Beyond a few key applications in HIV, HCV and sexually transmitted diseases, genomics has yet to make its presence felt in infectious disease testing. Technological advances in molecular testing, as well as a better understanding of genomics and a growing interest in defenses against bioterrorism are generating interest in new approaches to diagnosing infectious diseases and determining drug resistance. Several small companies are leading the way.

ACOs have been one of the most hyped innovations in the US health care sector this decade. The buzz may be overdone, but ACOs are now established as a different—and confusing—new customer segment for pharma. How is industry adjusting?

Pharma companies are building long-term value propositions that should appeal to Accountable Care Organizations into some go-to-market strategies for new drugs and to repositioning efforts of already marketed drugs that have hit snags. The rationale might seem straightforward—for example, more convenient dosing that improves compliance and cuts down hospitalization rates--but the nuances can be complex. Moreover, even when their products appear to have compelling cases for value, companies have not by and large made ACOs a distinct target for their commercial operations.