It took me a while to understand what people meant by the "new commercial model"—a phrase at once grandiose and vague.
But, hey, McKinsey was talking about it, so it must be important, right?
As I dutifully delved into the literature, I began to understand why I didn't initially understand. The NCM (the concept having
already achieved acronym status) meant, simply, that the healthcare world was changing very fast, and pharma had to change
right along with it: The patent cliff; managed care; restrictions on physician access; "developing" markets growing faster
than "developed" markets; Rx shares sinking versus generics ... (IMS predicts that the generics share of the US market, now
at 76 percent, is moving fast to 80 percent-plus.)
Oh, so that's it: Much ado about change? I had been bamboozled by sheer obviousness. The consulting firms had come up with
a single, important-sounding term for everything keeping pharmaceutical execs up at night, and tied it into a neat, three-letter
And yet while all of this is demonstrably and disturbingly 'true,' it seemed to me it misses an even bigger development. Because
roiling beneath the wave of NCM is a much larger force, one barely registering on even McKinsey's seismographs.
While all the concerns enveloped in the NCM framework are serious, they are to some extent a matter of the moment. So, for
example, while pharma pipelines have been achingly dry for a decade, in the long-term, human genome mapping will pay off,
science will advance, and products will be discovered, designed, or commercialized. This is not wide-eyed optimism; it's just
an acknowledgement of the cyclical nature of the drug invention business. In fact, the spigot may be beginning to sputter
to life as we speak: On July 11, the Wall Street Journal ran a story projecting a dramatic increase in new biologic drugs over the next five years.
Likewise, people seem to have forgotten that the current trend of pharma rep layoffs was repeated in reverse only 10 years
or so ago, when the industry, led by Pfizer, fattened up its sales force to sell lipid-lowering blockbusters.
So: Plus ça change, plus c'est la même chose.
But not everywhere. Because the more things change in technology, the less remains the same. This is the sort of change that
is not short-term, and in fact will not end in our lifetimes.
It's what I call "The Speed of Change."