Pharma’s Biggest Missed AI Opportunity Is Living Evidence
This article was originally published by Anna Forsythe in Forbes on 29 January 2026. At this year’s J.P. Morgan Healthcare Conference, the largest healthcare investment symposium in the industry, it is no surprise that artificial intelligence featured prominently across a wide range of discussions from drug discovery, target identification and molecule design to clinical trial optimization and operational efficiency. AI applications are now fully embedded in each of these core pharmaceutical R&D strategies. What was far less visible, however, was the role AI could play in the systematic evaluation of scientific literature that underpins nearly every strategic, regulatory and reimbursement decision in modern pharma—or evidence generation. This omission is notable, in fact critical, at a time when AI-assisted evidence generation represents one of the industry’s most immediate and measurable opportunities for return on AI investment. Where AI Is Being Applied Today Current AI adoption in pharma tends to focus on highly visible areas closely associated with innovation, such as accelerating discovery timelines, improving trial execution and supporting internal productivity. These use cases already demonstrate long-term value and competitive differentiation. Still, the majority of high-stakes decisions in pharma do not hinge on discovery algorithms alone. Instead, they depend, as they have for decades, on structured assessments of existing evidence about disease burden and unmet need, historical endpoints and comparator performance, safety signals and evolving standards of care. These traditional assessments inform decisions ranging from trial design and asset valuation to regulatory strategy and pricing. Despite their importance, evidence workflows remain largely manual and highly fragmented. Navigating Using Outdated Maps A useful analogy is navigation. When trying to reach a destination, no one relies on an outdated static map (remember MapQuest?) printed years ago. Roads change, traffic patterns evolve and more efficient routes emerge constantly. Modern navigation relies on GPS systems that update continuously and reroute in real time. Pharma, however, still navigates critical decisions using static evidence reviews. Systematic Literature Reviews (SLRs), which have long been the gold standard for evidence synthesis, continue to be conducted as project-based exercises. This one-off approach is expensive and time-consuming, and the results are quickly outdated as new publications appear, guidelines are revised or new therapies enter the market. Once completed, these product-based exercises often live in disconnected siloes, requiring tweaking or partial reconstruction to support the next decision In a scientific environment that evolves daily, this reliance on static evidence is an increasingly poor and outdated solution, especially at a time when living, continuously updated maps offer a cost-effective solution. Increasing Regulatory And Reimbursement Pressure The limitations of static evidence are becoming more consequential as medical reimbursement systems evolve. In the United States, Medicare price negotiations are now in their third cycle under the Inflation Reduction Act. Medicare Part B drugs in oncology, for example, once largely insulated from pricing negotiations, are now fully in scope as of 2026. Manufacturers are expected to justify pricing not only based on evidence available at launch but also relative to new comparators and changing standards of care that continuously emerge over time. In Europe, the Joint Clinical Assessments (JCA), designed to create a unified, cross-national analysis of the efficacy of new drugs, raise needs and expectations further. Companies must consider all relevant comparators across all EU member states, address multiple subpopulations and present comprehensive, transparent evidence syntheses that can withstand scrutiny across multiple jurisdictions. In both settings, evidence is no longer assessed at a single point-in-time. At a time when regulatory and reimbursement demands are continuously being re-evaluated, conventional static snapshots struggle to keep pace with these demands as they evolve. The Cost Of Fragmentation Despite this pressure, evidence generation in pharma remains highly fragmented. Different functions (R&D, regulatory, health economics, market access, commercial) often commission their own literature reviews for similar questions. Reviews are modified, repeated and localized across regions, frequently by different external vendors and internal teams. Assumptions diverge. Institutional knowledge is lost. Redundancy accumulates. That redundancy is costly. A single high-quality SLR routinely costs six figures and takes months to complete. For global organizations with large portfolios, the cumulative cost of duplicated effort is substantial. More importantly, fragmented evidence increases the risk of inconsistency at moments when alignment matters most. Why General-Purpose AI Falls Short Generative AI tools like ChatGPT and chatbots are often cited as a solution. While useful for summarization or exploration, they are not designed to produce regulatory-grade evidence. Regulatory and reimbursement decisions require predefined methods, transparent inclusion criteria, traceable citations, reproducibility and alignment with established systematic review standards. Outputs must be auditable and defensible. General-purpose AI systems prioritize fluency over traceability and cannot replace structured evidence synthesis. In low-risk settings, speed may outweigh rigor. In regulated environments, rigor is non-negotiable. The Case For Living Evidence The alternative is a shift from static reviews to living evidence. A living evidence approach treats evidence as shared infrastructure rather than as a series of isolated projects. Evidence is continuously updated as new data emerges, centrally governed, and organized by indication, population, comparator and endpoint. Updates are incremental rather than repetitive, and changes are transparent. Functionally, this mirrors how GPS systems work: always current, responsive to new information and capable of supporting multiple routes and decisions from the same underlying map. Such an approach could support better decision-making across the product life cycle, reduce duplication and improve consistency under increasing regulatory and reimbursement scrutiny. Why The Shift Has Been Slow If the potential benefits are clear, why has adoption been limited? One reason is organizational structure. Evidence budgets are typically allocated by function, by brand and by project. Living evidence, by contrast, is shared longitudinally and is cross-functional. Adoption requires investment at an enterprise level rather than ownership by a single team. Living evidence is also, by its nature, less visible than discovery breakthroughs or novel technologies. Yet visibility and return are not the same. As AI continues to reshape pharma, the most impactful opportunities may lie not only in discovering new drugs faster, but in navigating the increasingly complex evidence landscape more intelligently. In an industry under growing pressure to
From Evidence To AI: Why The Future Of Oncology Decision Support Must Be Built On Living Evidence
This article was originally published in Forbes on 18 September 2025. How do oncologists decide which treatment to give their patients? It’s rarely an easy choice. Physicians must weigh multiple levels of information, such as the patient’s disease stage, genetic markers, previous therapies, overall health in general and even personal preferences. Then comes the quest for evidence. In order to validate the optimal way forward, oncologists need not only know what is effective, but also whether it is FDA-approved, guideline-adherent or available through a clinical trial. To find the best, most up-to-date information, that validation typically involves toggling between PubMed, society guidelines, journal notifications and conference summaries, and then rationalizing information that doesn’t always align. All of this is tedious and time-consuming. Time that most oncologists don’t have. In a high-volume clinic, a medical oncologist may see 30 to 50 patients in a day. But even with all of those time pressures, each and every decision should be made with the latest, most complete and scientifically valid evidence available. The stakes are high. With the mountain of new research and evidence published in oncology journals constantly expanding, evidence literally shifts by the day. Those shifts in evidence—the decisions between the right and wrong treatment—can be life or death. The Enduring Value Of Evidence Hierarchies Medicine has long recognized that not all evidence is created equal. A single case report may stimulate ideas, but it cannot guide practice. Observational studies provide associations but not certainty. Randomized controlled trials minimize bias and provide more insight. But at the very top of the hierarchy are systematic reviews and meta-analyses, which combine the entire weight of the evidence. This hierarchy matters because medicine is complicated. If we relied on anecdotes or headlines in isolation, patients would be subjected to treatments that look promising by themselves but prove ineffective or even counterproductive when considered in context. For this reason, organizations from the FDA to WHO mandate Systematic Literature Reviews (SLRs) when shaping guidelines, approvals and policies. Systematic reviews are the gold standard for evaluating medical evidence—the safety net for modern medicine. They prevent us from the risks of cherry-picking studies, overvaluing anecdotes or relying on unverified opinions. The Lure And Risk Of Chatbots Given the deluge of new medical information—and the tedium of just reading it all, let alone evaluating it—it’s no wonder that AI chatbots have captured attention. Faced with information overload, the idea of typing a quick question and receiving a fluent, confident paragraph or two is more than just appealing. It can be viewed as a lifeline for busy oncologists. But that’s where the danger lies. Chatbots don’t conduct systematic reviews. They can’t distinguish between high-quality trials and weak studies. They don’t verify whether a therapy is FDA-approved or buried in an outdated guideline. And in some cases, they even fabricate references, miss key data or rank that data inappropriately. Convenience can be seductive, but in oncology, where the margin for error is minute, the cost of error, or incomplete or inaccurate information, is disastrous. That convenience might be harmless if you’re asking Siri to find the nearest grocery store. But in cancer treatment, the right choice can extend life. The wrong choice can cut it short. Evidence Hierarchies Matter Everywhere The lesson extends well beyond oncology. In cardiology, guidelines for heart failure shift frequently. Missing an update could mean prescribing a less effective therapy. In infectious disease, choosing the wrong antibiotic fuels global resistance—making “tried and true” therapies less potent, and new approved therapies a better solution. Outside of medicine, the same principle holds true. Financial advisors trust portfolio strategies grounded in decades of cumulative analysis, not a single trader’s hunch. Aviation safety regulations are shaped by the aggregation of countless investigations, not anecdotal exceptions. Across industries, systematic, comprehensive evidence beats selective inputs every time. From Static Reviews To Living Evidence If chatbots aren’t the solution, then what is? The answer lies in bringing evidence hierarchies into the era of AI. Imagine a living systematic review in real-time, providing a comprehensive, up-to-date synthesis of the evidence—backed by AI and vetted by humans. Instead of replacing systematic reviews, AI in this new paradigm augments them. Algorithms filter through the sheer volume of new publications, screen for relevance, raise quality issues and update evidence maps in real time. And then experts evaluate the results before they reach the physician’s desktop. This model is rigorous yet addresses medicine’s biggest bottleneck—time. Doctors would no longer be forced to sort through hundreds of studies manually. Instead, they would access a dynamic, physician-ready summary rooted in the totality of evidence. AI does the heavy lifting of scanning and sorting, while human experts remain the arbiters of interpretation. A Human-AI Partnership This combination is the future that I am dedicated to and the foundation of the work that my team is producing. At Oncoscope, we don’t rely on generative AI to spin out answers. Instead, we use a suite of AI models to reproduce and accelerate the standardized steps of a systematic review. Think of it like a symphony. AI can tune the instruments, arrange the sheet music and keep the score updated in real time. But only the conductor—the oncologist—can interpret the music for the audience. This collaboration leverages each party’s strength: Machines are better at speed and repetition, while humans are better at judgment and context. The end product is evidence, both thorough and up-to-date, that doesn’t overwhelm the clinicians who need to implement it. Why Caution Matters Now The enthusiasm around AI in healthcare is understandable. Physicians are busy, patients are better informed than ever and the pace of discovery keeps accelerating. But in our rush to adopt new technology, we risk abandoning the very safeguards that make modern medicine safe. It would be unthinkable to prescribe chemotherapy based on a single press release, yet we risk doing something similar if we accept unverified chatbot outputs at face value. In oncology, where decisions can never be undone, shortcuts are dangerous. Archibald Cochrane, the father
Founder Spotlight: Anna Forsythe, PharmD — Bringing Clarity to the Chaotic and Rapid Data Influx in Oncology with Oncoscope AI
As seen in Oncologist Daily, ASCO 2025 Edition The pace of progress in oncology is both exhilarating and overwhelming. New clinical trials, biomarkers, FDA approvals, and updated guidelines appear almost daily, creating a deluge of information that even the most diligent oncologists struggle to absorb. For Anna Forsythe, who had lost two good friends to cancer — and who is trying to help a third with a difficult diagnosis — this was more than just a challenge. It was a call to action. As the founder of Oncoscope AI, Anna has set out to build what she calls “a GPS for oncology.” Much like a car navigation system that recalculates routes in real time based on constantly changing traffic patterns, Oncoscope AI continuously updates to reflect the latest evidence — synthesizing and collating research data, treatment guidelines and regulatory approvals into a single, streamlined view designed for oncologists to use in real time at the point of care. “Oncoscope doesn’t replace the physician’s judgment,” Forsythe explains. “It augments it — giving clinicians a clear, current, and unbiased and easy to use view of what’s changing in real time, so they can spend less time digging through papers and more time with their patients.” This balance of innovation and practicality reflects Anna’s own background. A clinically trained Doctor of Pharmacy, she holds a Master’s Degree in Health Economics and Policy from the University of Birmingham (UK) and an MBA from Columbia University. Her career spans both the clinical and strategic sides of the pharmaceutical industry — with leadership in both oncology and non-oncology roles roles in global value and access at Eisai Co., and earlier positions at Novartis and Bayer in clinical research and health economics. She’s no stranger to entrepreneurship either. Anna previously co-founded Purple Squirrel Economics, a health economics consultancy that was acquired by Cytel, the Cambridge, Massachusetts-based statistical software developer and contract research organization, in 2020. Her work has appeared in leading journals and conference podiums alike, including a top-ranked JAMA Pediatrics article, which placed in the top 5 percent of all JAMA research outputs worldwide. But it’s Oncoscope that brings her experiences full circle — combining clinical insight, economic acumen, and a passion for scalable solutions that work in real-world oncology settings. As thousands of oncologists gather at ASCO 2025 to digest the latest data and translate it into better care, Oncoscope AI offers a timely reminder that innovation doesn’t have to be overwhelming — if it’s built from the ground up with the physician in mind. “We’re not a technology in search of an application — and we’re not at all suggesting that oncologists change how they practice,” says Forsythe. “They are the experts. We are merely helping them by building a tool that fits seamlessly into their reality — one that helps them keep up with the latest information, and communicate the most up-to-date strategies clearly with patients. The goal is to help them stay focused on what matters most: delivering the best possible care.” With Oncoscope AI, Anna Forsythe is leading a new kind of precision oncology — one where evidence and empathy meet at the bedside, powered by smart, real-time technology. Anna Forsythe is the Founder and President of Oncoscope-AI, the first platform to bring together real-time oncology treatment data, clinical guidelines, research publications, and regulatory approvals — all in one place, just like Expedia for cancer care. Available free to oncology professionals worldwide, Oncoscope-AI is redefining how cancer care information is accessed and applied. A clinically trained Doctor of Pharmacy (PharmD), Anna also holds a Master’s in Health Economics and Policy from the University of Birmingham (UK) and an MBA from Columbia University. She previously co-founded Purple Squirrel Economics (acquired by Cytel in 2020) and led Global Value and Access at Eisai Pharmaceuticals, following earlier roles at Novartis and Bayer in clinical research and health economics.