For startup companies, outstanding execution is non-negotiable. Funds are finite, and time to market is important for both competitive and financial reasons. In my experience, startups fail just as often from poor execution as they do from a concept or therapeutic that didn’t work.
IPM’s research has shown that alignment among executives is critical to achieving efficient execution. Biotech startups may think they are immune to misalignment since they are smaller and have fewer communication combinations.
But many, if not most, of the emerging biotech companies we work with still have misalignment in their goals, either among the executive team themselves, among the project execution team functional members, or between the project team and the executive team—any of which can hinder execution and cause critical delays.
Tales from the Front
A biotech company that we supported recently was in later stage development and facing the pressures of regulatory deadlines and product launch preparation. These pressures revealed misalignment in several areas. One was strategic versus operational, where frequent changes from the clinical team (e.g., protocol adjustments, accelerated timelines) clashed with CMC’s capacity. Another was that minimal project management structure left the teams without shared tools or decision-making processes. And a third was limited executive involvement to change a culture of hesitancy in cross-functional sharing of timelines, which undermined planning. Remedying these misalignments and issues created an environment where the team was able to execute much more effectively and efficiently.
Another emerging biotech we were brought into was in a key transition phase and had experienced significant leadership challenges when abrupt changes and removal of dissenting voices revealed poor alignment on strategic priorities and intolerance for healthy debate. Departures of key roles and the overlapping responsibilities of drug development blurred accountability, and decisions were poorly communicated. Additionally, some leadership-driven changes clashed with execution realities, generating wasted effort. Helping the company create clear governance structures, aligning strategic goals with operational capacity, and fostering transparency resulted in greatly improved execution.
Two Key Questions
There is a quick first step executives can take to ensure you are on the right path to outstanding execution. Ask yourselves and your teams these two questions. Everyone from the C-suite to the lab technicians should give the same answer.
- Question 1: What are the two most important measurable milestones we must achieve six months from now and 12 months from now?
- Question 2: What are our two biggest risks to achieving our six- and 12-month milestones?
My guess is that you will find many areas where both your executive team and your project execution team(s) disagree, particularly on the risks. Once you understand the gaps, you can address them. Achieving alignment will be critical to optimal execution—it will focus your resources to the most important few things.
Try asking the questions above and see what you learn. And if you have time, please let me know the results at [email protected].
For more insights about how leadership teams can get and stay aligned, including results from exclusive IPM research, download You’re Not as Aligned as You Think You Are.
October 20, 2025
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