Marker #1: A crisis of reputation Last year, Harris Interactive's reputation poll of 21 industries placed pharmaceuticals among the most unpopular—again. Certainly,
pharma's bad rep is nothing new, but things have gone from bad to worse. This crisis of reputation has forced pharmaceutical
firms to report their trials, inform the public about changes in strategy, and disclose pricing of drugs.
 How Vasella Interprets Data—and the Future
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"We are close to the bottom of the barrel," commented Wayne Rosenkrans, a strategist for AstraZeneca. "We are just a notch
above the tobacco industry. We went from just being greedy to being evil about a year ago."
It's not surprising then that, since 2000, pharmas worldwide have paid nearly $4 billion in settlements and fines.
Marker #2: The technology "revealer" It used to be that companies gained intelligence on how their drugs were faring in the marketplace through periodically updated
reports from IMS Health. But new modes of delivery for medical data are creating a quiet revolution. Companies now gain this
insight instantaneously by connecting with doctors at the point of prescribing and speeding intelligence directly to decision
makers. To do this, the industry relies upon vendors that collect information from doctors with handheld devices, or from
contract market researchers who survey physicians.
 Did You Know?
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"Many biotech products are carried and distributed by specialty pharmacies...[and] may require special handling," says Allen
Kamer, director of business development for Leerink Swann & Company, a healthcare-focused investment bank. "In order to stay
current with...demand, companies require real-time data and information about their products."
Marker #3: Government's heavy hand Over the past decade, the US government has forced open the doors to what used to be considered insider information. One of
the best examples came in 1997 when FDA began requiring companies to register clinical trials and then posted the list on
clinicaltrials.gov/.
The transparency juggernaut driven by government is gaining speed. Even now, the US government has begun to move aggressively
into the field of outcomes research, also known as health economics (which leads us to the next marker.)
Marker #4: Health economics and stealth agencies It used to be that slightly differentiating a drug was enough to get it on the formulary. Now, robust outcomes analyses that
demonstrate significant advantages are needed if a drug's potential market success is to be realized.
 Who Receives the Message?
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The Agency for Healthcare Research and Quality, part of the Department of Health and Human Services, is at the forefront of
applying health economics to the healthcare system. Its agenda may determine profit margins for the industry for years to
come. Yet, AHRQ is virtually unknown by industry analysts.
"AHRQ is going to have a great impact on our industry," says Rosenkrans. "What it is doing is centered on comparative effectiveness,
which has input into formulary decisions in ways that people don't really appreciate. I can't tell you how many times when
I speak in front of audiences and ask them what AHRQ is that not a single hand goes up!"
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