TL;DR
Life sciences companies are often blindsided because regulatory, commercial, medical, and finance teams are working from different assumptions. Political wargaming helps leadership anticipate competitor and market moves, agree on specific responses, and identify the signals that should trigger action—before an expensive surprise forces the issue.
“We never could have seen that coming.”
I’ve heard some version of that sentence more than once over the past 20 years.
A competitor gets to the FDA faster than expected. A new technology changes the economics of the market. A company with deeper pockets enters the category. A promising pharma partnership appears out of nowhere.
Everyone scrambles.
The commercial team revises its forecast. Regulatory defends the existing timeline. Finance starts asking harder questions about runway. Leadership debates what the competitor’s announcement really means while investors and board members are already asking what the company plans to do about it.
The event may have been unexpected. The possibility usually wasn’t.
That’s where political wargaming can help.
What a Biotech Launch Can Teach Us About the Unexpected
Let’s look at BioCo, a fictional biotech company based on a scrubbed version of actual, documented events. BioCo wasn’t my client, and the names and immaterial details have been changed.
BioCo was preparing to launch GeneCure, a gene therapy for a rare genetic disorder with few effective treatment options.
The company had spent years on research, clinical trials, and regulatory preparation. The science was strong. Leadership believed GeneCure had blockbuster potential. Its financial plans, investor story, hiring decisions, and commercial strategy were all built around a successful launch.
Then GenNova, a competing biotech company, announced progress on a similar therapy.
GenNova claimed better efficacy and lower production costs. Its regulatory review was expected to move ahead of GeneCure. There were also rumors that GenNova was negotiating a global distribution agreement with a major pharmaceutical company.
One announcement put pressure on nearly every assumption BioCo had made.
If GenNova received approval first, it could establish relationships with physicians, payers, advocacy groups, and treatment centers before BioCo entered the market. A major pharma partner could give it more commercial reach, more pricing flexibility, and the resources to expand internationally.
BioCo still had a promising therapy. But the market it planned to enter was changing quickly.
Leadership now had to answer some uncomfortable questions:
What happens if GenNova launches six months earlier?
What if its efficacy claims hold up?
What if a pharma partner gives it enough capital to price aggressively?
Should BioCo pursue its own partnership before approval?
Does the company conserve cash or spend more to accelerate launch readiness?
How much of the existing investor story still holds?
Those are expensive questions to answer for the first time while a competitor is already moving.
What Political Wargaming Means in Life Sciences
Peter Perla, author of The Art of Wargaming, describes wargaming as a simulation in which the decisions made by opposing players affect how events unfold.
In a life sciences company, the “players” might include:
Your company
A primary competitor
Regulators
Payers or CMS
Physicians and other clinical users
Patient advocacy groups
Investors
Potential commercial partners
The purpose is to put real people, incentives, constraints, and decisions into the scenarios you’re considering.
Traditional scenario planning might ask what happens if approval is delayed.
A wargaming exercise goes further:
How would your competitor respond to that delay? Would it increase spending, pursue a partnership, pressure the market on price, or use the additional time to lock up key opinion leaders and treatment centers?
Then your team has to decide how it would respond.
The exercise becomes much more useful once the market can make moves against you.
Why This Matters More in Life Sciences
A few months can have a significant commercial impact in a regulated market.
The FDA’s Priority Review designation, for example, reduces the review goal from 10 months to six months. That four-month difference can affect revenue timing, capital requirements, launch sequencing, investor confidence, and a competitor’s ability to establish an early market position.
Approval is only one source of uncertainty.
A product can receive approval and still face weak adoption. Physicians may be slow to change established workflows. Payers may limit coverage. Health systems may require more economic evidence. Patients may struggle to access treatment. A competitor may enter with a less impressive product but a much easier adoption path.
Strong science doesn’t make those forces disappear.
Your commercial plan needs to account for how the rest of the market is likely to behave.
How to Run a Life Sciences Wargaming Session
You don’t need a three-day offsite, a 60-slide deck, and several consultants wandering around with color-coded sticky notes.
A focused leadership team can make meaningful progress in 90 minutes if the exercise is built around actual decisions.
Step 1: Choose the Two Uncertainties With the Greatest Impact
Start by identifying the forces that could most significantly change the value of the company or the success of the launch.
Common examples include:
Regulatory timing or stringency
Physician and patient adoption
Reimbursement and payer coverage
Competitor funding
Manufacturing capacity
Clinical evidence requirements
Partnership activity
Pricing pressure
Choose two.
If you include every possible variable, you’ll create a complicated exercise that produces very little clarity. Focus on the uncertainties that could force leadership to make materially different decisions.
For BioCo, the two most important uncertainties were:
How quickly GeneCure and its competitor would move through regulatory review.
How quickly physicians, payers, and patients would accept gene therapy.
Step 2: Build Four Plausible Futures
Use those two uncertainties to create a simple 2x2 matrix.
For BioCo, the scenarios might look like this:
High Market Adoption | Low Market Adoption | |
Faster regulatory pathway | Rapid growth and pressure to scale | Approval arrives, but revenue lags |
Slower or more difficult pathway | Strong demand creates capital strain while the company waits | Delays, weak adoption, and a need to reconsider the commercial plan |
Give each scenario enough detail to make it believable.
What is the competitor doing? What are payers saying? What evidence do physicians want? How much runway remains? Is the board pushing for a partnership, a financing round, or a change in strategy?
The scenarios should be uncomfortable enough to expose weak assumptions without becoming far-fetched disaster fiction.
Step 3: Assign Roles Based on Real Incentives
Divide participants into teams:
Blue Team: Your company
Red Team: Your primary competitor
White Team: Regulators, payers, physicians, investors, or other market forces
Each team should make decisions based on the incentives of the group it represents.
The Red Team’s job isn’t to be reasonable or make life convenient for Blue Team. It should pursue market share, capital, partnerships, pricing power, and clinical influence as aggressively as the real competitor would.
The White Team should respond based on its own needs. A payer may care about budget impact. A regulator may require more evidence. A physician may care about workflow, patient selection, safety, and confidence in long-term outcomes.
This is where teams frequently uncover a major problem: their commercial plan depends on several outside groups behaving exactly as the company hopes they will.
That’s generally a bad plan.
Step 4: Require Actual Decisions
For each scenario, ask leadership to make specific choices:
Do we pursue a commercial partnership before approval?
Do we change our pricing or reimbursement strategy?
Do we delay geographic expansion?
Do we accelerate evidence development?
Do we increase commercial spending or protect runway?
Do we narrow the initial market?
Do we change the investor narrative?
Do we hire now or wait for a defined signal?
Write down each decision. Assign an owner. Define what would trigger the action.
“Stay flexible” doesn’t count.
If GenNova receives approval first and announces a major pharma partnership, what will BioCo do within the next 30 days?
That question should produce an operational answer.
Step 5: Identify the Signals That Tell You Which Future Is Emerging
The exercise only becomes useful when the team continues using it.
Choose a small number of signals for each scenario, such as:
Competitor filing announcements
FDA guidance or review changes
Payer coverage decisions
CMS reimbursement updates
New clinical evidence
Changes in KOL sentiment
Competitor hiring patterns
Capital raises
Partnership announcements
Adoption rates for similar therapies
Assign someone to monitor these indicators and report on them regularly.
A competitor hiring a large market-access team may tell you something. So might a sudden increase in medical affairs activity, a change in the language used by KOLs, or a new payer evidence requirement.
Individually, these signals may not mean much. Taken together, they can show you which scenario is becoming more likely while there’s still time to act.
What Usually Goes Wrong
Most companies already do some form of scenario planning. Unfortunately, it often happens inside separate departments.
Regulatory has its timeline.
Commercial has its forecast.
Finance has its runway model.
Medical has its evidence plan.
Each may be reasonable on its own. The trouble starts when they’re based on different assumptions.
Here are the problems I see most often.
The Company Assumes Better Science Will Carry the Day
A technically superior product can still lose.
The competitor may get there first, make the buying process easier, build stronger partnerships, produce more useful economic evidence, or tell a story the market understands more quickly.
Science matters. So do timing, access, adoption, capital, and execution.
Teams Protect Their Own Assumptions
Regulatory protects its timeline. Commercial protects its forecast. Finance protects the runway. Marketing protects the positioning.
Nobody wants to be the person who says the current plan may be wrong.
Wargaming gives teams permission to challenge those assumptions without turning the meeting into a turf war.
Capital Is Treated as a Separate Issue
Life sciences companies can burn through substantial amounts of capital before reaching commercial scale. A regulatory delay, slower adoption, or new evidence requirement can change the financing plan very quickly.
Your scenarios need to show what happens to cash, hiring, investment, partnership leverage, and fundraising timing.
Otherwise, you’re modeling a future your company may not be able to afford.
The Exercise Turns Into a Messaging Workshop
Positioning and messaging matter, but better words won’t solve a regulatory delay, reimbursement problem, evidence gap, or six-month competitive disadvantage.
The work should affect decisions about capital, partnerships, evidence, pricing, market entry, and commercial investment.
How You Know the Exercise Worked
You’ll see the difference when something changes in the market.
Leadership can respond faster because the team has already discussed the underlying choices. Forecasts move within expected ranges instead of being rebuilt from scratch. Capital decisions are connected to defined market signals. Board and investor conversations become more consistent.
You should also see fewer surprises between departments.
Commercial knows what regulatory is watching. Finance understands which adoption signals could justify additional spending. Marketing knows which claims and proof points matter under each scenario.
The team may still be surprised by the news.
It won’t be starting from zero.
Try This With Your Leadership Team
Schedule a 90-minute session and circulate one question in advance:
If our primary competitor receives regulatory approval six months before us and secures a top-tier commercial partner, what decisions will we make within the next 30 days?
Ask commercial, regulatory, medical, marketing, and finance to submit their answers separately before the meeting.
Then compare them.
If the answers are materially different, you’ve found a risk worth addressing.
Start there.
When to Bring in MESH
Political wargaming is especially useful when:
Your launch plan depends on assumptions that haven’t been tested across teams.
Commercial, regulatory, medical, and finance have different views of what could happen next.
A competitor, regulatory change, or partnership announcement could materially alter your strategy.
Leadership agrees on the goal but hasn’t agreed on what would trigger a change in direction.
Your company has conducted scenario planning but hasn’t turned it into owned decisions and measurable indicators.
I can help your leadership team build the scenarios, challenge the assumptions, and turn the discussion into decisions you can use.
Bring the messy version. That’s usually where the useful work starts.
