Following Ali Pashazadeh’s inclusion in The Medicine Maker’s 2026 Power List, the publication ran an authored piece on 7 August 2026 built from his answers to the questionnaire that accompanies the list. The Power List is the magazine’s annual recognition of the individuals shaping biopharmaceutical development and manufacturing, and the Musings series gives selected members space to set out their views at length. Pashazadeh, Founder and CEO of Treehill Partners, used it to argue that management failure, rather than scientific failure, sinks the majority of clinical programmes.
A turnaround on strategy
Asked to name his professional highlight of the past twelve months, Pashazadeh described taking on a company that had received negative feedback from the FDA having already spent millions of dollars on regulatory advice, and which was then struggling to attract the investment needed to recalibrate. Treehill identified and addressed a number of issues across several verticals that had not previously been surfaced, re-engaged with the Agency in a fraction of the time and cost, and raised capital for the company shortly afterwards. The lesson he drew is one the firm sees repeatedly: development failures are usually a function of the decision-making process rather than the molecule.
Management, not molecules
Pressed on a widely-held belief he disagrees with, Pashazadeh challenged the idea that drugs fail:
Treehill reviews hundreds of situations each quarter in which clinical programmes have gone wrong, and in the overwhelming majority the molecule was not the problem. The firm’s structured analysis of 1,200 Phase II and Phase III studies found that 80 percent contained at least one material design error, and that only 5 percent of the companies had a commercial target product profile that remained relevant at the point of launch. Wrong comparators, commercially irrelevant endpoints and an unexamined competitive landscape are, on that evidence, operational and strategic failures rather than scientific ones — and largely preventable.
Resilience, incentives and the next decade
On resilience, Pashazadeh argued for treating commercial strategy as a design input rather than an afterthought, and for the ability to revisit decisions dynamically as the regulatory, geopolitical and competitive landscape shifts. His proposed policy change was more structural: that contract research organisations be required to provide an independent strategic assessment of the study they are asked to run, separated from the commercial pitch to win the work. He drew the comparison with automotive safety, where manufacturers are not permitted to certify themselves.
Looking a decade ahead, he expects the geographic centre of gravity to move, with the majority of early-stage development conducted in Asia and Western pharma retaining strength in later-stage development, regulatory navigation and commercialisation. He also pointed to progress that goes underreported: the markedly higher scientific and commercial rigour of the biotech teams that survived the funding drought, and Roche’s sub-billion-dollar investment into the Korean ecosystem, which he regards as one of the more significant strategic moves of the past year.
Read the full article on: https://themedicinemaker.com/issues/2026/articles/august/musings-from-the-power-list-ali-pashazadeh/
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