China and India will not make pipeline better than Europe, UK and US. Outsourcing certain functions there will happen, but it will take them a while to gain the right experience, and even then, they won't produce much pipeline. Educational excellence in China and India is exaggerated, and they'll also suffer from the same managerial incompetence, because its the same big pharma companies that are outsourcing.

- Fundamentals of drug discovery sciences fully transferred to ChIndia
- Broke govts mean ageing western population dependent on last decade's medicines with declining longevity due to loss of living standards and lack of innovative medicines (forget high cost targeted medicines)
- South-south axis fully functional - western middlemen eliminated except for some consultants
- Biopharma still survives in the west, but only as a low cost option for outsourcing
- Innovative western graduates moving to Chindia for jobs
- Chindia making the mistakes of the west and waiting for the worm to turn
- India overtaking China due to a younger more innovative population and western-style democracy.
- Thai food still the best in the world...

* I do not believe that big pharma will reform its ways in the next 20 or 30 years. As long as a drug can make billions of dollars, you can expect these large companies to be run by business types. *

but if big pharma continue as they are, in 5 to 10 years they won't have the products that make billions of dollars. It won't be a case of choosing to reform their ways, they are being forced in to a corner because of the failure of their current ways and some won't survive. Relying on in-licencing from academia or small biotech won't save them in their current form either - the productivity in terms of new drugs is lower in academia+biotech than big pharma so productivity across the industry will fall further from where it is now if this is the chosen path.

VC funding will improve after the next 5 or so years. Big pharma will keep cutting to improve the bottom line in the short term, but this is at the expense of future growth. So bidding for drugs from smaller start ups will get competative, and when the deals get lucrative, VC financing of early stage startups will increase. Big pharma will also have an increasing cashflow, not because of new drugs, but because of an aging population, and they'll be eager to get even more money by in-licensing.

I do not believe that big pharma will reform its ways in the next 20 or 30 years. As long as a drug can make billions of dollars, you can expect these large companies to be run by business types. The money people can't resist, but at the same time, they can't manage scientists (they may dabble in science, but they won't succeed at getting pipeline). I don't see the incentives of the system changing in any way.

R&D to remain in the West, but much smaller teams of high calibre people. Smalller start-ups with ideas/IP, Uni. spin-outs and CROs funded by blue-chip to develop. China/India to do what they do best -manufacture only at lower cost than in West.

"Good animal models?? Such as?"

I wasn't suggesting the good animal models exist but that drug discovery efforts should focus on developing them.

Good animal models?? Such as?

Part of the reason why academic basic research doesn't translate to new medicines often enough. Agree with everything else you said though. Let's hope they realise before it's too late.

who is asking amd why?

hopefully there'll be something left after the destruction wreaked by allowing research based companies to be run by salesmen, lawyers and morons who believe, and take literally, everything they learnt on their MBA course (Jack Welch was a confidence trickster who propped up the numbers with creative accountancy at GE finance and left GE in so much debt that they needed a government bailout - he's not a business genius).
If there is anything left then it'll be back to future: companies based on a foundation of internal research not short term share price, basic research in to disease areas not short term metrics and bonuses, discovery programmes based on good animal models not HTS/numbers.....basically, back to the way things were when Pharma companies were successful.

Mass return to traditional Chinese medicine.
Prince Charles has new role as head of WHO.
???