers.

In one example, 20%-30% of prescriptions were being canceled—not denied or abandoned, but canceled by the specialty pharmacy. The reason was simple: patients didn’t answer calls from unknown numbers.

Addressing this barrier required coordinated action across the system. Physicians set expectations with patients to expect a call, offices reinforced it at checkout and support teams intervened quickly. Rejections dropped rapidly because the system moved as one.

But zero distance requires more than solving today’s barriers. It requires designing the system so those barriers never appear in the first place. Zero barriers. Biopharma has many places to drive this change today, whether in innovation readiness prelaunch, or in the design of the direct-to-patient infrastructure being created for your portfolio.

Zero silos

Despite years of transformation, fragmentation persists. Organizations continue to struggle with medical-commercial collaboration, disconnected insights and fragmented customer experiences.

The root cause is how we operate. We’re still working within yesterday’s logic of silos.

Zero distance requires common goals, common plays and common intelligence. Teams must align around solving real problems. When we have common goals, we no longer act with a theoretical RACI matrix, and the weight of our organization can make faster, tangible and more economical progress through the right plays. Similarly, insights must travel to wherever action can happen next. Insights that stay within a team don’t change outcomes. This is the foundation of the competitive and intelligent enterprise of the future.

Zero waste

The industry is investing heavily in AI, but too often it accelerates reporting instead of decisions. If AI makes reporting easier but decisions move just as slowly, that’s waste. If it generates insight but does not change who acts or leads to a better decision, that’s waste.

AI should collapse the time between signal and action. If it doesn’t change who decides, how fast and with what evidence, it modernizes the dashboard, not the decision.

Leaders who want to succeed need to make three deliberate moves :

• Priority-zero focus: They pick the one “zero” that matters most—time, friction, lag or gap—and align relentlessly around it (because if everything is a priority, nothing is).
• Decision-flow redesign: They redesign decision flows, not just tasks—clarifying decision rights, shortening cycle time and automating the path from signal to action.
• Outcome-led investment: They stop legacy spend that doesn’t move outcomes. If an investment doesn’t reduce distance, it’s not strategic, even if it’s familiar.

When we innovate and architect zero distance, we drive outcomes that matter

Biopharma occupies a unique position within the healthcare ecosystem. We engage across the journey—from clinical development through long-term care—and connect with patients, providers and institutions at critical moments.

We’re already beginning to see what this looks like in practice.

In one case, UCB set out to address the long and complex path to diagnosis for myasthenia gravis, a journey that can take more than seven years and involve multiple specialists. Instead of adding more programs or touch points, referral patterns or roles, they redesigned the journey itself into four clear steps: identify, assess, connect and enable. They took a different approach in how they found patients, moved up access to specialists and made it much more likely that a patient would be recognized earlier.

The result wasn’t just a better experience, but faster outcomes—20 diagnoses in the first six months—achieved with less spend, not more.

This is what zero distance makes possible.

What patients deserve: An end to fragmentation in healthcare

In a recent interview, Alysa Liu described what changed in her return to competition. Her support system knew her challenges and her needs and created a foundation of stability that allowed her to focus on what made her exceptional.

That is what great systems do.

And that is what patients deserve.

Because patients don’t experience our org charts. They experience the distance we leave between need and care.

The leadership decision: Zero distance now

As long as patients remain the project managers of their own care, distance remains.

The question is no longer whether we can improve the system. It is whether we are willing to redesign it. We can help patients manage the distance, and we are every day, with co-pay cards and patient support services and more. But leaders will design a path that has the potential to remove it all together.

As you evaluate your next launch, that next capability or intervention idea, ask yourself: does this reduce distance or does it decorate a piece of it?

Zero distance is not a mantra. It is a central directive. A choice that the leaders of this next phase of competitive pressure and patient needs will make.