On the 12th Day of Christmas in Discover Pharma’s industry outlook series, Ledger Run and AcuityMD said 2026 will be defined by practical AI adoption that reshapes how clinical trials operate and how MedTech companies prove value to healthcare systems.

The predictions form part of a wonderful end-of-year roundup and reflect the companies’ views on where operational, commercial, and site-level pressure points are converging, rather than new clinical or regulatory announcements.

For Ledger Run, the focus is firmly on clinical trial operations, where inefficiencies in contracting, budgeting, and payments continue to delay study startup and strain site relationships.

John Chinnici, CEO of Ledger Run, said AI is now positioned to deliver measurable impact in areas that have long resisted automation.

Chinnici said: “AI will make a measurable dent in clinical trial inefficiency, particularly in study startup timelines.”

He said administrative bottlenecks across contracting, budgeting, and payment processing have slowed trials for decades, despite advances elsewhere in clinical research. According to Chinnici, AI-driven automation in these areas will begin to demonstrate clear returns.

“By targeting the administrative bottlenecks that have plagued clinical trials for decades including contracting, budgeting, and payment processing, AI will begin to demonstrate return on investments and accelerate trials significantly,” he said.

Ledger Run estimates that AI could reduce study startup timelines by 15–20% on average, delivering meaningful cost savings per global trial. Chinnici said the value of AI does not depend on scientific discovery alone.

“AI has proven it doesn’t need to design the next blockbuster molecule to transform the business of clinical research,” he said, adding that smarter operations would allow research teams to refocus on sites and patients.

Kevin Williams, EVP and chief strategy officer at Ledger Run, said 2026 will bring renewed attention to the needs of investigative sites, as sponsors and CROs compete for capacity.

Williams said: “Next year will finally be the year of the site.”

He said sponsors are reassessing sourcing models and engagement strategies but warned that many sites remain sceptical of tools that add complexity rather than reduce workload. Williams pointed to data showing growing strain at site level and said future progress depends on technologies that streamline operations without disrupting daily workflows.

“The next wave of advancement will leverage technologies like AI to streamline operations and enhance visibility without disrupting the natural flow of daily site activities,” he added.

While Ledger Run’s outlook centres on clinical trials, AcuityMD expects parallel change across MedTech commercial and market access strategies.

Mike Monovoukas, CEO and co-founder of AcuityMD, said AI will increasingly shape how MedTech companies demonstrate both clinical and financial value.

Monovoukas said: “Next year, AI will redefine how MedTech proves value to healthcare systems.”

He said AI-driven analytics will allow companies to quantify treatment impact on demand, reducing reliance on retrospective studies and enabling faster alignment with clinical and financial decision-makers.

“Rather than relying on retrospective studies or data, AI-driven models will provide evidence on demand,” he said, adding that transparency and measurable outcomes will become competitive differentiators.

Alex Wakefield, chief revenue officer at AcuityMD, said commercial teams are already shifting away from static planning models, a trend he expects to accelerate in 2026.

Wakefield said: “Commercial teams will operate like technology companies.”

He said increased funding pressure and market volatility will force MedTech organisations to reallocate resources more frequently, using real-time data rather than annual plans.

“In 2026, MedTech commercial teams will stop relying on the annual plan to tell them where to go next,” Wakefield added, describing shorter feedback loops and more decisions driven from the field.

Together, Ledger Run and AcuityMD said AI-driven operational and commercial change will favour organisations that prioritise execution, visibility, and adaptability over complexity, setting the pace for the next phase of life sciences transformation.