As costs increase and competition intensifies, Luciano Conde explains why mid-size pharma companies are better poised for success in the market.

In ways both expected and unexpected, 2006 was a year of tumult for global pharma as the dynamics of the market continued to shift. New products shook up major therapy classes, promising molecules stumbled, governments and others tackled issues of access and affordability in earnest, and at least one major group (the Gates Foundation) threatened to side-step the pharma industry in seeking new solutions for HIV/AIDS. At the same time, millions of patients were newly diagnosed, treated and helped by pharmacotherapy.

When I joined Penn Pharmaceutical Services (UK), there was a strong sense of d?j? vu; Craig Rennie, Penn's exiting chairman, had joined in 1999 with a view to selling the business. Once he had understood the company's potential, however, he quickly decided that he wanted to be a part of its future growth. Ultimately, he bought the company via a management buy out (MBO) worth ?12 million in 2000.

The exodus of bright young talent from France was one of the more interesting themes of the recent French presidential election. Observing the debate from the UK, France's very open struggle to adapt to the modern world seems not dissimilar to that of pharma companies trying to create the best environment for discovering and developing drugs.