Clinical operations planning is critical for aligning clinical supply and demand and reducing costs and development times. Leading life sciences companies are employing "sales and operations planning (S&OP)-like" processes for clinical trials. However, there is currently no common definition of key elements like forecasts that different stakeholders can agree on. The core elements of an effective demand driven value chain include demand and supply visibility, translating demand into a manufacturing plan through a common process, and factoring in business and risk tradeoffs.