18. If a drug importation bill—or the threat of one—does not reduce the price differential between US, Canadian, and European drug prices, Congress will look for other ways to do so.

19. Drug companies will start to take a tougher line with some foreign governments on drug pricing, including walking away from some countries.

Companies' pricing strategies will become less aggressive.

L.J.SELLER, SENIOR EDITOR

» Jane Sarasohn-Kahn, MA, MHSA Management consultant and health economist

In 2005, the driving forces shaping the outlook for inrormation technology in the pharmaceutical marketplace include the demand for monitoring and measuring healthcare quality and patient outcomes; growing concern about a safer pharma supply chain; and the global demand for transparency. Together, these drivers converge toward the following events:

E-prescribing comes of age. Health plans—both private and public—are arming physicians with PDAs and personal computers to enable e-prescribing (eRx). CaféRx, an alliance of Allscripts, Cisco, HP, Microsoft, NCPDP, NDCHealth, and others, will provide end-to-end eRx capability. This initiative could be eRx's tipping point. Health plans and payers will benefit as physicians have formulary information, including available generic substitutes, for each patient at the point of prescribing.

Integration across silos. Payers and providers are increasingly able to marry patient data from different sources. As claims data can be integrated with patient outcomes data (for example, employer's return-to-work statistics with patients' perceived quality of life), payers and plans will be able to compare the true cost-effectiveness of various treatments. Groups such as the National Business Coalition on Health have begun to study this process.

RFID goes beyond Wal-Mart. Importation of pharmaceuticals in the United States has gained bipartisan support in Congress. To ensure a safe supply chain, pharmaceutical manufacturers, distributors, and retail pharmacies will come together to adopt the first stages of RFID across the supply chain.

Public and private health plans will offer end-to-end electronic prescribing.

PHARM EXEC SAYS: » Cost consciousness will rise again and again—not only among consumers. Pharma will tighten its belt to compensate for the squeeze on profits.

MICHAELD. LAM, ASSOCIATE EDIOTER