Three companies faced challenges commercializing new products in the US healthcare system: Company A scrapped a lab diagnostic project due to lack of differentiated clinical value and reimbursement approval. Company B's injectable biologic faced poor adoption due to label restricting administration and causing coverage under medical instead of pharmacy benefit with more hurdles. Company C helped increase utilization of its artificial disc replacement through an appeals program that collected patient quality of life data to submit personalized appeal packages on behalf of surgeons and patients, lowering administrative burden.