Key Takeaways
- Academic Centers of Excellence can influence diagnosis, referral, education, guidelines and adoption far beyond the patients they personally manage.
- Map referral networks early—community entry points often differ from where treatment decisions occur.
- Medical Affairs engagement with Centers of Excellence should begin before promotional launch activity.
- Rare disease commercialization is a network problem, not simply a territory coverage problem.
Rare disease markets are often defined not simply by patient numbers, but by where expertise is concentrated.
Academic Centers of Excellence can have a disproportionate influence on diagnosis, research, referral, physician education, treatment decisions, guidelines and adoption. Understanding this ecosystem can materially change commercialization strategy. See rare disease commercialization consulting.
Centers of Excellence Are Network Nodes, Not Just High-Volume Accounts
The commercial importance of a Center of Excellence may extend well beyond the number of patients treated directly within the institution.
Centers can influence:
- diagnosis
- referral patterns
- clinical trials
- treatment standards
- physician education
- specialist networks
- guideline development
- advocacy relationships
- adoption of new therapies
Commercial planning should therefore evaluate influence rather than simply patient volume.
Map the Referral Network
For many rare diseases, the physician who first sees the patient is not the physician who ultimately confirms the diagnosis or initiates treatment.
A useful commercialization model should understand:
- where patients first enter care;
- where diagnostic delays occur;
- what triggers referral;
- which specialists confirm diagnosis;
- where treatment decisions are made;
- whether patients return to community care or remain within specialist centers.
This network can materially affect field deployment, Medical Affairs strategy, patient identification and commercial organization design.
Commercial and Medical Roles Must Remain Distinct but Aligned
Medical Affairs frequently establishes scientific relationships with expert centers well before commercial launch activity begins.
Commercial planning should benefit from understanding the institutional landscape while maintaining appropriate functional responsibilities and compliance boundaries.
The objective is organizational alignment around the same market reality—not inappropriate overlap between Medical and Commercial responsibilities.
Related: rare disease commercialization, patient journey mapping, commercial market access strategy and first commercial launch.
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About Joseph McCoy
Joseph McCoy is Founder and Principal Consultant of PharmaKonsult and an executive commercial strategy advisor with more than three decades of pharmaceutical and biotechnology commercial leadership experience across neuroscience, rare disease, endocrinology, institutional healthcare and specialty pharmaceuticals.
