In a 2026ZS surveyof U.S. pharmaceutical chief digital and information officers (CDIOs), fewer than half reported measurable value from commercial AI efforts, citing fragmented data, unclear ownership, and limited change management as persistent barriers. Further, leaders on ZS’s CIO Advisory Council say they struggle to tie substantial CRM transformation investments to revenue gains. Repeatedly, executives tell us that digital initiatives fall short of expectations: improving execution but not strategy, increasing efficiency but without freeing capacity for higher-value work, showing strong adoption but limited business impact, and creating disconnected solutions that don’t fit with existing workflows. Despite deploying the latest systems, companies are realizing only a fraction of the benefit they hoped for.