The net result of ongoing cost pressures and a precipitous decline in R&D productivity will be an unprecedented decline in the share of the overall healthcare profit pool captured by the largest research-based pharmaceutical companies, while lower-margin sectors, like generic manufacturers, will increase their share. The critical question for these companies is how to evolve their business model in order to thrive in a world of shifting profit pools by focusing on outcomes rather than by simply generating more inputs—more products, more procedures and ultimately more cost to the payers.
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