The Fractal Force Frequency — September 2026

Introduction

Welcome to the September edition of The Fractal Force Frequency. It's a special one.

You didn't hear from us in July and August. We took the summer off, like most of you, and absolutely enjoyed it. We also used these quieter weeks to rebuild and resharpen Fractal Force.

We've now been on the market for almost two years. In that time, we've grown, we've become more international, and we've added more clients, partners, and projects. While our operating model- a global plug-and-play network of senior experts and tech partners remains, our positioning has got sharper along the way, and so has what we offer. Today it covers three things: strategy, execution and products. We set the direction, we help you make it work in practice, and we build the tools and workflows your team can use without us. Effectively making them self-sufficient.

The new website and our refreshed branding show that. They're the next step in becoming a more professional, international consulting firm, backed by a network of senior experts and technology partners. Have a look at the new www.fractal-force.com and tell us what you think.

This edition brings our two latest articles, a reminder of our launch white paper, and three outside voices: ZS on AI, Christine Ong on KOLs, and Viseven on digital opinion leaders.

Different angles. Same thread: you can only act on what your foundations let you see.

1 | Our Latest Thinking

The Boardroom Illusion and The Non-Linear Lie

We published two articles since the June edition. Both start from the same problem. Much commercial planning rests on what's easy to see, not what matters.

The Non-Linear Lie is about journeys. An oncologist doesn't wake up and step neatly into your funnel. She ignores five emails, reads a paper at midnight, glances at a rep's leave-behind three weeks later, and only then changes her view. Only around 23% of HCPs complete the journeys pharma designs for them. The other 77% aren't disengaged. They just don't move in the order you planned. Two fixes work together. Group HCPs by clinical mindset, digital appetite and barrier to adoption, and re-score them as behaviour changes. Then measure the signal across a whole cohort, not the individual click. Medical Affairs needs this as much as Commercial does.

Read The Non-Linear Lie here →

The Boardroom Illusion is about measurement. Picture the quarterly review. Commercial shows 80,000 email opens, 3,000 landing page visits and a click-through rate up 12%. The room nods. Nobody can say whether a single doctor changed how they prescribe. A metric is a number. A KPI is a metric tied to a target that proves something shifted: an attitude, some knowledge, a clinical practice. Roughly 70% of digital transformation spend fails to deliver the return it promised, and that's rarely the technology. It's usually the measurement. The fix is to work backwards from the behaviour you need to change, and only then decide what to track.

Read The Boardroom Illusion here →

If you missed it over the summer, our white paper The Launch Decision Architecture now has a home on the new website. We compared forecasts with results for 50 recent launches. Fifteen were clear misses, and only two of those failed on the science. The other thirteen reached the market with good data and fell short on the foundations underneath. The paper shows how to design for that: what head office sets, what each country chooses, and how the model changes as the market moves.

Read The Launch Decision Architecture here →

2 | Worth Reading

The future of pharma marketing is human-led and AI-powered (ZS)

ZS starts from a point we'd agree with. AI is taking over much of the execution work that used to define pharma marketing: content, segmentation, campaign optimisation, reporting. ZS says its own client work shows agency spend down by 20% to 30% and content personalisation up by 50% to 60%. The question is what marketing does with the time and money that frees up.

The authors describe two futures. In the first, companies treat AI as a cost tool. Marketing gets faster, cheaper and more alike from one brand to the next, and patients get a more efficient version of the same fragmented system. In the second, marketing takes on a bigger job: finding the barriers that keep patients and HCPs from a good outcome, and owning their removal. The article points out that 29% of US patients never start the treatment they were prescribed. ZS also describes the marketer as an expedition leader, not a travel agent: someone who stays in the journey and keeps adjusting the route.

The part we'd underline is what they call convergence. If every company runs the same tools on the same data, everyone reaches the same insights and writes the same messages. One ZS client spent months on positioning and campaign content. Shortly before launch, a competitor rolled out an almost identical campaign, with the same insights and the same messages. ZS calls the result "efficient mediocrity at scale". They also offer a quick test. Pull six months of HCP-facing content and set aside the label claims. If a competitor could have produced more than half of it, you have an efficiency problem dressed up as strategy.

Here's what we'd add. Convergence is a foundations problem. The tool doesn't make you different. What you feed it does. Two companies can run the same AI and get different answers, if one has clean customer data of its own, segments that reflect how HCPs really behave, and measurement that shows whether behaviour changed. The other gets the answer everyone else gets. ZS also argues that marketing should own removing barriers. We agree, with one condition: the operating model must give marketing the authority and shared data to do it. Without that, it's a new job title with no power behind it. The AI is ready. The open question is whether the foundations are.

Read the full article here →

3 | Words That Stuck

"The KOL network is part of the market. It's not the market."

Christine Ong, PharmD wrote those words in a LinkedIn post that asks whether Field Medical teams have let the KOL map become a substitute for the market. She calls KOLs invaluable. Her point is that a KOL map shows the people who are easiest to see. Care in the real world is shaped by many others: diagnostics, care pathways, access and reimbursement, the site of care, treatment sequencing, patients and caregivers, and community clinicians.

Commercial teams have the same habit. Segments get built on specialty, hospital size and prescribing volume, because that's the data people have. The list looks precise, yet it only describes the part of the market that shows up in the data. Seeing more means changing what you collect and how you connect it. That's why data and segmentation are the first two pillars of our foundations model.

Her real question is whether the insights strategy is broad enough to notice what KOL conversations miss. That links to a point in our article above: The Non-Linear Lie. The signals behind scientific exchange, such as which topics trigger follow-up questions and where clinical uncertainty clusters, can be tracked across a cohort without scripting a single conversation. Without that, the KOL map stays the only map.

Read Christine's post here →

4 | Partner Spotlight

Viseven: reaching the clinicians who shape prescribing

Fractal Force works with a global network of senior experts and technology partners. When a client needs the thinking, we bring it. When they need specific platforms and tools, we bring in the right partner and run the work as one team. Viseven is one of those partners. Mark Watson joined their CEO, Nataliya Andreychuk for a webinar in April, and Viseven has now published an article in Fierce Pharma that's worth your time.

The article opens with a slow fact: new evidence takes about 17 years to become standard clinical practice. Meanwhile, it says, 61% of physicians regularly scan social media to see where science is heading, and 57% say it has changed their view of a medication. Direct access to HCPs has also fallen, from 60% to 45% in recent years. So digital opinion leaders (DOLs), clinicians with a large online following, now shape a lot of the conversation. The article says a single DOL with millions of followers can influence the prescribing decisions of thousands of HCPs.

The hard part is picking the right ones. Companies often confuse visibility with influence. The article suggests a simple check, the 5Rs: resume, resonance, relevance, reach and reliability. A high score is only part of it: teams should also check that the DOL fits local market goals and that a partnership is realistic. The article also says to set your rules before you search: your goal, your audience, your therapy area, your markets and your channels. Then give the people you work with approved, ready-to-use material, be open about why you're working together, and keep monitoring what they post and how their audience responds. Viseven's part is finding, validating, engaging and monitoring these voices, together with its ewizard tool, which organises approved claims by therapy area and links each one back to its approved source.

This is Christine's question in digital form. Who really shapes what HCPs think, and how do you know? The article quotes our co-founder Mark from the Pharma Talks podcast: "A brand plan and HCP personas are useful, but effective physician engagement depends on understanding what HCPs are thinking right now and what they need today. That is what a real conversation looks like." Seeing that takes the same foundations as everything else in this edition: data that shows who is relevant and not just visible, segments that show what each group needs, and measurement that tells you whether the conversation changed anything.

Read the full article here →

Help us shape the conversation.

We're still working on our white paper on measurement frameworks for HCP engagement. It moves beyond activity metrics to measure what actually matters, the same ground as The Boardroom Illusion. If you're a life sciences leader with a view on what impact should really mean, we'd like to include your voice. Maybe you've built a framework that works, maybe you've struggled with one that doesn't, or maybe you just have a strong opinion on what the industry gets wrong.

Your insight will shape the paper. We'll credit your name if you wish, and you'll get early access to the findings. Interested? Reach out at info@fractal-force.com or send Mark or me a LinkedIn message.

And do take a look around the new website. It brings together how we help, how we work, case studies and all our insights and white papers. It also has a free Foundations Macro Audit, which scores your foundations across our five pillars and shows where to start.

Visit the new website →

Until next month, keep building on foundations worth building on.