By Laura Farmer, President, Opus Strategy
JPM Week in San Francisco is always a useful barometer for the life sciences industry. Not for what’s “trending,” but for what is moving from possibility into execution. The conference itself matters, but the real signal often comes from the adjacent meetings, the smaller sessions, and the conversations that happen when people stop pitching and start problem-solving.
This year, the tone felt more constructive than it has in a while. Not exuberant. But steadier. Investors were asking more disciplined questions about differentiation, durability, and proof. Operators were sharper about what they need in order to win the next phase. And in many rooms, the conversation shifted away from “big ideas” toward pragmatic plans: how to generate evidence efficiently, how to scale manufacturing, how to secure coverage, and how to make adoption predictable.
For pharma leaders, that shift matters. It suggests the industry is entering a phase where the winners will be the teams that can translate scientific promise into repeatable value creation, across portfolios and across therapeutic areas.
As went to events and spoke with colleagues, there were three themes I heard repeatedly:
First, the funding environment is reopening, selectively. Capital remains scarce for programs with weak data or unclear clinical utility. But for companies with credible differentiation and a coherent path to adoption, the window feels less constrained than it did even 12 months ago. Importantly, “strong data” is no longer interpreted narrowly as a positive trial readout. It increasingly includes clarity on the patient definition, the biomarker strategy, the regulatory plan, and the pricing and access narrative. In other words, teams are being rewarded for reducing uncertainty across the full development and commercialization arc.
Second, large pharma is in pipeline-building mode, unmistakably. Between patent expirations and growth expectations, the pressure to build and buy is real. What stood out this year is how central precision medicine and novel modalities have become a pipeline strategy. These are not side bets. They are core to how many organizations are thinking about the next decade of growth, particularly in areas where payer and provider expectations are tightening and where “me too” products face a rapidly shrinking runway.
Third, scalability has become a litmus test. The industry is no longer satisfied with brilliant therapies that cannot be produced at scale, delivered efficiently, or reimbursed sustainably. The conversations are increasingly integrating manufacturing, logistics, evidence requirements, and workflow adoption into the scientific story. Breakthrough biology is necessary, but it is not sufficient on its own. If you cannot make the therapy, deliver it, and get it used in real-world settings, the science will not matter as much as it should.
Precision medicine as the connective tissue
These themes converge most clearly in precision medicine. Leading into JPM, the field has been moving from “promise” to more visible proof. We are seeing better multi-omics integration, improved biomarker rigor, and a faster feedback loop between discovery, development, and clinical decision-making.
AI is clearly a catalyst here, but the most credible narratives were not “we used AI.” They were “we used AI to reduce uncertainty.” Better patient selection. Faster identification of responders. Earlier signals. A more precise understanding of heterogeneity. Pharma teams have heard the AI hype. What they are looking for now is a measurable advantage that shows up in development timelines, trial efficiency, label strength, or commercial adoption.
At the same time, expectations for commercialization are rising. Precision medicine programs are increasingly expected to show early thinking on access, evidence, and adoption. The best teams are building with payer logic and clinical workflow reality in mind from the beginning, not bolting it on after publication. For medical directors and product teams, this is a meaningful shift. It changes when and how you engage on evidence generation, and it raises the importance of aligning clinical development with the future label story and the future value story.
A session that went deeper: Penn Center for Innovation on Precision Health
One of the most substantive discussions I attended was a Precision Health session hosted by the Penn Center for Innovation. It was a welcome contrast to the usual surface-level conversations and got into the hard truths that will shape what happens next. Three themes stuck with me:
“Best of times, worst of times” for academic medicine
Dr. Jonathan Epstein, Dean of the Perelman School of Medicine and Executive Vice President of the University of Pennsylvania for the Health System, was candid about the strain on academic research. Funding pressure is real, and it directly affects the biomedical pipeline that industry ultimately depends on. At the same time, the opportunity is enormous, especially as AI-enabled discovery and translation help compress timelines from insight to intervention. The tension is clear: the science is accelerating, but the ecosystem that generates and validates that science is under increasing stress.
For pharma leaders, this is more than a macro observation. It will shape access to partnerships, the pace of external innovation, and the availability of high-quality translational research. It also underscores the value of academic-industry collaboration models that are built for speed and rigor, not for optics.
Rare and ultra-rare therapeutics need a better commercial path
Dr. Peter Marks, Senior Vice President of Molecule Discovery and Head of Infectious Disease at Eli Lilly and former Director of the FDA’s Center for Biologics Evaluation and Research, highlighted a reality that the industry continues to struggle with: if we want a full complement of rare disease therapies, the path must become faster and less expensive without sacrificing rigor.
One idea that resonated was the concept of process-based approvals. Instead of forcing each molecular variant through a full regulatory “toll booth,” a validated end-to-end lab and manufacturing process could potentially be reused across individualized therapies. For regulated science, this is a meaningful reframing. It shifts the value from a single asset to a scalable platform and challenges us to rethink what we define as “the product” when therapies are increasingly personalized.
For medical and commercial teams, rare disease strategy has always required careful choreography between evidence, access, and trust. What changes now is the scale of the ambition. If the industry wants broader rare disease coverage, the system must evolve to support it. Otherwise, the economics will remain structurally misaligned with the clinical need.
Immune health as a transformational frontier, with AI as an enabler
Dr. Allison Rae Greenplate, Adjunct Assistant Professor of Systems Pharmacology and Translational Therapeutics and Director of Immune Health at Penn Medicine, described a vision that felt both ambitious and increasingly plausible: decoding an individual’s immune profile at scale and using it to match patients to therapies with far less trial-and-error.
This is where precision medicine starts to look less like a niche approach and more like a broader operating system for care. Stratify better. Treat smarter. Reduce waste. Improve outcomes that matter clinically and economically. For pharma, this is a reminder that the future of differentiation may be less about “a new mechanism” and more about “a better match,” supported by evidence and operationalized through diagnostics, data, and workflow integration.
The practical question precision medicine keeps forcing us to answer: How do we build trust?
Precision medicine is fundamentally a trust business. Trust that the data are sound. Trust that stratification is meaningful. Trust that outcomes translate to real-world settings, not just curated cohorts. This is where medical affairs and evidence strategy become central to success, not supportive functions downstream.
Why this matters now
The next phase of precision medicine will not be won by the loudest storytellers. It will be won by teams that translate complexity into clarity:
The science of precision medicine is moving fast. The healthcare system is still the healthcare system. Translation is the work.