Biopharma's costly blind spot: Exhausted minds, expensive mistakes

The biopharma industry prides itself on being a relentless engine of innovation, pouring billions into R&D to bring transformative therapies to life. We talk endlessly about molecules, platforms, valuations, and endpoints – the tangible assets of our scientific ambition. But beneath this obsession with innovation, our industry is quietly haemorrhaging something far more essential, and far less quantifiable: the very well-being and cognitive resilience of its leaders.

We rarely discuss what’s happening inside the people expected to carry these multi-billion-dollar ambitions forward. Burnout isn't just a personal issue anymore; it’s a strategic imperative. And it's costing us far more than we admit: in compromised agility, diminished decision quality, stifled creativity and, ultimately, in trust within our teams and with external partners.

The case for an industry reset: Running on fumes in a war zone

Even before the global health crisis, biopharma was a high-stakes, high-stress environment, where market access windows were narrow and R&D failures were common. The pandemic intensified this dramatically. What was once a competitive race became an all-out war: emergency approvals, unprecedented global vaccine logistics, non-stop clinical trial pivots, remote launches under immense pressure, and accelerated R&D timelines. The adrenaline fuelled three years of hyper-output – and then, without a collective pause, we just... kept going.

We normalised 16-hour days, even celebrated them. We lionised urgency above all else, creating a culture where sustained reflection was a luxury, not a strategic necessity. The consequences are now undeniable across the industry:

Accelerating C-level turnover: Executives, particularly those navigating complex global portfolios, are facing unprecedented pressures, leading to increased attrition at the very top. Replacing a C-suite leader isn't just costly; it disrupts strategic continuity, delays critical decisions, and impacts investor confidence.
Eroding mid-career talent retention: High-performing mid-career talent, crucial for pipeline execution and commercialisation, are quietly cracking under the weight. They are often the ones driving the day-to-day work, implementing complex strategies, and managing cross-functional tensions. Their departure creates a vacuum of institutional knowledge and critical skill sets.
Functions cracking under pressure: Entire functions critical to value creation – like global commercial, market access, and regulatory affairs – are showing strain. This isn't just about individual stress; it manifests as delayed market entries, suboptimal reimbursement negotiations, missed regulatory filings, and a lack of creative solutions for complex patient access challenges.
Compromised decision quality: We are still asking our leaders to make multi-billion-dollar pipeline decisions, navigate M&A landmines, anticipate exponential market shifts, and balance an increasingly complex web of stakeholder demands – all while running on fumes. This unsustainable pace undermines our ability to think clearly, to apply nuanced judgment, and to leverage the foresight needed for truly strategic choices.

It’s not sustainable. And worse – it’s actively undermining our ability to lead and innovate effectively in the exponential era.

What sabbaticals actually do: Data + lived experience for biopharma

Sabbaticals are not just extended vacations. They are intentional resets of the cognitive and emotional systems leaders rely on to make sound decisions, navigate ambiguity, and inspire teams. In a powerful article published in Harvard Business Review, DJ DiDonna examined the long-term impact of sabbaticals based on data from hundreds of professionals across industries. The findings offer critical insights for biopharma:

Values clarification (60%): In an industry increasingly focused on ESG (Environmental, Social, and Governance) and patient outcomes, 60% of leaders reported sabbaticals clarified their values. For biopharma, this means realigning individual purpose with the organisation's broader mission, fostering authentic leadership, and anchoring strategic decisions in shared societal impact.
Creativity & problem-solving breakthroughs (40%): Nearly half experienced breakthroughs in creativity and problem-solving. This isn't just about personal insight; for biopharma, this translates directly to novel R&D strategies, disruptive commercial models, creative market access solutions, and fresh approaches to intractable scientific challenges. It fosters the "computational imagination" needed to combine market fragments into new economic systems.
Energy & focus restoration (80%): Four out of five leaders returned with more energy and focus. For biopharma leaders managing global launches and complex portfolios, this means sustained endurance for long-game design, sharper pattern recognition, and renewed capacity for high-stakes negotiations.

Let’s be clear: a long weekend or a two-week PTO, while valuable, doesn’t cut it. Research consistently shows it takes nearly two months just to mentally and emotionally detach from the relentless rhythms of work. If you’re not gone long enough to forget your password, you probably haven’t truly disconnected enough to shift your mindset and gain true perspective.

I know this firsthand. Last year, after more than two decades of non-stop output in biopharma, I stepped away. No medical leave. No exit package. No safety net. Just a self-given sabbatical. Once the fog lifted, something profound happened: my decision-making lens sharpened. I saw patterns in the industry more clearly, identifying the cultural undertow that holds organisations back. I found the space to reimagine how I’d lead next – not just reactively execute what came next. One of the most powerful benefits? Rebuilding my relationship with time. I stopped measuring worth in deliverables and started evaluating impact through clarity. That shift alone fundamentally changed how I now approach high-stakes leadership.

Why this matters for biopharma: Sabbaticals as strategy accelerators

In biopharma, we often say, “Timing is everything” in drug development. But clarity is too. And clarity comes from space – mental , emotional, and strategic. Yet, our current culture rewards speed over sense-making. The executive mindset often defaults to execution over reflection. We chase velocity without asking: To what end? At what cost?

In reality:

A rested biopharma leader sees early megatrend signals faster, anticipating market shifts and emerging competition from outside our traditional view.
A restored biopharma team innovates with less friction, translating complex scientific breakthroughs into streamlined R&D pipelines and agile commercialisation models.
A recalibrated mind makes better trade-offs – especially when the data for multi-billion-dollar pipeline decisions is ambiguous, and the stakes of global market access are high.

Sabbaticals aren’t soft. They’re strategy accelerators. For functions like early pipeline strategy, portfolio governance, and business development – where pattern recognition, judgment, and the ability to "play the board" are everything – space to think isn’t a luxury. It’s a non-negotiable necessity for sustained exponential leadership.

From gimmick to governance: Institutionalising renewal in biopharma

Sabbaticals shouldn’t be acts of rebellion in biopharma. They should be part of how we design sustainable leadership pipelines and ensure our human capital is as robust as our scientific capital.

That means moving from exception to expectation. From guilt-ridden exits to institutionalised renewal. Some biopharma companies are beginning to shift, showing early signs of a positive trend:

Start-ups and VCs in biotech are quietly allowing founders to take brief structured sabbaticals post-Series B to preserve clarity heading into pivotal growth stages, recognising that founder clarity can make or break a company's next phase.
A few mid-cap biopharmas have experimented with “innovation sprints”, where senior leaders step back from operations for 30 days to focus on big-picture strategy and optionality planning, aiming to break the "legacy pull" of day-to-day execution.

These are steps in the right direction. But they’re still sporadic. And often stigmatised. Imagine the transformative impact if sabbaticals were:

Baked into succession plans for critical roles navigating complex clinical failures or large-scale M&A integration?
Normalised as onboarding prerequisites for new executives taking over high-burnout roles, like global launch leads or R&D portfolio heads, ensuring they start with peak clarity and resilience?
Tied to leadership development frameworks, alongside board training and M&A scenario planning, specifically for navigating exponential market shifts and the ambiguities of future value creation?
What if we treated human capital renewal as critical infrastructure – not an indulgence?

The cultural reckoning ahead: Leading with clarity

Here’s the quiet truth most of us in biopharma won’t say out loud:

The relentless pace we’re running isn’t making us better leaders. It’s making us faster executors of broken, linear systems designed for a past era. We need space to think. To feel. To examine. The science we work on demands rigour, reflection, and painstaking iterative development. Why should leadership, especially in an industry tasked with solving the unsolvable, be any different?

Sustainable pipelines demand sustainable people

Biopharma prides itself on solving the unsolvable. But maybe the real unsolved puzzle is us – how we work, how we lead, and how we build our organisations.

If we want sustainable pipelines, we absolutely need sustainable people. That means creating room for reflection. Investing in clarity. And designing careers with chapters of renewal, not just endless ladders of escalation.

Sabbaticals aren’t a threat to productivity. They’re a return to higher-order leadership. And it’s time biopharma takes them seriously.

About the author

A curious scientist, strategic thinker, and operational executor, Nausheen “Noshi” Khokhar-Billiouw is a biopharma growth expert who has dedicated over 25 years to scaling biopharma organisations and launching transformative therapies. Spanning 20+ assets and 10+ therapeutic areas across R&D, commercialisation, and global leadership, she delivers exceptional ROI while ensuring patients access life-changing treatments. Khokhar-Billiouw has built multi-billion-dollar franchises, secured #1 positions for blockbuster therapies, and achieved double-digit CAGR. Managing P&Ls from $300M to $4B, she drives top-line growth through portfolio strategy and clinical trial design and bottom-line efficiency via cost optimisation and organisational alignment. Khokhar-Billiouw builds high-performing teams, fostering innovation and trust while securing C-suite and investor support for bold strategies.