Pharmaceutical supply chains don’t usually fail because teams lack effort or systems lack sophistication. They fail when planning assumptions drift away from regulatory and manufacturing realities. Qualification timelines extend beyond forecast accuracy. Batch release variability disrupts availability assumptions. CDMO networks operate under different constraints than commercial teams expect. As complexity grows, organizations compensate with spreadsheets, buffers, and informal coordination. What appears as execution failure is often structural misalignment between governance, planning rhythms, and operational constraints. Stability in regulated environments does not come from more dashboards or tighter KPIs. It comes from making constraints explicit, clarifying decision ownership across functions, and ensuring systems reflect how work actually happens under FDA timelines and GMP requirements. Understanding where decisions break not just where metrics dip is what separates firefighting from predictable execution.