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Darwin's Medicine blog

Professor Brian D Smith is an authority on the pharmaceutical industry and works at SDA Bocconi University and Hertfordshire Business School.

A frugal future

Novartis, GSK and AZ show that the demand for value is shaping our industry

My continuous trawling of industry news, searching for patterns in our industry's evolution, caught three interesting examples recently. Novartis' Joe Jiminez, describing new product uptake, said that “the model has changed” and “we're just not going to see the hockey-stick shape we had”. A few days later, GSK's Andrew Witty pointed to “a very sustained set of changes of procurement practice”. And almost simultaneously, AstraZeneca announced a $1.1bn cost-cutting plan to finance its shift towards higher-value medicines. Now when contemporaneous signals from three such prominent players all point one way, it suggests that something fundamental is happening. And this is completely consistent with what my research, applying evolutionary science to the life science industry, tells us to expect. As usual, let me get down to the science before I come back to the practical implications.

Most environmental change is slow and steady and, in biological evolution, life forms adapt steadily to those shifts. Change, when it does happen, is typically incremental and localised. Think of the evolution of peppered moths from white to black as the industrial revolution made British cities sooty and then back again as emissions legislation cleaned up the environment. Or, in Homo sapiens, the evolution of pale skin as we moved out of Africa into higher latitudes with less sunlight to produce vitamin D. Evolutionary history is full of these sort of events, which are relatively restricted in their effects on species and their geographical scope. Rarely is an evolutionary episode a truly global event. But there are some fascinating examples of evolutionary change that are much more wide-ranging, affecting most of the biosphere and changing the course of evolution in quite a fundamental way.

For example, all of us have heard of the changes, triggered by some combination of a meteor strike and volcanic activity, which led to the decline of the dinosaurs and, coincidentally, made ecological space for placental mammals - and therefore you and me. Even more important was the Great Oxidation Event when, about 2.3 billion years ago, oceanic cyanobacteria evolved photosynthesis and started spewing out oxygen. As nice as this sounds to us air-breathers, oxygen was essentially toxic to the then-current anaerobic life forms, many of which became extinct. It is for good reason that the event is also called the Oxygen Catastrophe. Not only did the development of an oxygen environment have far-reaching effects but it also happened relatively quickly. Or to be more accurate, it built slowly, reached a tipping point and then progressed quickly. As a result, we aerobic organisms now dominate our world.

Now, back to the life science industry. I will, I'm sure, be criticised for saying this but our industry evolved in a fairly affluent environment. Relatively speaking, western governments in the post-war world were rich and healthcare was a priority. A look at government spending will tell you that. Of course, our customers have always wanted to pay less but, as recent data about US drug spending shows, they are paying more. But that environment is changing.

Free-spending, arguably profligate life science companies will die out and frugal, ruthlessly efficient companies will replace them

The causes of these changes lie both outside and inside our industry - disease patterns, demographics and secular stagnation on the one hand; technological advance, aggressive pricing and systemic healthcare inflation on the other. The combination of these and other effects is shifting our industry environment to one in which 'The Great Value Shift', as I called it in one of my recent articles , is one of a handful of pressures selecting for and against variations in our industry business models. If my research on this doesn't convince you, then perhaps the words and actions of Joe Jimenez, Andrew Witty and Pascal Soriot will.

So if we are witnessing something we might call 'The Great Value Event' - or perhaps 'The Value Catastrophe' - what are the implications for the life science industry? Well, I think there are perhaps three. Firstly, it's unstoppable. Value will dominate the industry environment and anyone who thinks they can put that genie back in the bottle is naive. Secondly, it will cause a mass extinction event and a parallel flowering of new models. Free-spending, arguably profligate life science companies will die out and frugal, ruthlessly efficient companies will replace them. Finally, the speed of the event will not be linear. We will continue to see stories like those three I mentioned above with increasing frequency and then we will reach a tipping point where the demand for value explodes. Perhaps we are close to that point already. Whatever the timing, the industry that evolves to fit this new environment will be very different from that in which most of us grew up. Be prepared for a frugal future.

17th May 2016

From: Sales



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