Deals involving major players have been growing in size, and despite the emergence of new technologies, it is becoming increasingly challenging to find a breakthrough molecule in many research areas.

As pharmaceutical companies have grown larger, they have become increasingly focused on blockbusters, leading to high competition in a few key disease areas.

Failures in these blockbuster areas are very large and very public, while successes are requiring investments in sales and marketing, coupled with an increasing understanding and ability to operate effectively within an ever changing and challenged NHS.