A few years ago in this magazine, a very senior pharma executive laid out what seemed to be the necessary preconditions for organizational change.

“There is no change in pharma unless there’s the perception of a near-death experience,” the exec was quoted as saying at an MM&M event. “We have not been unsuccessful enough yet.”

He was talking about the evolution of digital, circa 2013. That formula still applies to digital and to other catalysts for institutional change, including patient-centricity, harnessing big data, and drug-pricing reform, but with an important caveat.

Yes, dissatisfaction often must exceed satisfaction for progress to occur. Regardless of where companies are on that curve, however, influential leaders can at times get things done by sheer will.

Which brings me to this month’s cover montage. Each person shown there was selected for a different reason to be the face of a new MM&M list — the Health Influencer 50 — assembled in conjunction with our colleagues at Haymarket Media sister brand PRWeek.

Each wields significant influence at a major health-related organization and boasts high-profile accomplishments, oftentimes ahead of the aforementioned pain-of- change curve.

See the Health Influencer 50

As global CEO of one of the largest global agency networks, McCann Health’s John Cahill makes the list not only for his thought leadership, but also for his prescience (now a reality) about the coming integration wave among big healthcare communications agencies.

Only a year and a half old, ­IBM Watson Health, led by GM Deborah DiSanzo, has struck up partnerships with a host of organizations that promise to harness machine learning to improve clinical care and patient-coaching systems while boosting accuracy at predicting aspects of disease.

Julie Gerberding, formerly CDC director, is now Merck’s chief patient officer and, since assuming her new role in late 2014, has spearheaded a $15 million oncology initiative to support programs aimed at providing timely access to patient-centered care.

In September Brent Saunders, Allergan CEO and president, said that the drugmaker would limit branded drug price increases to once a year and that those increases would be restricted to single digits as part of a pledge not to engage in “predatory or price-gouging” actions.

Finally, Ed Wise, longtime CDM Group exec, gets much of the credit for unifying Omnicom’s numerous specialty healthcare shops under the Omnicom Health Group banner earlier this year, a move that stunned some industry observers, but has mostly won applause.

Few leaders are more emblematic of the recent wave of leadership tech than these five.

They’re joined by 45 others from the ranks of health marketing, comms, and beyond, all of whom lay strong claim to the influencer mantle. See for yourself by diving into the complete list. Rounding out this special issue are features on some of the biggest health issues facing marketers today: ensuring outreach to millennials is culturally relevant; three highlights from the next wave in health tech; and how manufacturers are confronting negative drug-pricing sentiment.

Marc Iskowitz is editor in chief of MM&M.