The pharmaceutical (pharma) industry is a key player in a complex health ecosystem involving patients, health providers and payers, industry suppliers, researchers and government. This ecosystem is currently facing the healthcare equivalent of global warming, a 'tidal wave' of complex age and behaviour related diseases which are increasing healthcare costs and research risks and challenging delivery models.

Pharma has to manage an increasing number of contradictory demands. Patients, providers and payers are seeking better, more effective, medicines at affordable prices. At the same time, industry has to develop medicines at prices that justify the substantial risk and investment required to bring new drugs to market in an increasingly challenging regulatory environment.

This paper examines some of the underlying drivers of the 'tidal wave' of diseases, illustrates an alternative way of thinking about the demand challenges and suggest some emerging ways in which industry and the healthcare system can address them. Specifically, that pharma has to continue to innovate while focussing on de-risking its research, development and commercialisation models.

In examining the underlying drivers of the changing nature of disease and its implications for the pharma industry, we have been deliberately provocative in suggesting how the pharma company model needs to change. Our intention is to stimulate discussion and debate and as always we welcome your feedback.

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