patients, and the requirements of regulatory authorities vary widely
from country to country.^5
Take, for example, depression. Among U.S. patients, this con-
dition manifests itself mainly with feelings of sadness or lethargy;
while in Japan a depressed person’s chief complaint is more likely
to be a stomachache.
“Without experienced physicians from many countries weigh-
ing in on how the trial should be structured, what we should mea-
sure, and so on, we’re forced to take a cookie-cutter approach,” says
Dr. Mike McDonald, vice president for global clinical research and
medical affairs. “This tool provides a way to become truly global
and more patient-centered in the way we handle clinical trials.”^6
Capitalist ToolA third collaborative approach, while still in an experimental
mode, may ultimately encourage better and more creative decision
making at Lilly. Specifically, the company has conducted a simula-
tion using a tool that applies the dynamics of the ultimate free-
market symbol, the stock market, to the complex process of
portfolio management.
Lilly has more promising drug candidates than resources to
develop them. The fact that this problem makes Lilly the envy of
most competitors does little to make the portfolio management
process easier. Vast quantities of data, from toxicological studies to
market projections to financial analyses of competing products, are
weighed in order to make a “go” or “no go” decision and allocate
resources to the candidate’s further development. It is, of necessity,
an excruciating process. It also requires speed, since the resources
that are freed up when less productive projects are terminated can
be redeployed in more promising directions.
Lilly’s pilot used a tool from Incentive Markets, Inc., to portray
drugs in its pipeline as securities or stocks. Supplied with informa-
tion on their properties and market forces, company decision
makers then bought and sold the securities on a simulated stock
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