Why Doesn't Pharma Get Smaller?

Pharmas continue to diversify into lower margin businesses because CEOs and boards are betting on different requirements from a new system of health care delivery. They also figure their jobs will be safer. The choices: Is the likeliest avenue to growth through successful R&D, or through positioning appropriate for future health care delivery and payment systems? Bristol-Myers and Amgen have chosen the former - both because each is too small to diversify and because each believes it has a reasonable track record in innovation. Novartis and most other large pharmas want to take both roads at once--and are either dramatically expanding to enable product bundling or to give themselves enough time to prepare for what the health care system demands. Either way, the wild card of health care reform is making business strategy something of a crap shoot for companies both large and small.