How Pharma can accelerate performance post-restructure. Pitfall #1: Avoiding the “Tangled Red Thread”

Why Pharma organisations struggle to perform and transform

For Pharmaceutical organisations, unlocking a new level of performance through restructure is a strategic priority.  With patent cliffs, intensified competition, evolving commercial models, and digital disruption reshaping the landscape, organisations are under pressure to perform and transform simultaneously — with little room for error.

At Rubica, we’ve supported numerous clients through restructures and transformation programmes, and observed 6 recurring pharma transformation pitfalls that have a major impact on the speed and magnitude of desired performance improvements.

One recurring challenge we see is a disconnect between strategic intent and strategy execution — what we refer to as the “Tangled Red Thread”.

What is the “Red Thread” in Pharma transformation and why does it get tangled?

The “red thread” refers to the clear line of sight between strategic goals, performance metrics, and the ways of working required to achieve them. When this thread becomes tangled, teams lose clarity. They’re busy, projects are multiplying, but impact is unclear. Leaders debate what success looks like, while teams ask for direction despite new structures and roles.

This misalignment often stems from a common assumption: that organisational design operating models alone create clarity. In reality, redrawing org charts and redefining accountabilities doesn’t automatically translate strategic goals into meaningful strategy execution.

Without a shared understanding of what “performance” means in the new context, vague terms like growth, efficiency, or innovation are interpreted differently across teams. This leads to fragmented efforts, diluted impact, and missed opportunities — especially in high-stakes environments where performance dips are not tolerated.

How to reconnect strategy and execution

To drive real performance improvement post-restructure, pharma organisations must:

• Define a common language of performance: Identify 3–5 core outcomes that matter most and clarify what success looks and feels like for each.
• Make strategy actionable: Use tools like the Lean X-matrix to connect every workstream and KPIs back to strategic outcomes.
• Adopt a robust measurement methodology: Frameworks like PuMP performance measurement to help build clarity and alignment around performance indicators.
• Test alignment through cross-functional dialogue: If teams can’t articulate the connection between their work and strategic goals in one sentence, it’s not clear enough.

Driving real results through clarity and focus

Restructuring alone won’t deliver results. Clarity, alignment, and execution are what turn strategic intent into measurable performance gains. Untangling the red thread is essential to unlocking the full potential of transformation efforts.