186 sCenarIos desIgn tion is driven in part by pharmacogenomics, in part by advances in diagnostics, and in part by renewed cost- consciousness amid growing awareness that prevention is less expensive than hospitalization and treatment. These two drivers suggest trends that may or may not materialize and thus provide four scenarios illustrated in the fi gure opposite. These are: • business as usual: Personal medicine fails to materialize despite its technological feasibility (e.g. for privacy reasons, etc.) and treatment remains the core revenue generator. • my.medicine: Personal medicine materializes, but treatment remains the core revenue generator. • the healthy patient: The shift toward preventive medicine continues, but personal medicine remains a fad despite technological feasibility. • reinventing pharma: Personal and preventive medicine comprise the new growth areas of the drug industry. Future Scenarios The scenario is another thinking tool that helps us refl ect on business models of the future. Scenarios kick-start our creativity by providing concrete future contexts for which we can invent appropriate business models. This is usually easier and more productive than free brain- storming about possible future business models. It does require, however, developing several scenarios, which can be costly depending on their depth and realism. One sector under strong pressure to devise innovative new business models is the pharmaceutical industry. There are a number of reasons for this. Major player research productivity has declined in recent years, and these companies face enormous challenges discovering and marketing new blockbuster drugs—traditionally the core of their businesses. At the same time, patents on many of their cash cow drugs are expiring. This means revenues from those drugs are likely to be lost to generic drug manufacturers. This combination of empty product pipelines and evaporating revenue are just two head- aches plaguing incumbent pharmaceutical makers. In this turbulent context, combining business model brainstorming with the development of a set of future scenarios can be a powerful exercise. The scenarios help trigger out-of-the-box thinking, which is not always easy when trying to develop innovative business models. Here’s an overview of how such an exercise might be conducted. First, we must devise a set of scenarios that paint pictures of the future of the pharmaceutical industry. This is best left to scenario planning specialists equipped with the right tools and methodology. To illustrate, we developed four bare bones scenarios based on two crite- ria that may shape the evolution of the pharma industry over the next decade. There are, of course, several other drivers and many different scenarios that could be crafted based on deeper research into the industry. The two drivers we’ve selected are (1) the emergence of personalized medicine and (2) the shift from treatment toward prevention. The former is based on advances in pharmacogenomics, the science of identifying underlying causes of diseases based on a person’s DNA structure. Someday, this may result in completely personalized treatment, using customized drugs based on a person’s genetic structure. The shift from treatment to preven- 186 bmgen_final.indd 186 6/15/10 5:44 PM