Breaking Silos in Medical Affairs — A Cross-Functional Leadership Blueprint

The silos between Medical and Commercial teams emerge because the former is often seen as a team “to get approval from”, rather than an equal partner to build with.

In the latest episode of PharmaTalks, host Nataliya Andreychuk sat down with Laragh De Bhulbh, leadership coach, strategy consultant, and an advocate for combating organisational silos in the pharma industry.

With 15 years of experience working across Medical Affairs (MA) and brand teams, Laragh has seen how cross-functional friction kills performance.

She is convinced that one of the biggest bottlenecks in pharma today remains poor cross-functional communication and the siloed thinking that sustains it.

Medical Affairs Has Evolved. Has the Rest of the Organisation Kept Up?

The role of Medical Affairs in pharma has undergone a transformation. McKinsey’s vision for 2025-2030 positions Medical Affairs as a strategic pillar alongside R&D and commercial, a core driver of organisational direction.

And yet, not everyone has moved with it. “Medical Affairs supports marketing in creating and reviewing materials, yes,” Laragh explains, “but what really needs to happen is seeing it as a cross-functional whole. What are we, as a team, trying to achieve? And how does each function contribute to that?”

The boundary between medical and commercial is not static. Depending on the lifecycle and the product, there are moments when Medical Affairs must lead strategy. Communication, she argues, is the mechanism that makes this possible.

“When you break silos, teams can go further and faster. Everyone is on the same page. You can disagree but you do it in a safe environment.”

Where an Opportunity Lies

Leaders often insist their teams are functioning well. And perhaps they are but they could work so much better.

When there’s trust inside a team, challenges are discussed openly, so you align faster and reach solutions quicker. You don’t have to agree on everything, but you’re allowed to share your opinions.

“If we step back and ask what we’re trying to achieve as a team, and who has the best skill set to lead on each piece, things become much smoother.” Sometimes that means disease awareness, traditionally a marketing responsibility, is better led by medical when deeper scientific understanding is required.

And once teams get early insights from their actions, they should feel comfortable sharing them. But what often happens is that teams build sophisticated data collection processes, report up, and then never come back to these insights again.

Trust between teams is what changes that. It allows them to share not just positive outcomes, but setbacks too. They learn faster, recover quicker, and come up with better solutions.

On Facing Fears

A significant driver of dysfunction, Laragh notes, is fear. For example, teams can fear medical will automatically say no to their ideas, or that commercial will push too hard.

There’s also fear at a personal level. Fear of creating friction, looking incompetent by asking questions, damaging relationships or challenging the room with a different point of view.

That fear can be paralyzing. Teams refuse to speak up, sweep their needs under the rug, and limit co-creation. When trust and clarity are missing, they default to inertia, worried about seeming out of control or not competent enough.

This is the moment where teams need to see the cost of inaction and agree on small steps they can take together toward common goals.

Introducing the CATALYST Framework

Over years of working with cross-functional teams, Laragh developed an eight-pillar framework she calls CATALYST. Each letter maps to a distinct organisational capability that, together, create the conditions for high performance.

(C) Clarity of purpose	(A) Active collaboration	(T) Trust & empowerment	(A) Adaptable strategies
Shared understanding of roles, objectives, and responsibilities across all functions.	Communication that goes beyond talking, ensuring the right messages reach the right people.	Building genuine trust between functions, so teams feel empowered to act.	Moving beyond tactical planning to strategic thinking that responds to market shifts.
(L) Leadership alignment	(Y) Yielding results	(S) Shared success	(T) Timely execution
Achieving alignment even when Medical operates without formal authority.	Reconciling medical’s long-term timelines with commercial’s monthly targets.	Celebrating each function’s wins as the whole team’s achievement.	Moving fast enough to capture every opportunity to improve patient outcomes.

The “Yielding results” pillar is the most challenging one. The thing is that medical results play out over years, shifting physician behaviour, building disease understanding. Sales and marketing are measured month to month. If you don’t align on what success looks like across those timeframes, friction is inevitable.

Medical Strategy Should Align with Marketing Without Overlapping It

Medical strategy should not replicate what marketing does. It should create the foundation on which commercial messaging lands.

When the science changes, or the market shifts, this kind of deep cross-functional collaboration becomes even more urgent. If there are new trial results, new data, or a market change, collaboration is what allows to pivot quickly. Trust and aligned purpose allow teams to run faster with their decisions.

Hot or Not Game

Nataliya asks Laragh to do a quick-fire “hot or not” blitz test, answering her, sometimes, controversial statements.

• “Medical affairs is now the most strategically important function in pharma.” Not.
• “Commercial silos are a leadership failure, not a structural problem.” Hot.
• “You can’t fix cross-functional alignment without fixing individual incentives first.” Not.
• “Most strategic planning in pharma is still done in silos.” Hot.
• “Trust is more important than process when it comes to cross-functional collaboration.” Very hot.
• “The best cross-functional leaders are the ones who are willing to give up credit.” Very hot.

Closing Thoughts

If we had to sum up the conversation in one line: know what you’re aiming for and communicate it clearly.

Medical and commercial teams need to align on short- and long-term goals and openly share perspectives to define a common path and roles. And this communication must be built on mutual trust, where everyone feels safe voicing their ideas, so the team can reach shared objectives faster and in a more efficient way.

Want to unify your Medical and Commercial operations in one system? Drop us a line, and our experts will guide you through it.

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