Stop Buying Hours. Start Buying a Mandate.

The fractional model has grown up fast. The pool of fractional executives doubled from roughly 60,000 in 2022 to 120,000 in 2024, and 72% of CEOs plan to increase their use of fractional leaders in the next year. Life sciences is part of the shift. Search firms now describe fractional CMOs, CFOs and COOs as a core operating model, not a stopgap.

The timing is not an accident. Pharma faces a $300B+ loss-of-exclusivity wave through the end of the decade, and a traditional executive search still takes six (6) to twelve (12) months. Brand teams cannot wait three quarters for thinking they need this quarter.

The demand question is settled. The real question is how that leadership gets bought.

THE OLD WAY: BUYING A SLICE OF A CALENDAR

Most fractional arrangements are still priced on time. One to three days a week. A percentage of a full-time salary. That creates three problems. It rewards activity over impact. It caps the thinking at the hours purchased. And it treats an outside expert as a scaled-down employee instead of a source of outside perspective.

WHAT CHANGED: EXPERTISE PLUS AI

The problems on a commercial leader's desk today are narrow and deep: a direct-to-patient program that launched but never scaled, an omnichannel plan that cannot prove impact, an AI roadmap with no owner. A generalist on a three-day week learns on your dime. A subject matter expert starts with the pattern.

AI widens that gap. A senior expert who uses AI well compresses weeks of analysis into days, which delivers three things clients want: faster decisions, insight that arrives with action attached, and sharper judgment instead of more output. The senior hour is worth more than it was two years ago, and fewer of them are needed. Billing by the hour punishes that efficiency.

WHY NOT AN AGENCY OR A TRADITIONAL CONSULTANCY?

Agencies and consultancies do important work, and I have spent much of my career inside them. But three structural issues follow them.

Incentives: agencies earn on scope and media, consultancies on team size, and neither is paid to tell you to do less.

Continuity: North American agency turnover averaged 18% in 2024, against 13% across all U.S. industries, so the team that learns your brand this year may not be there next year.

Execution: by McKinsey's own count, roughly 70% of transformations fail. The recommendation is rarely the problem. The firm leaves when the deck is delivered, and no one stays accountable for making it work.