Always protagonists of the managerial world, the big pharmaceutical companies seemed hidden in recent years, covered - in the managerial literature - by the "usual" automotive sector, by new media, by technology, by the economy of experiences. But sometimes they come back: this is how "Harvard Business Review" dedicates a special article in the May issue to research and development in these companies, which have always been the organizational benchmark for Research & Development in other industrial sectors. After all, the strong interest of managerial magazines for ethical issues also requires a return of attention to the world of medicines and to the organizations that offer health products and services on the market. Historically, writes Jean-Pierre Garnier in "HBR", the pharmaceutical industry has been a leader in terms of financial performance and value creation. In recent years, the stock market has raised serious doubts about the sustainability of successes in this sector. In a certain sense, the pharmaceutical industry has become the symbol of a discussion on the sustainability of industrial capitalism, based on the paradigms known today. In a world where copyrights, patents, knowledge-based competitive advantages are fluid entities, how can industry sustain a knowledge-based "competition"? From 2000 to 2008, the 15 leading pharmaceutical companies have steadily lost value on the stock markets. Price pressures, legislative demands, legal issues, and a sharp decrease in R&D productivity have increased costs and reduced corporate revenues. For this reason, the article describes the experience of change in GlaxoSmithKline, a company that has decided to redesign the organization of research and development, abandoning the classic hierarchical pyramid and redefining small groups, whose leader is a person capable of guaranteeing services with high added value, in a decentralized way. The company recognized the need to improve the quality of leadership in this space, recognizing that there is no superior research and development without superior leaders. Finally, the company has launched a cultural revolution, also facilitated by the introduction of bonus systems that reward those who really produce value by responding to the needs of the organization and customers. According to "The Economist", the change of pharmaceutical companies is dictated by the rapid growth in developing countries. For most of its history, the industry had focused on diseases afflicting people in rich countries, investing little in research and development on diseases in poor countries. But the reduction of profits in Western countries, described above, and the rapid growth of developing countries, have imposed a new strategy on the sector. Once again the protagonist of a recent reorganization is GSK. The company has integrated all the small divisions dealing with developing countries into one large dedicated group. Novartis has opened a research center in Shanghai and another in Singapore, focused on tropical diseases. The company understands that viral cancer is rare in Europe, but common in China. And also Asians and Europeans respond differently to anesthesia. And innovation also concerns the commercial method in these areas. Some companies have adopted a differentiated pricing scheme, based on per capita income, to set lower prices for medicines in poor countries. Furthermore, different price policies are being tested within the same countries for the different social groups, even in the absence of intermediation by the welfare state: an absolute novelty
