There is also the question of whether "superior products" make the new horizons described here more or less moot. Will strong products, products with a unique mechanism of action, and products that are effectively differentiated be immune to the challenges posed by these new horizons? That, it would appear, is an open question, but the odds are, even superior products will likely face greater vulnerability should their managed care divisions fail to think through the marketing challenges and competitive threats the three new horizons pose in the years ahead.

I am grateful to Norm Smith from Viewpoint Consulting and Nancy Featherstone from AstraZeneca for their reviews of a prior draft.