The Patrick R. Coyle Library
Nearly twenty years of work on the space between a prescription and a positive outcome, organized the way the work actually runs. Learn it, align on it, then change it.
Updated September 2026
Learn. Align. Transform.
Learn, Align, Transform is the three-pathway model Patrick R. Coyle uses to close the gap between patient experience and reported revenue. Learn is executive education, Align is facilitated cross-functional work on a live launch, and Transform is strategic advisory.
Three pathways that close the gap between what happens to patients and what appears in the ledger. Take one, or take them in order.
The Two Sides of the Vinyl™
Build a shared understanding of commercialization through executive education. Eighteen sessions across Side A, Side B and The 12″ EP, in two delivery modes.
Alignment Labs™
Apply the concepts to your own launch. Four facilitated Labs where Commercial, Market Access, Patient Services and Finance take positions and name owners.
Strategic Advisory
Financial visibility, forecasting, Gross-to-Net strategy and organizational effectiveness, informed by intelligence that identifies the patient through a dynamic lens rather than a static data point.
The same journey, counted and priced
The 10 Exits of Therapy™ and the 5 Layers of GTN™ are two views of the same patient journey. The Exits count where patients leave therapy. The Layers show which function’s decisions priced that loss into Gross-to-Net.
One counts the patients. The other prices them. Every exit lands in a layer, and they do not distribute evenly.
Same journey, two coordinate systems. Four of the ten exits land in Affordability & Support, twice as many as any other layer, and it is the layer owned by a function that is not measured on Gross-to-Net.
The 10 Exits of Therapy™
Where people leave, and what each exit costs.
The 10 Exits of Therapy™ is a framework that maps the ten points between diagnosis and a sustained positive outcome where a patient can leave therapy, and assigns a cost to each.
The 5 Layers of GTN™
Which layer creates a number, and which only reports it.
The 5 Layers of GTN™ is a framework that organizes Gross-to-Net into five decision layers, Clinical and Product, Access and Policy, Channel and Distribution, Affordability and Support, and Financial and Reporting, and shows that only the first four create the number.
Product Lifecycle Phases
Product Lifecycle Phases is the four-phase commercialization model used across this site: Phase 1 Pre-Launch and Launch Readiness, Phase 2 Launch and Early Commercialization, Phase 3 In-Market Optimization, and Phase 4 Lifecycle and Loss of Exclusivity. Each phase has one question that is answerable at that point.
Most advisory work is sold by function, so the organizational chart becomes the taxonomy and you are asked which box your problem belongs in. The problem rarely sits in one box. This map is organized by where a product sits in its commercial life instead, and therefore by which question is actually answerable right now.
Pre-Launch and Launch Readiness
How should we build the commercialization system?
Everything is still a decision and almost nothing is measurable. The only phase where the system can be designed rather than corrected.
Launch and Early Commercialization
Is the access infrastructure performing as intended?
The architecture is running and there is data for the first time. It is thin, noisy, and easy to over-read.
In-Market Optimization
Where are patients and value being lost?
The most data and the least clarity about what it means. The leakage lives in the seams between well run partners rather than inside a failing one.
Lifecycle and Loss of Exclusivity
How should the system evolve to preserve value?
Treated as a pricing exercise, it is framed too narrowly. Loss of exclusivity is a commercialization transition.
Phase 1 is the Design track. Phases 2 to 4 are Re-Align.See how the two tracks run →
Use Cases and Field Guides
A Field Guide is a short, practical document that takes one piece of a finance or Gross-to-Net problem and turns it into use cases a team can run on its own. The two tracks are Financial Transformation and Financial Navigation.
Two problems come up more than any others. Below each one is what the work actually involves, and the Field Guides that take a single piece of it a level deeper into a set of use cases you can run yourself.
Financial Transformation
Turning a finance function from a reporting service into a strategic engine.
The symptoms are consistent. Data preparation eats most of the team’s time. Disconnected systems produce multiple versions of the truth. Forecast accuracy is poor enough to cost credibility with investors. Reporting explains what already happened and predicts nothing. And there is usually a history of digital initiatives that did not land.
The work is a technology roadmap, ERP and EPM implementation, process automation, data architecture and governance, change management, and team enablement, run in that order. Automating a process before redesigning it is the most common way these programs fail.
Who it is for: CFOs and COOs leading an organizational pivot, finance teams buried in manual reconciliation, organizations evaluating an ERP or EPM migration, and high-growth companies scaling operations.
Platforms deployed
Fourteen platforms across two years of a single finance transformation. Named rather than counted, so you can check the work.
Deployed under Patrick R. Coyle’s leadership as CFO of a global pharmaceutical company’s Americas organization, 2020 to 2022.
Field Guides in this track
Financial Navigation
CFO-level leadership for life sciences growth companies, without the full-time hire.
The presenting complaint is usually one of three. Gross-to-Net behaves like a black box, with volatility, forecast misses and surprise true-ups. The close is slow and the accruals are not defensible. Or Finance, Market Access and Commercial are each working from a different number and have stopped arguing about it.
The work covers Gross-to-Net strategy and methodology, forecasting and accruals, reconciliation and controls, pricing and access tradeoffs, systems architecture across Model N, SAP and EPM, and the board-facing side: runway, FP&A, and decision support.
Who it is for: CFOs, VPs of Finance and Controllers from pre-commercial through global scale, earlier-stage biotech CEOs who need the leadership without the hire, and revenue accounting, compliance and internal audit stakeholders.
Field Guides in this track
The Case Files
The Case Files are ten engagements from nearly twenty years of pharmaceutical finance and commercialization work, each recording the decision, the authority it was made under, what was built, and what it cost. None report performance figures.
Ten engagements across nearly twenty years, in the order they happened, which is also the order in which each one taught something. Each names the decision, the authority it was made under, what was built, and what it cost. No performance figures appear in any of them.
Can We Actually Find Them
A label narrower than the trial that supported it, and the question no forecast model asks.
Every Function Green, the Aggregate Red
A specialty product with acceptable coverage, underperforming its forecast, and a working explanation that was wrong.
The Leak I Built
I had constructed a Silent Leak™ inside my own finance organization, and I did not see it.
Questions this Library answers
What is Patients + Profitability™?
Patients + Profitability™ is the idea that patient outcomes and sustainable profitability are interdependent rather than opposing. Innovation creates possibility, access turns it into treatment, treatment creates the chance of an outcome, and sustainable economics let innovation continue. The patient journey and the economic journey are the same journey seen from opposite sides.
What is The Silent Leak™?
The Silent Leak™ is revenue lost to patient friction that no single function sees because each function’s own metrics look acceptable. The 10 Exits of Therapy™ is how it is measured.
What is the difference between The 10 Exits of Therapy™ and The 5 Layers of GTN™?
The Exits count the patient journey. The Layers price it. Every exit lands in a layer, and four of the ten land in Affordability and Support, a layer usually owned by a function that is not measured on Gross-to-Net.
What are Product Lifecycle Phases?
A four-phase model of a product’s commercial life: Pre-Launch and Launch Readiness, Launch and Early Commercialization, In-Market Optimization, and Lifecycle and Loss of Exclusivity. Phase 1 is the Design track. Phases 2 to 4 are Re-Align.
What is a Field Guide?
A short, practical document that takes one part of a finance or Gross-to-Net problem, such as close cycle automation, accrual design or true-up governance, and turns it into use cases a team can run without outside help.
Who is Patrick R. Coyle?
A strategic finance executive with nearly twenty years in life sciences across Bayer, Novartis, Insmed, Eisai, IQVIA and Baker Tilly, including service as CFO of a global pharmaceutical company’s Americas organization. He advises on Gross-to-Net strategy, patient access and financial transformation.
New work, as it publishes
Field Guides and case studies publish on the site first, then reach LinkedIn and Substack a day or two later. Subscribe and you see them first. No cadence promises, no filler.
Patrick R. Coyle
GTN Thought Leader & Commercialization Strategist
Patrick R. Coyle is a former pharmaceutical CFO and Gross-to-Net advisor whose work covers Bayer, Novartis, Insmed, Eisai, IQVIA and Baker Tilly. He is the author of the Patients + Profitability™ series and the creator of The 10 Exits of Therapy™.
Nearly twenty years across Bayer, Novartis, Insmed, Eisai, IQVIA and Baker Tilly, spent on both sides of the line between patient access and commercial performance. The through line is one idea: patient friction creates revenue leakage, and Gross-to-Net is the financial expression of the patient journey.