Beyond Geography: Dynamic Operating Models for Market Expansion and Portfolio Transitions

Any drugmaker that intends to deliver therapies beyond a single market must decide how to launch and operate across diverse market environments. Which countries share an organizational home? Who leads the interactions between headquarters and the field? Where is therapeutic, brand, and asset strategy set? How does an enterprise best balance global consistency and local expertise? Launch success, durable market presence, and scientific leadership across borders all depend on some form of a Global-Local operating model.

These questions first surface when commercial ambitions cross borders for the first time. They returns as the portfolio evolves: legacy products turn over, the company enters new disease areas and modalities, the pipeline changes where the next wave of value will be created, and the organization must transform accordingly.

In each case, the operating model has to account for where the business operates, but geography alone does not determine how it should be organized. Designing the right model means looking past geography alone and weighing the portfolio, the surrounding pathways, and market presence.

Geography is only a starting point

The first instinct in many organizations is to treat Global-Local operating models as a question of proximity and time zones and to answer it as a matter of geography. That instinct reflects real factors but stops short of the full systemic picture. Geography solves for pragmatic needs: meeting schedules that work across a shared set of hours, supply planning, and, in Europe, for example, a shared spine of regulatory and access pathways.

It is a reasonable baseline, and many companies are already operating within it. The problem arises when geography becomes the central organizing principle rather than one input into the decision. Growing harmonization of regulatory and reimbursement pathways, along with the increasing ability to rely on common data packages across more distant and disparate markets, has loosened some of the old ties between proximate neighbors.

Limitation one: alone in a group

Companies routinely cluster markets by proximity and then find, over time, that neighbors on a map have less in common than they thought when it comes to launching a product.

Canada is the clearest example. Its proximity to the US, shared time zones, and deep trade and supply integration all make a compelling case for grouping it into a North America unit and drawing on nearby US experience and earlier launch learnings. But the demands of Canada's national health system, evidence-based pricing negotiation, and a layer of provincial bodies make its launch planning resemble the UK, Australia, and New Zealand far more than the US.

A North America structure that treats Canada as a satellite of the US risks isolating it precisely where it matters most: integrated evidence design and launch planning. Canada is a significant ex-US market in many disease areas and an important contributor to global clinical research, but structuring it as an afterthought risks leaving value on the table.

Limitation two: the international grab-bag

For companies already operating across dozens of markets, the challenge becomes how to organize markets that launch, commercialize, and engage their local scientific communities on staggered timelines and with uneven resourcing.

Later-wave markets tend to represent smaller shares of the total global opportunity, so they are frequently swept into a single bucket labeled "international" or "intercontinental." In many organizations, that bucket is so broad it can hold 40 or more countries spanning 10-plus hours of time zones, from Latin America to the Middle East to Oceania, each working through its own largely non-overlapping approval and payer systems.

There is a fair argument for this. A single large international grouping lets a company make decisive prioritization calls around its first-wave commercial markets. But if the purpose of operating as a global company is to deliver therapies globally — and hedge against volatility and disruptions in major markets — an overly broad rest-of-world structure can quietly write off a meaningful share of both returns and scientific leadership in the markets it lumps together.

Moving past geography: portfolio, pathways, and presence

Beyond geography, three sets of factors can help determine and design the right model.

Portfolio

A Global-Local model needs to reflect where the company is developing and preparing to commercialize its assets, not simply where it has the strongest commercial presence today. A balanced view encompasses the commercial realities of the pipeline, where research and clinical trials sit, the present and future therapeutic mix, and which markets the company is prioritizing now and in the years ahead.

Pathways

Effective models consider the complex mix of external pathways that each drug must navigate. This includes the surrounding circumstances of local launch environments, key patient populations, regulatory requirements, realistic opportunities for harmonization, pricing and reimbursement pressures, and the dependencies among them.

Presence

Global-local models that work well optimize for current and future market footprints. This involves considering the competitive picture in each market; established vs. emerging disease-area experience; the remit and capacity of global, regional, and local teams; and the cross-market/cross-functional interactions the model must support. Underneath all of this is enterprise intent: what is the company trying to build internationally, and how should an operating model serve that ambition?

Taken together, portfolio, pathways, and presence provide a stronger basis for Global-Local operating model design than geography alone. But they are inputs to a decision, not a prescriptive formula. The challenge is knowing how much weight each should carry in context.

Balancing the factors

Like with geography, the danger lies in allowing any single factor to become the central organizing principle. The strongest models come from weighing them together and thoughtfully balancing.

Harmonization is an alluring trap. Shared regulatory, reimbursement, and evidence pathways create real efficiencies, but pursuing them too aggressively can shrink the overall Global opportunity. A company rightly committed to Germany can pour effort into fitting smaller EU countries into shared operating logic while underinvesting in far larger opportunities in Asia or Latin America.

Existing market presence can elevate risks through biasing. Strong local teams, productive research relationships, and established infrastructure are genuine assets when they serve the future portfolio and liabilities when they anchor the company to its past. Historical strength in cardiovascular medicine is unlikely to help a company launch complex immuno-oncology therapies. Infrastructure built around therapeutic areas a company once led will lose value as the pipeline moves toward new therapies in markets with limited pathways to deliver on them.

Internal alignment can also distort the picture. R&D and commercial teams often plan from different impressions and mindsets of where the company is heading, while headquarters priorities and local incentives add their own pull. This disconnect is a persistent challenge to any successful transformation, but even more so in the context of market expansion or portfolio evolution.

All these factors are most useful when considered together. The portfolio should challenge assumptions about presence. Pathways should challenge assumptions about geographic proximity. Presence should be tested against where the portfolio is heading.

Pressure-testing the model

After weighing these factors, the question becomes whether the resulting model holds up against the realities of the business. Before turning a Global-Local model into an organizational chart, leadership should pressure-test the assumptions behind it.

Portfolio

• Where are you actively planning launches over the next few years, and does your current model give those markets the attention warranted by their contributions to the opportunity?

• Where is your M&A and licensing outlook likely to steer the portfolio, and would today's model still fit the company you are likely to become?

• Where do your trial sites and patient populations sit, and does everyone building the model have a clear, current view of that footprint?

Pathways

• Where does harmonization pay, and where does the pursuit of shared approaches risk quietly shrinking your larger-scale ambitions?

• Which coverage and reimbursement dependencies could delay or constrain a launch?

Presence

• Where is your existing footprint a real asset for the portfolio you are building, and where is it a legacy strength that the portfolio is moving away from?

• Where are R&D, Medical, and Commercial teams working from different pictures of the world, and what would it take to close these gaps?

These questions, and many more like them, will not produce a single correct map. They should expose where the proposed model is working with, and against, the portfolio, pathways, and presence.

Global-Local model design in action

These tensions resolve differently at every company. There is no one-size-fits-all Global-Local operating model; the right answer depends on the circumstances of the business and how its competing priorities weigh against one another. Across our work, we have seen these models designed, built, revised, and completely overhauled. Four stand out, each providing a different answer to the same problem.

Clustering Canada with Western Europe. One company grouped Canada with its Western European markets rather than inside North America. Canada was deeply embedded in the company's collaborative research networks; its HTA-based evidence requirements and two-layer national and provincial pricing looked more like the UK than the US; and, an experienced local team gave the market a strong operating base. Geography pointed one way. The business pointed another.

Sub-clusters within Intercontinental. Another company, commercializing in over 50 markets beyond its major regions, refused to sweep them into a single flat "international" layer. It built named sub-clusters instead, grouping LATAM, MENA and the Gulf countries, South Asia, Central and Eastern Europe, and Oceania. The pipeline was globally dispersed, and these sub-regions carried a growing share of trial sites, but their regulatory and reimbursement realities varied too much to harmonize with the largest markets. Rather than stretch a global team that could not reach every downstream market, the structure empowered leading local markets to guide their neighbors.

Earlier regional and local input. A third changed the timing of each region's involvement, gathering localized input ahead of key program governance milestones rather than after them. Local pathway realities helped shape global development strategy while they could still adjust course, and the markets that would eventually execute against those decisions had a voice in making them.

Dividing HTA and non-HTA Europe. A fourth split its European coverage along HTA lines, organizing around the EMA/EU-HTAR pathway separately from its non-HTA markets. With a pipeline aimed at large, broad-based patient populations and a shared EU-HTAR framework to work within, the split let the company plan more decisively around EU optimization without diluting that focus across markets that did not share the pathway.

In every case, the design was only the beginning. What separates a model that works from one that fails is whether the organization can actually use it.

The work that makes a model real

A Global-Local model becomes meaningful only when people change how they work around it. New reporting lines are easy to announce. The harder work is resetting decision rights, information flows, processes, and expectations so the organization operates according to the new structure rather than the old habits underneath it. A model that is announced but never adopted turns into a scapegoat. This is where the distance between thinking and doing is widest, and where most strategic transformations lose momentum.

This is the work we do. Acquis partners with emerging and established life sciences companies to build operating models grounded in the realities and ambitions of the portfolio, then carry them through the change management that makes them real. That is Think+Do in practice: strategy and execution as one continuous commitment, and a model that works on paper and in practice, with the flexibility to evolve as the business does.

Connect with us to learn more.