Though I don't have any inside knowledge or insight into what ails the pharmaceutical industry, I am keenly interested in how Big Pharma might return to health. The symptoms are well documented: Feverish costs, underwhelming pipelines, and a personality defect that is making it increasingly unpopular with the public.

There's certainly no shortage of advice. For example, leaders at a recent conference roundtable ( suggested remedial business school education for executives, outsourcing all R&D, and focusing on the long term (effectively telling Wall Street, "up yours").

But I also speak to industry insiders and have heard recurrent criticism of the silo mentality, that is to say the compartmentalization of people and processes, and the rigidity of leadership. That makes me wonder if the problem isn't closer to home: the culture within Big Pharma. Improving the long-range health of pharma is not straightforward, not least because the problems are...


1. L. Menand, 'Everybody's an expert," The New Yorker, Dec. 5, 2005.

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