Pharmaceutical Market Europe • November 2025 • 12

DARWIN'S MEDICINE

BRIAN D SMITH
DARWIN’S MEDICINE 
WHY BAD HABITS ARE SABOTAGING YOUR STRATEGIC DECISIONS

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If you’re a senior strategist, your job is to make the best decisions you can

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That old saying – if you’re not making mistakes, then you’re not trying hard enough – has a lot of merit. I’m all for big, audacious goals, to use a phrase from Collins and Porras’ ‘Good to Great’. And it is true that, when strategising, it’s impossible and counterproductive to try to eliminate risk or be certain of outcomes. But it’s also true that, if you’re a senior strategist, your job is to make the best decisions you can. Over the years, I’ve helped many leaders and their teams do that and here are three lessons I’ve learned that I think you will find useful.

Noise, not bias

First, a bit of decision science. Some bad decisions are the result of biases, of which there are various flavours, such as confirmation, anchoring and recency. Good strategists are generally aware of bias risk and, by seeking diverse perspectives, can overcome it. But as Kahneman, Sibony and Sunstein put it, even the most unbiased decisions still suffer from noise, the random variability in human judgement. If you’ve ever seen colleagues go two different ways in two apparently identical situations, you’ve seen noise. It’s inherent in most strategic decision-making. Learning from Kahneman, I’ve found there are three sources of noise in pharmaceutical marketing strategy and each has a mute button, if you choose to use it.

Silence emotions

Our decisions are remarkably vulnerable to our emotions. We make bad decisions when we’re tired, hungry and, especially, when we’re arguing or if we’re feeling pressured. If you think about it, you will realise that you’re in one of these emotional states more often than not. It’s relatively unusual for us to be rested and relaxed. That’s why I advise strategists to get into the right frame of mind as a prelude to strategising. Just as some emotions create noise and lead to poor decisions, some emotional states do the opposite. It helps if the leader in the room reduces pressure, ensures there’s plenty of time, defuses conflicts and engenders a mood of positivity and, even better, curiosity. This can seem counter-intuitive to some hard-driving leaders, but thoughtful and reflective doesn’t have to mean dilatory and indecisive. The more that the noise of our emotions is silenced, the better our decisions become.

Tier decisions

Almost all our decisions are part of a cascade. For example, positioning decisions flow from earlier choices about who to target and what to offer, choices that themselves flowed from previous decisions about what disease area to be in. But we often rush to the next, lower tier in our waterfall of decisions, driven by haste and the feeling of comfort we have when making less momentous calls. I encourage strategists not to be so impatient because lower decisions, for example about messaging, are weakened if the preceding higher decision, for example about target segments, is not finalised. Consequently, it helps to focus on what decision still has to be finalised and to make it, with confidence and clarity, before considering the lower decision it leads on to. This can be laborious, especially if it means nailing down difficult analyses before getting to the fun part of the job, like discussing creative execution. But, as it turns out, making decisions sequentially reduces noise substantially.

Sharpen processes

Life sciences companies are passionate about process, especially when it comes to decision-making. Your organisation probably has a panoply of templates, each executed in a choreographed annual ritual. But, too often, process drifts into pantomime: boxes get ticked, forms get filled and the tools meant to sharpen thinking end up replacing it. Ritual displaces rigour and the value of those tools is never realised. I recommend using the tools of strategy – Segmentation, Targeting, Positioning and others – but using them well, understanding the management science that underpins them and eschewing the value-destroying charades that supplant hard thinking. This is perhaps the most difficult lesson to follow because it requires deep knowledge and skills that only come from years of reflective experience. But rigorous process is noise-cancelling for strategists.

Decision hygiene

Kahneman called the steps for reducing noise ‘decision hygiene’ and it’s a powerful allusion to the dangers of ‘dirty decisions’ caused by emotions, haste and performative processes. Just as washing your hands reduces infection, emotional silencing, decision tiering and process sharpening improve strategic decision-making. Make them habitual and your decisions will become cleaner, clearer and more consistently right.


Professor Brian D Smith is a world-recognised authority on the evolution of the life sciences industry. He welcomes questions at brian.smith@pragmedic.com. This and earlier articles are available as video and podcast at www.pragmedic.com