The pharmaceutical industry is facing many challenges today including declining drug approvals, rising generics competition, increased regulatory scrutiny, and a broken R&D process. Proposed changes like high-throughput screening and biomarkers have failed to significantly improve R&D productivity. Outsourcing drug development and focusing on commercialization may be a solution. Healthcare is also transitioning to personalized and preventative care focused on diagnosis over acute treatment, making patients more proactive consumers. Pharmaceutical companies will need new business models that integrate with changing healthcare systems.