Recent discussions of the growing importance of specialty products in the pharmaceutical markets (discussions that include this month’s cover story) got us thinking about the long-term evolution of the drug industry…and the curious parallel evolution of communication technology.

Consider: in the age of snake oil and patent nostrums, products promised all things to all people, but delivered practically nothing but alcohol and a touch of opium or coca. It was one-drug-fits-all-diseases. Ads for products like Ballard’s Snow Liniment (“Cures rheumatism and all pain”) and the Celebrated Oxygenated Bitters (“A sure remedy for Dyspepsia, Asthma, and General Debility”) rolled off printing presses—because mass communication, too, was one-size-fits-all, and a single message in a single medium went to everyone.

By the 1980s, biotechnology had awakened the first glimmers of personalized medicine. Some people started to notice that blockbuster drugs, like blockbuster movies, demand huge marketing efforts and massive audiences…but they saw an alternative. Targeted specialty and biotech drugs were like cable TV—specialized offerings could succeed by getting higher shares of smaller but more devoted audiences.

That was before the Internet and the age of ‘omics. Both are driven by digital technology, huge masses of data, and intensive analysis. Both bring exquisitely individualized, ever-more-effective offerings to ever-smaller audiences.

A case-in-point is Vertex’s Kalydeco, approved earlier this year for treating one specific form of cystic fibrosis (CF). CF occurs when mutations cause the Cystic Fibrosis Transmembrane Regulator (CFTR) protein to fold improperly. CFTR is a relief valve, regulating the cell’s levels of water and chloride. When it doesn’t work, things go wrong, and heavy mucus can clog the patient’s lungs. Kalydeco helps the body refold CFTR so that it works better—but the drug works only in patients who have a specific mutation in just one of the CFTR gene’s 189,000 DNA pairs.

Vastly more effective, but only for the exact right population. That also goes for the marketing these drugs demand. I can’t imagine developing products like Kalydeco without automated gene sequencing, vast databases, and rigorous computer analysis. And I can’t imagine marketing products like this without the full range of traditional and electronic media backed by sophisticated, data-driven targeting.
P.S. We’re also waiting to find out who will earn Trailblazer honors this coming September. There’s still time to win your place in the spotlight. Go to and enter yourself or a colleague.


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