A Sales Plan Sits Inside a Commercial Plan

A sales plan sits inside a commercial plan

I had a wonderful conversation with Craig T. Ingram. He made a point that seems obvious once you hear it, and deserves more attention in MedTech launch planning.

“Do you have a commercial plan?”
“Yes, we have a sales plan.”

Craig described asking founders whether they have a commercial plan and hearing about their sales plan in response. That is my paraphrase of his framing.

A sales plan usually brings together a few target accounts, a quota, the first reps or distribution partners, and price assumptions. Those are useful decisions. They tell a team where to sell, through whom and toward what revenue target.

A commercial plan asks what has to happen for those accounts to buy, implement, use, pay and repeat. It brings the sales plan together with the other functions that make adoption possible. The work requires a strategy, different owners across the team and someone coordinating the decisions between them.

That is where the distinction becomes practical. A rep can identify interest while a hospital works through evidence review. A clinician can choose a product while the operating team prepares the workflow. A coverage policy can open a path while an individual patient’s authorization still needs attention. Each step carries its own owner and evidence.

The commercial plan makes those dependencies visible before they reach the revenue forecast.

Three milestones, three kinds of evidence

Recent company announcements show why a commercial plan needs a wider view. These cases illustrate different milestones. Each has its own commercial meaning.

CVRx: access, productivity and the outlook

In its August 6, 2026 results release, CVRx reported second-quarter revenue of $15.7 million, up approximately 16% from the prior-year quarter. It also reported 258 active U.S. implanting centers and 56 U.S. sales territories as of June 30. Humana’s Medicare Advantage coverage policy for Barostim had taken effect on May 1. [1]

In the same release, management explained its lower outlook through fewer sales territories than anticipated, lower sales-force productivity and a prolonged challenge with a large payer. Those are the company’s reported reasons. They connect field execution, payer access and the forecast in a single commercial picture. [1]

CVRx defines an active implanting center as a customer with at least one commercial heart-failure implant in the previous 12 months. That definition establishes a useful starting point for the account base. A launch team evaluating repeat use then needs a more detailed view: recent implants by center, referral conversion, authorization timing and productivity by territory. Those measures are proposed operating questions, distinct from the figures CVRx disclosed.

The lesson is about how a team reads evidence. Revenue growth, a coverage milestone and a larger account base can sit alongside execution problems. The operating review needs room for all of them.

Medtronic: a broader instrument set

On September 16, 2026, Medtronic announced FDA clearance of the LigaSure RAS Maryland jaw device for use with the Hugo robotic-assisted surgery system. The announcement described a broader instrument set for U.S. surgeons and identified Hugo’s U.S. clearance for urologic surgical procedures. It also described plans to expand indications. Those expansion plans remain forward-looking in this source. [2]

The milestone is instrument clearance. The commercial questions concern hospital readiness and use: which accounts have the system, which teams are prepared, which eligible cases enter the schedule and how often the instrument is used.

For a startup, the equivalent discipline is to connect a new capability to a specific account decision. A broader offering matters commercially when the account can put it into its workflow. Training, scheduling, service and the economics of use belong alongside the selling plan.

Corcym: the first implant

Corcym’s September 23, 2026 announcement reported the first-in-human implant of Memo 4D Curve at UVA Health University Medical Center. The announcement also stated that the ring was FDA cleared and commercially available in the United States. This is a company-reported first-use milestone. [3]

The FDA’s June 18 clearance letter records a substantial-equivalence determination for the device’s stated indications. That is the regulatory basis documented in the letter. Comparative superiority and repeated adoption require their own evidence. [4]

For a commercial team, the next questions concern approved accounts, trained surgeons, stocking and repeat cases. Those are proposed measures for following adoption. The announcement establishes the first implant; the next operating review must establish what follows it.

Together, these cases give a launch team three separate evidence labels: economic and field performance, product availability, and first use. Keeping the labels clear makes the plan more useful.

The ten workstreams

A commercial plan connects these workstreams around the same account journey. The purpose is to give each function a specific contribution and make the handoffs visible.

1. 01Beachhead buyer

   Define the first account type that can buy, implement, repeat and justify the product. Map the clinical user, economic buyer, budget owner, procurement gate and workflow owner. Select the first accounts against those conditions, then record why each belongs in the beachhead. A named list becomes useful when the team understands the path through each account.

2. 02Clinical evidence for committees

   Build the evidence around the decision an account must make. A clinical champion, value-analysis committee and payer can each need a different part of the evidence story. Separate the regulatory basis, clinical-use findings and economic case. Give every outstanding evidence request an owner and a decision it will support.

3. 03Pricing, contracting and reimbursement

   Map the path to paid use: contract terms, budget source, coding, coverage, authorization and the economics after support costs. The relevant question is whether the account, physician, payer and patient can move through the proposed arrangement. Track the terms and barriers encountered in real accounts, then update the plan as that evidence arrives.

4. 04Champion and system adoption

   A champion creates clinical interest and momentum. Institutional adoption also requires approval, funding, stocking, scheduling and operational readiness. Record what the champion can influence and identify the people responsible for the remaining gates. The account plan should show how clinical interest turns into a repeatable institutional pathway.

5. 05Account ownership

   Give someone responsibility for the account after its first win. Define who expands use, supports cases, handles reimbursement questions and escalates stalled decisions. For distributors, specify territory rules, field feedback and review criteria. Clear ownership lets the team turn account experience into decisions that improve the next account.

6. 06Procedure ramp

   Follow first use through second use and sustained use. For procedural products, examine cases by clinician and account, the time between cases and the share of eligible procedures where that information is available. For other products, use the equivalent repeat-use event. Each step should reveal the barrier holding back the next one.

7. 07Training and field enablement

   Name every role that needs preparation, from the physician and clinical team to billing staff and field support. Define what each role must be ready to do and how early use will be supported. Track training alongside activation and repeat use so the team can see where readiness translates into account progress.

8. 08Denial and exception handling

   Create a path for authorization denials, procurement delays, evidence requests, inventory shortages and workflow problems. Classify the issue, assign an owner and record the next action. Repeated exceptions should change the commercial plan, the account criteria or the support model. The team learns faster when an exception has a consistent route through the organization.

9. 09Cross-functional cadence

   Bring commercial, clinical, reimbursement, operations and finance into one decision rhythm. Review the account evidence, the current barrier and the tradeoff that needs a decision. Name a coordinator with authority to bring the relevant owners together. Each function keeps responsibility for its work; the coordinator keeps the dependencies moving.

10. 10Leading indicators

    Choose a small set of measures that shows movement through adoption. Qualified accounts, approval-stage progression, authorization timing, first and repeat use, unresolved barriers and account economics can all contribute. Use the measures that fit the product's actual buying and use pathway. Pair every metric with a decision the team can make when it changes.

Run a weekly review

The table below is a starting ownership model. Adjust roles to the team you have. In a lean company, one person may hold several roles; the workstreams still need separate evidence and decisions.

Add an evidence date, a next decision and a due date to each row in your working version. These fields turn a planning category into an operating responsibility.

Start the review with the account or patient pathway that is stuck. Identify its current gate. Put the responsible owners together and make the next decision: request evidence, change the account sequence, support a case, revise the access path or adjust the forecast.

Finish by recording what changed in the plan. A useful review leaves the team with a clearer account path and a decision someone owns.

Build the commercial plan around paid, repeated use

The sales plan remains an essential part of the commercial plan. It gives the team its accounts, selling motion and revenue ambition. The wider plan supplies the evidence, economics and operating work that make that ambition credible.

Pick one of your first accounts. Walk from interest through approval, implementation, first use, payment and repeat use. At each step, name the owner, the evidence and the next decision. The gaps you find become the next version of your commercial plan.

Which of these workstreams do commercial leaders own week to week, and which still fall between functions?

Sources and evidence scope

Public case evidence checked September 30, 2026. Case descriptions preserve each source’s reporting period. The ownership model and recommended measures are the author’s framework.

1. CVRx, “Second Quarter 2026 Financial and Operating Results,” August 6, 2026. Company-reported results and management outlook, filed as an SEC exhibit.
2. Medtronic, FDA clearance for LigaSure RAS Maryland instrument, September 16, 2026. Company announcement; planned indication expansion is forward-looking.
3. Corcym, first-in-human implant of Memo 4D Curve, September 23, 2026. Company-reported first implant and U.S. availability.
4. U.S. FDA, Memo 4D Curve clearance letter and 510(k) summary, K261707, June 18, 2026. Regulatory determination for the stated indications.