WL: How do you see your work and the external pressures on business development changing over the next three years?

Altomari: The timeline for identifying an opportunity and negotiating a successful transaction is going to get longer. If there is some good endpoint you can identify, then there is a prospect for taking an asset quickly to auction. But this will be the exception, not the norm. Managing everyone's expectations is one reason why the process will grind on.

Another trend we will face is more "blind spots" in the community of deal makers. There will be people across the table who we know little about. Israeli, Turkish, Indian, and Chinese companies are at the stage where they will be looking at opportunities beyond their own markets. Will they want to buy my product, invest in my company, or partner with me to gain a foothold in the US? I suspect we know much less about them than they know about us. Companies must work to establish the bona fides of these emerging but still peripheral players.

Ryan: The financing part of the business is likely to transform as well. There will be more "boutique" firms trolling for possibilities, and a greater variety of firms will be taking smaller stakes in the transactions. The trend is a refutation of the idea that interest of the venture capital community in life sciences has waned due to tough times. Departure of the big firms is creating opportunities for those with a niche perspective.

Talley: It is going to be more difficult to be successful. You have Big Pharma partners who demand biotech take on increasing levels of risk, and payers who don't want to pay a premium for that risk. The hurdles are going to be high, but for those who can demonstrate their medicines advance the current standard of care, it remains possible to become profitable.

Stewart: Deal valuation is going to be impacted negatively by the soaring cost of clinical trials. Spending is driven by the costs and high performance of the comparator arms, which leads to the need for very large test populations. Companion diagnostics will have to be vetted as well. Do the math; someone has to pay for it.

Trempe: Public budgets for healthcare are going to be pinched. The government share of health spending is destined to rise under the US reform legislation, so the basic medical value proposition is likely to override everything else in the appraisal of an asset.