Go-to-market models are being reimagined across industries as customer behavior, data, and digital economics reshape how organizations grow. The examples in this article come from the pharmaceutical sector, where human engagement and digital orchestration must coexist within regulatory and scientific constraints. The same logic applies to any business balancing cost, control, and customer connection in a digital-first world.
GTM as an economic system
Most GTM debates still start with channels, and that frame is too narrow. GTM should be viewed as an economic system that converts strategy into repeatable revenue at the lowest feasible cost of growth. For each brand, leaders make three linked choices: who to target, how to reach them across human and digital touchpoints, and what unit economics will sustain the approach at the current stage of growth.
Direct uses your own field force and owned marketing channels. It provides maximum control with higher fixed cost. It suits scaled flagship brands and contexts where scientific dialogue, access shaping, and coordinated field coaching matter. When the goal is to shape the conversation and own the relationship, direct works.
Partner involves co-marketing agreements and in-licensing. It shares control and reduces fixed cost. It works for mid-tier brands and for geographies where others have stronger distribution or credibility. You trade some margin for reach and risk reduction.
Platform leverages digital trade channels and marketplaces. It carries minimal fixed cost with variable margins. It suits mature or tail brands that do not justify field coverage but still need presence and availability. Use it to keep presence efficient.The point is not to pick a single motion. It is to match the motion to the brand’s economics and stage on the adoption curve. A launch product might start direct in key centers while using partners in secondary markets. A mature brand might shift from direct to platform as growth slows. The portfolio evolves as brands mature.
Evidence over instinct: two simple checks
Before committing resources, two checks keep decisions grounded.
Cost–Volume–Profit (CVP) crossover. Plot profit curves for a brand under two approaches: a direct model with higher contribution and fixed overhead, and a partnered model with lower contribution and near-zero fixed costs. The lines cross at a breakeven revenue point. Below that point, partnerships outperform. Above it, direct typically dominates. Calculate this breakeven for each brand. Use it as a standing diagnostic. Revisit it every six months as volumes, prices, and fixed costs shift. Some brands maintain direct models at sixty percent of breakeven and burn cash; others stay partnered well past breakeven and leave margin on the table. Let the math decide.
Working capital drag. GTM choices change cash conversion in ways that P&L statements miss. Direct distribution with large chains can expand receivables to 120–150 days. Platform motions shift toward variable cost with 30–45-day cash cycles. Many teams track revenue growth but ignore what the balance sheet reveals about investability. If annual revenue looks strong but accounts receivable grows faster than sales, the business is not scaling; it is being subsidized. Put cash metrics next to growth metrics. Judge GTM on both performance and payback. A brand growing twenty percent with deteriorating cash conversion may be worth less than one growing ten percent with improving cycles.
A simple filter for brand-by-brand decisions
A clear filter helps avoid politics and fashion. Ask three questions. If the answer is not “yes” to at least two, change the motion.
Scale. Can the brand reach volume that pays for field overhead within the next twelve to eighteen months? If not, use partner or platform while you build demand.
Signal. Does the belief you need to change depend on dialogue and evidence, or does it follow availability and habit? Where belief shift is the constraint, such as vaccines with access dynamics, complex or high-involvement launches, use direct or co-promote. Where availability drives choice, platform is a sensible default.
Specificity. Does the brand require targeted work such as KOL engagement, centers of excellence, or patient programs? If yes, invest in high-touch; if not, move to a lower-touch play.
This filter ties service level to economics and clinical reality, not to organizational history.
What digital actually changes
Digital should not sit in a parallel lane. It strengthens three parts of the system.
Discovery and intent formation. Professional networks, digital learning platforms, and peer communities shape interest before a sales conversation. If the message lives only in a detailing aid, the team is late to the conversation. Digital surfaces early intent signals that guide where to focus scarce human time.
Precision and timing. CRM signals, e-prescription data, and consented engagement cues indicate when to show up and with what content. This shifts attention from raw frequency to fit and timing.
Cost of growth. Digital trade and fulfilment can compress fixed cost for mature SKUs. Protect core brands and price ladders while using platform routes to manage the long tail. This is not about replacing the field. Blended models perform best: human conversation where beliefs move, coordinated digital everywhere else.
Running today’s cash and building tomorrow’s specialty
Many teams frame choices as a trade-off between protecting stable revenue and funding specialty growth. The better frame is capital allocation over time.
Protect current cash, reduce unnecessary cost. Retain direct coverage where contribution margins justify it. Move non-incremental activity from the field to digital workflows for sampling logistics, reminders, and foundational education. Free capacity without cutting coverage.
Stage specialty growth. Start with focused direct support through MSLs, KAMs, and patient programs, along with a small omnichannel footprint. As adoption grows, set clear thresholds, such as number of active centers and patient starts, that trigger scaled investment.
Use partner and platform for flexibility. Shift mid-tier and tail SKUs to lower-fixed motions. This protects the P&L while freeing funds for the next S-curve.
This sequence keeps the portfolio balanced and invests where belief and access work take longer to mature.
Execution traps that stall progress
Five traps show up repeatedly.
- Activity theater. More messages do not equal more persuasion. Track belief and action such as initiation, titration, and persistence, not just contacts.
- Channel cannibalization. Without deliberate rules, platform promotions will undercut direct value. Protect flagship brands and price ladders.
- Under-resourced change. Specialty adoption needs capabilities, not only messaging. Treat enablement as a P&L lever, with budget for access, KOL programs, and patient support where needed.
- Single-period budgeting. GTM shifts compound over multiple periods. Build in quarterly CVP reviews and be ready to reallocate based on evidence.
- Orchestration gaps. Assign ownership for the choreography across field, marketing, medical, access, and platform routes. Commercial excellence can serve as the operating system when it has the mandate to set standards and resolve conflicts.
A leadership team that wants to move now can create visible progress in one quarter.
- Run the brand-by-brand CVP. Red-amber-green each SKU for GTM fit. Confirm which brands warrant direct, which suit partner, and which should default to platform. Publish guardrails for platform-eligible, partner-eligible, and protected-direct lists.
- Rewire the funnel. Define one diagnostic per brand that predicts conversion rather than counting calls. Measure it across human and digital touchpoints. Tie weekly field coaching to that diagnostic.
- Restructure the field calendar. Remove the bottom twenty percent of non-value activities and replace them with automation and digital workflows. Redeploy saved capacity to coaching and complex accounts.
GTM is choice under constraint. Digital has expanded the menu of choices, but it has not changed the basic economics. Leaders who match motions to the math, and then coordinate people and technology with discipline, build advantages that last.
The author is Sunder Ramachandran, healthcare commercial leader at GSK, Pfizer, and Dr. Reddy’s.
Disclaimer: The views expressed are solely of the author and ETCIO does not necessarily subscribe to it. ETCIO shall not be responsible for any damage caused to any person/organization directly or indirectly.
