You can’t be too successful, can you?” The senior commercial executive asked me what he obviously thought was a rhetorical question as we worked on the launch plan of his exciting new product. So he was surprised when I gave him the answer that he wasn’t expecting: “Mmm, sometimes you can.” But then, giving answers that no one expects was the reason I was in the room. The interesting, useful conversation that followed will be useful to other life sciences companies too, so I’ll reprise it here.

The context for our meeting provided its own metaphor. The company’s offices had recently been refurbished to a high environmental standard and the talk at lunch had been about how the company was doing all it could to reduce its carbon footprint. Environmental sustainability is one of the few non-contentious subjects one can discuss these days and my knowledgeable lunch companions widened the topic to include pressure on water resources, soil and other irreplaceable natural resources. When, after lunch, we got to the ‘too successful’ conversation, I began by reflecting on the lunchtime chat. All of those things, and others besides, were examples of our species being so successful that we risk compromising our environment. Some scientists think that all eight billion of us descended from a population bottleneck of only 20,000 humans about 75,000 years ago. If that isn’t success, what is? And yet here we are worrying about running out of soil, water and other things on which our existence depends. The natural sciences offer other examples of species destroying their habitats – locusts and carp are oft-quoted examples – but we humans are the poster boys for doing so well we might harm ourselves. History is replete with examples of man-made ecosystem collapse, such as the 1930s dust bowl in the US, but we are now looking at planet-wide unintended consequences of our species success.

My intelligent, thoughtful colleagues bought into my ‘too successful humans’ metaphor quickly, but how does this relate to successful product launches? Well, it’s neither secret nor surprising that the life sciences industry and its wider health sector habitat are a complex, adaptive system just like any natural environment. And, like natural environments, our industry depends on a delicate balance between the different parts of the system. In our case, the balance lies in the social contract between the industry and society. Society facilitates innovation, creates markets and enables monopolies. In return, the industry gives it new medicines and, eventually, a pile of low-cost generics. For decades, this system has worked well but, as we’re finding out with our climate, we shouldn’t be complacent. Catastrophic change would come quickly if we broke this social contract.

And some of the innovative new products reaching the market might indeed threaten our industry’s delicate arrangement with society. In my research, one of the 26 industry business models I talk about is the ‘budget buster’, in which excellent, expensive products are developed for very high-volume markets. In today’s market, Wegovy and Lecanemab are early signs of such business models emerging. They will have no shortage of demand and might even dwarf Humira, Lipitor and other historic blockbusters. And that’s when we might start to worry about being ‘too successful’.

Whether you think it is justified or not, Humira’s huge, persistent sales have become a stick with which to beat pharmaceutical companies’ pricing policies and patenting strategies. We saw similar enraged responses, despite its efficacy, over Sovaldi. And, after many years of commercial success, Eli Lilly’s change to its insulin pricing is seen by many as ‘jumping before being pushed’. From society’s point of view, the value of the social contract might be a chronic issue, but new ‘budget busters’ are acute problems. In this context, life sciences strategists would be naïve if they didn’t ask themselves what might happen if several ‘budget busters’ launched, across different indications, in the next few years. And wise strategists would think beyond their own commercial success to the wider impact on the social contract. It’s entirely conceivable that we might see a backlash against exclusivity and pricing conditions that would make today’s squabbles, such as those over Medicaid price negotiation in the US and VPAS in the UK, look minor. And, goaded by social media and sound-bite politicians, we would be overly optimistic to expect sensible, balanced changes to the social contract. Much more likely is a dangerous, populist backlash.

What all this means is ‘caveat subscriptor’ – let the seller beware. In the same way as the success of the human species is threatening our natural environment, so a flood of ‘budget busters’ might grow the industry’s profits tomorrow but destroy them the day after that. To avoid this, the industry needs not only to demonstrate the value its new products create, but also learn how to share that value equitably and generously with the society that makes its existence possible.

Podcast and video versions of this article can be found at www.pragmedic.com