“Health Affairs” just published an analysis that showed economic returns from the development and marketing of pharmaceutical products (revenues less the cost of research, development, marketing and tax) declined through the 90s and 00s1. What’s more, returns on launches made through 2005-2009 (the most recent period analysed) have, on average, yielded a negative return. Suggesting, despite the market exclusivity afforded to innovative products, it now costs more to research and bring a medicine to the market than prospective lifetime revenues. In the medium to long term, an evolution of the model used to develop medicines is needed to improve returns and sustain current rates of innovation. In advance of these major changes, the short-term challenge is to improve returns by maximising revenues.