With the first baby boomer turning 60 in 2006, many see a booming market for a variety of products and services (The Economist, 2002; Greene, 2004) and the potential for "gray" markets and "silver" industries. For the pharmaceutical industry, this growing population will need new drugs to treat their chronic conditions over a longer lifetime. Some believe that eldercare represents a tremendous growth opportunity for the industry (Shalo and Oliff, 2002).
Clearly, an increase in the number of older patients translates to potential growth in the sales of drugs for a variety of diseases. It is estimated that between 30 percent and 40 percent of pharmaceutical products are used by people over the age of 65 (Middleton, 1999) and, on average, the older patient will take four or five drugs regularly (Common, 2004). Obviously, more old patients living longer means more doses. This opportunity, however, cannot be viewed simply as an increase in the number of treatment days or doses.
Indeed Avorn (1990), pointing to drugs as the centerpiece of geriatric care, suggests that die aging demographic and national drug policy are converging, and that issues related to the use of drugs by older people will dominate policy concerns. The recent debate concerning a drug benefit for Medicare recipients supports this view. Further, focusing on medications and the elderly, Avorn (1990) notes "a landscape of black holes" in terms of lack of knowledge about differences in the physiological effects of pharmaceutical agents on older people, long-term surveillance of drug reactions, and physician prescribing habits. These issues certainly focus on more than simply more drugs and more doses.
This article examines three factors as they will influence the traditional process of taking chemical compounds discovered in the laboratory through clinical study and product development, and on to marketing and postmarket monitoring. A number of "black holes" or perhaps better stated, "challenges," surface that face the pharmaceutical industry and healthcare policy makers.
The three factors that have the potential to reorder priorities and strategies when dealing with a new aging demographic are the following:
* The "new" elderly are different from the "traditional" elderly.
* The industry is experiencing a great deal of structural and economic change that could alter investment decisions and the allocation of resources in pursuing the opportunities presented by the aging population.
* The dynamics of the marketplace are changing; for many health problems, drugs are no longer the only treatment option.
THE OLD PATIENT AND THE 'NEW' ELDERLY
The "new" elderly, the men and women approaching age 60 in increasing numbers, are generationally different from their parents. Basically, they are healthier, will live longer and more productive lives, are more physically active, and are better educated (The Economist, 2002). They also control a large share of the nation's wealth and are spending it (Henderson, 1998).
Today's elders are also more technology savvy (Shalo and OlifF, 2002). According to the Pew Research Center's Internet and American Life Project, 53 percent of "wired" older adults have gone on-line seeking health information. This compares with 58 percent for the general population (Shalo and Oliff, 2002). With baby boomers as the new elderly, one can only conclude that this percentage will go up, and this generation of elders will use information sources regularly to research alternative approaches to treatment rather than accepting a prescription and filling it at the local drugstore. This will represent a change for the industry and regulators. Drug companies will need to keep the older patient in the loop and, in doing so, ensure that they provide data to support their case for treatment with their product.
While much is changing, the unique relationship that the customer has with die manufacturer has remained intact. …