Wrong on Timing, Right on Direction

Forecasting under asymmetry in pharma

Fifteen years ago, I wrote a piece called I Was Wrong.

Back in 2011, tired of hearing that the blockbuster era was over, I made a public bet that there would be more products with annual sales above $5 billion in 2015 than there had been in 2010. I lost. The numbers went the other way - 12 rather than 15.

That mattered. The small-molecule loss-of-exclusivity wave hit hard, and for a while the pessimists looked right. The industry was moving towards specialty and orphan drugs, with narrower populations and, in many cases, narrower peaks. If you drew a straight line forward from that moment, the blockbuster looked like a fading model. (I’m an optimist (a rational optimist, in the Matt Ridley sense…), so I rarely accept pessimism.)

But that was the problem: it was a straight line. (I posted on X yesterday about how McKonsultancies keep drawing straight lines through heterogeneous noise…)

From the vantage point of 2025 and 2026, the blockbuster did not disappear. It changed shape. In some ways, it became more extreme. We now live in a world of mega-blockbusters - products and franchises capable of sustaining revenue on a scale that would once have looked exceptional even by pharma standards.

That matters not just as a market observation, but as a forecasting lesson.

Most forecasting in this industry still carries an implicit symmetry. We take current conditions, add some reasonable assumptions, and project forwards as if change will arrive in orderly increments. But the reality is more lumpy than that. Most things disappoint. A few things compound far beyond what seemed plausible at the outset. The winners are not always the ones that looked most obvious early on, and the path from modest signal to dominant franchise is rarely linear.

GLP-1s are the clearest recent example. It is easy now to talk about obesity and metabolic disease as though the scale of the opportunity was always self-evident. It was not. What mattered was not simply having the asset. It was being willing to explore broadly enough, and think expansively enough, to see what else might be there. The same pattern shows up repeatedly in pharma: value is often visible before it is fully recognised.

That is why I find the blockbuster question interesting again. The real error 15 years ago was not just a bad sales forecast. It was a framing error. Too many people assumed that because the old blockbuster model was under pressure, large-scale winners would become rarer or less important. In practice, the industry was moving towards a different form of concentration, not away from it.

That should make us a little more careful about how we forecast now.

Forecasting under asymmetry does not mean abandoning models or becoming romantic about uncertainty. It means recognising that returns are uneven, that optionality matters, and that short-term disappointment does not always invalidate the larger thesis. It means building portfolios that can survive many misses in order to capture a few outsized wins. It also means being suspicious of tidy narratives, especially when they are based too heavily on the recent past.

A great deal of industry thinking remains overly linear in exactly this way. We overweight what has just happened. We underweight the possibility that a platform, mechanism, or disease area may expand into something much larger than first assumed. And we are still too quick to confuse a changing form with a dying model.

I was wrong on the 2015 outcome. I do not think the larger instinct was wrong.

The blockbuster era did not end. It evolved. And being wrong early is not the same as being wrong overall.