Executives across the life sciences industry are navigating the most complex period in recent history.  As the commercial and policy landscape grows more complex, the role of the finance organization is fundamentally shifting. CFOs and finance/accounting teams are moving beyond retrospective revenue management and becoming proactive architects of pricing, contracting, and Gross-to-Net (GTN) strategy.  The pharma/biotech CFO is in the middle of the GTN pressure cooker and continuously fielding inquiries and complex questions from key stakeholders looking for directional insights on:

• Inflation Reduction Act (IRA) impacts related to:
  • Mandated Part B and Part D Inflation Rebates
  • New Medicare Drug Program (MDP), formerly Coverage Gap
  • Medicare Negotiations setting a Maximum Fair Price (MFP)
• Physician Fee Schedule (PFS) Final Rule with short-term Compliance 
• 340B Rapid Growth & Rebate Model Pilot Program Implications
• Direct to Patient (DTP) Program Popularity
• Most Favored Nations (MFN) Business Operations & Financial Risk
• Medicaid Budget Cuts Impacts on Patient Mix and Programs
• AMP Cap Removal Still Driving Business & Contracting Decisions
• and Tariffs are the final punch to the gut…

Financial leaders are expected to decipher these transformational changes, while still wrangling classic GTN pressures from Distribution, Payer, and Provider stakeholders. In addition, data expectations are evolving faster than most commercial and finance organizations can manage. As a result, CFOs must rethink how they manage Net Revenue trends and key drivers to ensure alignment among internal and external stakeholders, that span across the entire commercialization journey. Achieving this level of coordination, with the volume of stakeholders below, is nearly impossible for any one individual within an organization.

In recent years, I’ve facilitated 1:1 discussions with industry CFOs and CCOs, giving me the opportunity to listen, compare perspectives, and synthesize recurring insights. Following the CFO Showcase at IntegriChain’s 2025 Access Insights conference, I consolidated the key observations shared by these leaders. While each organization faces its own challenges based on product archetype, patient mix, portfolio maturity, and company dynamics, a few directional themes to drive Net Revenue Optimization emerged:

• Game Theory, Strategic Modeling: CFOs emphasized that finance must be engaged early and well before pricing, contracting, or access decisions are finalized, not simply to approve decisions, but to shape them. Early collaboration, with Strategic Net Revenue Optimization focus is quickly becoming a best practice.  It is clear now that a cross-functional driven, dynamic, cross-channel, bottoms up scenario development process drives the sensitivity analysis that the CFO’s key stakeholders are craving.
• Unified Data & Analytics: Executives highlighted the need for better data literacy and governance. Finance often takes direct responsibility for data quality, stewardship, and interpretation to ensure accurate accruals, forecasting, and reporting. Many finance leaders are intentionally working very closely with IT partners to develop a holistic data and analytics strategy.
• Policy, Compliance & Reimbursement Expertise: Policy changes, critical compliance requirements, like government pricing and state price transparency, and Payer/Provider reimbursement dynamics carry significant financial implications. Unless a manufacturer has an experienced compliance and policy organization, gaps in expertise may unintentionally create financial and operational risk.

Finance Perspective is Critical to Optimize Commercial Decisions

One of the strongest priorities we see in the current marketplace is the need for finance to be plugged in well before product launch or product price/contracting decisions are finalized. Too often, financial leaders are brought in once assumptions are already cemented, pricing strategies are locked, or payer contracting is underway. Across multiple organizations, finance executives described a similar pattern: commercial teams initiate pivotal decisions quickly and under pressure, relying on finance to validate or operationalize changes after the fact. Yet the potential risks require deeper financial modeling upfront. Why? It’s because each of the following product archetypes and patient scenarios yield a wildly different GTN picture:

Once business and finance leaders lock in and understand product archetype implications, they quickly agree upon and emphasize that this is not about slowing down the business, it’s about reducing the volatility that arises when assumptions are made without full visibility. CFO/Finance Team involvement enables the organization to quickly:

• Pressure Test Assumptions with more rigorous scenario planning
• Identify Business & Financial Risk tied to critical company forecasts
• Ensure Price & Contracting Optimization with a long-term profitability view
• Drive Strategic Business Decisions to capitalize on BD opportunities

CFOs are increasingly advocating for structured touch points earlier in the process, not simply to “approve” decisions, but to shape them. This shift toward early collaboration is becoming a defining best practice among sophisticated manufacturers.As regulatory expectations continue to evolve, leading manufacturers are formalizing cross-functional touch points and decision frameworks that embed finance alongside market access, trade, government pricing, and compliance from the outset. These structured collaborations enable faster, better-informed decisions while maintaining consistency across assumptions, methodologies, and data sources. Ultimately, organizations that treat cross-functional alignment as a core operating discipline, rather than an ad hoc coordination effort, are better positioned to navigate policy change, protect net revenue, and sustain compliance over time.

Final Thoughts

Gone are the days of the ‘back of the napkin’ economics in the pharma cafeteria. As pricing, contracting, policy, and reimbursement pressures mount, the industry is shifting toward a mandatory bottoms-up strategic net revenue modeling framework. If you aren’t analyzing each pressure point specifically related to each product archetype and patient scenario, you’re leaving your margins to chance. In today’s hyper-competitive market, precision isn’t just a tactical advantage—it’s a fundamental requirement.The manufacturers that will outperform in the years ahead are those that empower finance to lead with insight, shape decisions, and ensure that every commercial choice is grounded in disciplined assumptions and transparent data. In a world where GTN exposure can change overnight, Proactive Strategic Net Revenue Optimization is becoming the new industry standard.

To learn more about how IntegriChain’s Advisory Practice partners with manufacturers to optimize GTN, improve profitability, and drive data-informed access strategies, visit IntegriChain.com or contact our Advisory team jsharpe@integrichain.com