You’ve done the research. You know what needs to change. You’ve built the business case and prepared your arguments. You’ve done the prep, but you’re not getting traction. The senior leaders aren’t moving, and the harder you push, the more resistance you meet.

This is one of the most common frustrations I hear from life sciences professionals, particularly those in expert functions such as market access, regulatory affairs, or medical affairs. The influence you need can far outweigh the authority you hold.

The Problem

In large pharmaceutical and biotech companies, real change rarely starts with the person who identifies the problem. It starts with the people who have the power to act on it. And those people (franchise heads, clinical development leaders, executive committee members) are busy, sceptical, and already satisfied that the current approach is working, at least well enough. As the proverbial saying goes, they’re deep in the trees and can’t see the wood.

When someone in a technical or expert function tries to shift their thinking, the message gets dismissed. Not because the argument is wrong, but because the messenger doesn’t carry enough weight. Most experts respond by pushing harder: more data, more presentations, more persistence. That usually makes things worse, because it confirms the very box they’ve already been placed in.

Alexandre Jouyeux found a better way. Now Chief Operating Officer (COO) and President of FatiAbGen International GmbH, Alexandre spent years leading global patient access and market access functions at Novartis and Merck KGaA.

His career began with an early gamble: fresh from his PhD and struggling to find work, he borrowed money from his girlfriend to attend an exclusive biotech conference in Quebec City, walked into a room full of Canadian CEOs, and left with his first job offer. It was a move that taught him something he has carried ever since.

“You need to be aware of where others aren’t… You have to be a bit bold, because otherwise you get lost in the mass of very good people, because there are very good people everywhere.”
— Alexandre Jouyeux

Early in his career, he was handed an enterprise-wide challenge with no team, no authority, and a lot of resistance from people far senior to him. What he did next taught him something he’s carried through every leadership role since.

“Trust allows us to build bridges, and bridges [allow us to] create shared success.”
— Alexandre Jouyeux

The question he had to answer was: how do you build that bridge before the trust exists?

The Solution

Step 1: Accept That Your Voice Has Limits

The first thing Alexandre did was something most experts resist: he accepted that he was the wrong messenger.

Early in his career, he had been tasked with integrating market access considerations into clinical development much earlier in the drug lifecycle. The logic was clear. The data supported it. But the resistance from senior clinical and commercial leaders was significant, and no amount of internal advocacy was moving things forward.

“I realised that my voice wasn’t going to be sufficient to change things.”
— Alexandre Jouyeux

For many experts in large life sciences organisations, this is a hard pill to swallow. Your credibility within the business can actually work against you. Senior leaders have heard your arguments before. They know your perspective, they’ve ringfenced you, and they’ve moved on. When you accept this, you stop trying to persuade people with more evidence. You start asking a different question: whose voice would move them?

For Alexandre, the answer was clear. As he put it, “I thought, if I don’t have authority, who does? And it’s the customer in the end.”

Step 2: Design an Event Around the Right External Voices

Once Alexandre identified that external voices would carry more weight than his own, he built something  designed to let those voices do the work for him.

He organised a workshop and filled the room with the company’s most senior leaders: heads of clinical development, commercial leads, and executives, up to the CEO level. Then he brought in three external payers: one from the United States, one from Europe, and one with a broader international remit.

“I had zero authority over any of them, but I invited three payers… and I told the payers to discuss it in front of the audience, and they basically trashed the target product profiles.”
— Alexandre Jouyeux

He had handed out anonymised target product profiles for drugs already in the company’s pipeline, products the audience would recognise but stripped of any identifying information. Then he stepped back and let them speak. The payers were direct. They openly critiqued the profiles in front of the entire room, explaining exactly why those products would struggle with reimbursement.

This wasn’t a gamble. Alexandre had done the groundwork.

“It was a calculated risk. In my interviews, I had seen that some people were really open to the change and some people were very resistant to it.”
— Alexandre Jouyeux

Because the feedback came from the people who would ultimately decide whether those drugs got reimbursed, nobody in the room could dismiss it. The same argument, politely ignored by a market access director, landed very differently when it came from a US payer sitting three metres away.

This approach works across life sciences organisations wherever there is a gap between what insiders believe and what customers want and need. Whether it’s a patient advocacy group, a key opinion leader (KOL), a regulator, or a payer, the right external voice can move an audience that your own voice cannot.

Step 3: Come With the Solution, Not Just the Discomfort

This is where many change-makers stop short. They create the moment of discomfort (the realisation that something is wrong) but leave the audience with nowhere to go. Alexandre did not make that mistake.

The workshop was designed with a clear goal. As soon as the payers had made the problem real, Alexandre was ready with a clear proposal for how the company could fix it.

“I had the solution ready. I had the proposal for how to go forward. But they needed to hear it from the external audience.”
— Alexandre Jouyeux

Getting the order right matters. If you arrive with the solution before the room feels the problem, people defend the status quo. If you create the problem without offering a path forward, people feel stuck. Showing the gap first, then presenting a clear proposal, is what gives internal advocacy its best chance of landing.

Alexandre described the broader principle this way:

“If I could find a way to fully communicate the vision… not only the solution, but also the problem, the problem statement… I could influence without authority. And for me, that’s leadership.”
— Alexandre Jouyeux

This is a model any life sciences leader can apply, whether you’re trying to shift how your organisation approaches early clinical development, change how a cross-functional team works together, or make the case for a new commercial approach ahead of a launch.

It also requires a certain kind of confidence:  the confidence to step back and let the right voices carry the argument.

“You need to be aware of where others aren’t… You have to be a bit bold, because otherwise you get lost in the mass of very good people, because there are very good people everywhere.”
— Alexandre Jouyeux

The Evidence

The impact was swift. Following the workshop, the company overhauled the criteria it used to advance drugs through phase gate reviews, embedding market access considerations much earlier in clinical development. What had been treated as a technical function’s concern became an enterprise-wide priority. A single workshop, run by someone with no formal authority over anyone in the room, changed how the organisation developed medicines.

What made it stick was the source of the pressure. The senior leaders in that room didn’t change their minds because an internal colleague made a compelling argument. They changed because the people who control reimbursement budgets told them directly that their pipeline wasn’t good enough. That’s a different kind of persuasion, and it’s very difficult to dismiss.

Alexandre has applied the same principle at every stage of his career. When he decided to move from large pharma into biotech building, he didn’t wait for the right opportunity to appear. He went to conferences, identified the CEOs he wanted to meet, and put himself in rooms where the right conversations could happen. The approach that got him his first job offer at 27, borrowing money to attend a conference full of Canadian CEOs, turned out to be the same approach that shaped his entire leadership philosophy. Build the bridge first. Let the right voices do the work. Come with the solution ready.

Your Next Move

If you’re trying to drive change in your organisation but hitting a wall, ask yourself three questions before your next attempt:

1. Am I the right messenger? If you’ve already made this argument internally and it hasn’t landed, your credibility in this area may be working against you. Think about who the decision-makers in the room would actually listen to. A payer, a patient advocate, a regulator, or an external partner can often move people that you cannot.
2. Have I made the problem real? Data tells people there is a problem. The right external voice makes them feel it. Before you present your solution, think about how you can design an experience that closes the gap between what your organisation believes and what the outside world is telling you.
3. Do I have the solution ready? Creating discomfort without offering a path forward leaves people stuck and unlikely to act. If you’re engineering a moment of clarity, come prepared with a concrete proposal for what happens next.
4. Am I putting myself in the right rooms? Alexandre’s career, from that first borrowed conference fee to landing a role with a Korean biotech CEO, was built on showing up where others weren’t. If the conversations you need aren’t happening inside your organisation, think about where they are happening and whether you’re there.

Alexandre Joyeux’s full conversation on the Active Ingredients podcast explores further topics including how to hire for potential rather than experience, why diverse teams outperform homogeneous ones, and how international career moves shape leadership capabilities