L'evolució dels processos actuals d'innovació farmacèutica queden ben explicats a Nature. En Pammoli et al. ho descriuen i analitzen en un article clar. Selecciono aquest paràgraf:
The rate and direction of pharmaceutical innovation will continue to be affected by the interplay between patterns of technological change and market regulation. In our view, the value and cost of innovation should be assessed not only from a static efficiency perspective, but also from a dynamic one. From a static efficiency perspective, when two projects with the same potential market value but different POS values are compared, it is rational to drop the riskier project. However, such aEl que no expliquen és si aquestes àrees d'elevat potencial (valor de mercat), són també pels problemes de salut més rellevants (valor de salut). Aquesta qüestió acostuma a quedar pendent.
perspective fails to take into account the dynamic effects of competition among different organizations on market value and the risk of R&D projects. First, if all the organizations choose to invest in therapeutic areas in which the POS is high, those markets will experience fierce price competition, also due to the incentives designed by regulators and institutional payers through reimbursement and pricing schemes. If payers do not recognize any premium for incremental innovation, it is rational for investors to aim to achieve market exclusivity in difficult areas, which are characterized by a low POS, rather than being forced to compete on price in a low-risk but highly crowded market. Second, the benchmark to measure the degree of risk is endogenous: at the aggregate level, the more firms invest in high-risk markets, the lower is the risk premium each of them has to pay to investors. Taken together, these two effects have pushed pharmaceutical companies to focus on high-risk, high-potential areas of activity.
