Purpose This paper develops a systemic framework for investment decision-making in pharmaceutical and biotech companies, addressing growing complexity driven by regulatory uncertainty, technological disruption, and evolving market needs. It seeks to move beyond traditional, fragmented approaches toward more integrated and viable innovation strategies. Design/methodology/approach The study adopts a systemic perspective that combines risk management, strategic partnerships and technological enablers such as artificial intelligence and predictive analytics. Drawing on case studies from AstraZeneca and Eli Lilly, as well as on notable failures such as Pfizer's torcetrapib and repeated setbacks in Alzheimer's research, the analysis illustrates how systemic approaches enhance portfolio resilience and decision quality through cross-functional governance. Findings The findings demonstrate that a systemic model built around four interrelated pillars – scientific merit, regulatory feasibility, commercial viability and competitive positioning – supports better risk-adjusted decisions and stronger alignment between R&D, financial, and strategic functions. By integrating these dimensions, organizations can improve the robustness of their investment portfolios and foster long-term innovation capability. Originality/value This study contributes a novel conceptual and practical framework that links strategic intelligence, technological tools and governance mechanisms in the investment decision-making process. It offers actionable insights for managers, investors, and policymakers seeking to align capital allocation with sustainable innovation. By adopting systemic approaches, pharmaceutical and biotech firms can transition from reactive, fragmented decision-making toward proactive, evidence-based strategies that optimize risk-adjusted returns and accelerate the delivery of transformative therapies.
Cosenz et al. (Thu,) studied this question.