As life sciences organizations expand into rare and ultra-rare disease markets, traditional approaches to sales quota management are proving insufficient. Unlike large, established therapy areas, rare-disease launches operate in highly complex environments marked by small patient populations, diagnostic delays, and cross-functional dependencies. In this context, setting the right sales goals is not about forecasting numbers alone, it becomes a strategic lever for shaping behavior, aligning teams, and signaling what truly matters.

This blog, a joint perspective from Indegene and Aurochs Solutions, explores why commercial teams must anchor sales goals in clinical and operational reality. Here, we unpack how quota-setting can evolve into a forward-looking strategy for rare disease markets.

Why traditional sales quota management falls short in rare disease markets

Rare diseases are a growing focus for the life sciences industry. In 2024, over 52% of FDA approvals were for orphan drugs, yet only about 5% of 10,000+ identified rare conditions have approved therapies 1,2. When treatments do reach market, they serve highly fragmented populations, often fewer than 25 eligible patients per territory. Diagnosis can take 4–5 years on average3 making identification more complex than prescribing.

In this environment, conventional sales quota planning models built on volume, past sales, or uniform growth break down. Sales quotas must reflect market readiness, incentivize patient-finding behavior, and recognize collaborative access work. Without that, they risk demotivating your teams.

These challenges show why sales quota planning must be rethought for rare diseases. Quotas need to reflect the complexity of the patient journey, changing access conditions, and the reality of working with very few but high-value patients.

The VALID framework: A better way to set sales quotas in rare diseases

Traditional quota models overlook what truly drives success in rare diseases, i.e. educating providers, identifying patients, navigating access, and working across teams. That’s why we collaboratively developed the VALID (Vet-Affirm-Leverage-Iterate-Disseminate) framework, a step-by-step approach to building smarter, fairer, and more flexible quotas.

Each step helps commercial teams plan and adjust sales goals based on real patient opportunity, field feedback, market changes, and team contributions.

Vet: Start at the patient level

Use predictive analytics to uncover where future patients may be diagnosed. This means going beyond past script trends and using data such as:

• Newborn screening coverage by geography
• EMR phenotypes and claims signals (to identify undiagnosed but probable cases)
• Diagnostic test volume trends (to understand regional diagnostic readiness)

Affirm: Ground numbers in field intel

Even the best AI models need to be refined with real-world, contextual inputs. Gather insights from:

• Rep and MSL feedback on HCP behavior
• Awareness gaps or referral patterns
• Operational gaps such as closed labs or regional payer restrictions

Leverage: Simulate before you deploy

Use sales quota management sandboxes or simulation engines to test how changes in the market might affect achievability. Model scenarios like:

• Label expansions, payer access changes, or step-edit policy removal
• Site-of-care shifts or newborn screening mandates
• Sudden eligibility changes post-hub launch

Iterate: Update with each trigger

Quotas should be updated when major events occur. Set event-based recalibration rules for:

• FDA or EMA label updates
• New diagnostic codes or screening grants
• Changes in formulary status or prior-authorization requirements

Disseminate: Share the “why” across roles

Reps perform better when they understand how their sales quotas are built. Transparency builds trust. Ensure:

• The data inputs (screening rates, access barriers, etc.) used in quota models are clearly communicated
• Reps have access to dashboards that show live progress
• Credit is shared with Access, Reimbursement, MSLs, and Patient Services

Is your sales quota management model ready for the realities of rare disease market?

Designing quotas in rare-disease markets is not about guiding your field teams through a complex and high-stakes journey where each patient, provider, and approval can change the path to success. Before you finalize your sales quota model, ask yourself the following questions.

Rare disease quota readiness checklist for commercial leaders

If you answer “No” to three or more questions, your current quota model may not be built for rare-disease conditions. Here’s what commercial leaders need to assess and adjust.

Do your quotas reward patient-finding work, and not just filled scripts?

In rare diseases, reps spend significant time on education, screening, and referrals before a diagnosis. Quotas that focus only on prescriptions ignore a large part of their effort.

Solution

Include KPIs for diagnostic activities like test orders, site activations, and HCP education to recognize pre-diagnosis work.

Can you simulate the impact of label changes and payer shifts?

Policy changes and access updates can quickly make static quotas obsolete. If you can’t adjust in time, you risk quota misalignment.

Solution

Use simulation tools to model scenarios and reallocate sales quotas before changes hit the market.

Does every rep see the “Why” behind their number on day 1?

Transparency improves buy-in. Reps are more engaged when they understand how patient volume, screening rates, and access dynamics shape their quota.

Solution

Deploy dashboards with drilldown view that clearly explains the inputs and logic behind each territory’s target.

Are cross-functional milestones (Access, MSL, Patient Services) present in the sales quota management methodology?

In rare diseases, the path to treatment involves multiple functions. Ignoring this creates silos and undermines collaboration.

Is there an event-triggered quota review tied to payer or regulatory shocks?

Once-a-year quota setting can’t keep pace with how fast rare-disease markets evolve.

Solution

Build logic for auto-adjustments triggered by major market events—like label expansions or payer coverage changes.

The way forward for sales quota management

Sales quota management shapes how field teams prioritize, where they focus, and what actions they take. When built around clinical realities and access challenges, quotas can drive the right outcomes like patient identification, timely diagnosis, and coordinated access work. But when it misses these factors, it misguides effort, lowers morale, and risks delaying treatment. Undoubtedly, the message behind every quota matters. Make it clear and make it count.

References

1. U.S. Food and Drug Administration. Novel Drug Approvals for 2024 [Internet]. Silver Spring (MD): FDA; 2025. Available from: https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2024

2. Genomics Education Programme. The diagnostic odyssey in rare disease [Internet]. Health Education England; 2023. Available from: https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/the-diagnostic-odyssey-in-rare-disease/

3. United States Government Accountability Office. Rare Diseases: Federal Actions Are Needed to Help Facilitate Timely Diagnoses [Internet]. Washington (DC): GAO; 2025. Report No.: GAO-25-106774. Available from: https://www.gao.gov/products/gao-25-106774