Several new developments were threatening the success of Big Pharma. The patents on well-known blockbusters were reaching expiry, and generic manufacturers were eagerly waiting to produce lower-priced copies. Throughout the world, governments were taking a more active role in determining the prices at which drugs could be sold. The expansion of government insurance programs was adding to the complexity of the marketing challenges. Another change involved a shift towards direct-to-customer advertising, including the proliferation of information on the Internet, in addition to the traditional process of sales visits to family doctors. Research funding had doubled since 1991, but the number of new drugs emerging each year had fallen by half. The research and development process was also changing dramatically. Whereas blockbuster drugs had been developed as general treatments for common conditions, it was becoming increasingly apparent that not all patients reacted in the same ways to these drugs, and some - although a very small percentage - suffered serious side effects. This reality was expected to lead to the creation of a much larger number of niche drugs, each one targeted at a narrower group of patients. Related to this development was the growth of biopharma in which new biotech companies were creating drugs that could attack specific cells. Some analysts felt that Big Pharma was in a peculiar predicament in that profits were still very large, and this served as a barrier to necessary changes in strategy.
