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Medical care is increasingly something that you're not going to get exclusively at a doctor's office. It will be knowledge-based, and it won't require a doctor's hands-on presence.

AD: Will health-care marketers be able to count on any kind of mass market in the future?

DS: Yes. You're going to see some categories where the mass market does grow, and where drugs become more sophisticated. There will be large markets for more narrowly defined cures, such as the drugs that target the flu virus, for instance. There will be a dramatic increase in demand for that category of drugs, and since the virus affects many people in about the same way, it can be a mass market. However, the drug will have to change every year as the virus mutates. But some categories of medicine will go away on a mass scale. For example, some of the generic treatments for the respiratory diseases will go away and some of the stronger, over-the-counter type of cold medicines will be replaced with individually-targeted medications. Mass markets for multivitamins are also going to disappear in favor of targeted vitamin therapies.

AD: Even if it's technologically possible to do this, how will pharmaceutical companies be able to produce individualized medicine in a cost-effective manner?

DS: Point-of-use manufacturing. It's already here in the electronics industry. Many chemicals are similar in many different drugs, the pharmacist will be able to mix the drug that's right for you. You'll be able to go to the pharmacy and have the exact chemicals pressed into a pill for you, while you wait.

AD: Why not do this at home, using the Internet?

DS: You could probably do it at home, but you lose quality control. Pharmaceutical manufacturing is going to require quality control, and records, such as legal and insurance records. I don't see home manufacturing of pharmaceuticals as a trend anytime soon.

AD: After individually-designed medicine, what's next?

DS: Eventually, medication will be designed to get to know you better as you use it, and it will change as you use it. For example, lots of folks have asthma and there are so many things that can trigger an attack - it might be dust, or an animal, or a change in the weather or temperature, or a fabric - lots of different things. The way it works today is that a doctor gives you a set of different medications and you try them out and see how it goes. There's some research that says that part of what triggers the asthmatic reaction is based in genetic code. Using a genetic approach, the asthma medication would learn your specific triggers, and learn to make modifications in your system - at a genetic level - to make the medicine more effective. If I'm a marketer, this means that what was once a continual sell becomes a one-time sell. The medicine cures your asthma quickly, and then you don't need the medicine anymore.

AD: How will all of this change health care, and what will it mean to marketers?

DS: Medical care is increasingly something that you're not going to get exclusively at a doctor's office. It will be knowledge-based, and it won't require a doctor's hands-on presence. All medical information will be available on a computer, in the form of databases. Many pharmaceutical marketers will concentrate on selling medical databases and software to consumers. At the same time, the doctor will be transformed from "all knowing" to just part of the medical value chain. Consumers are becoming much more adept as vital elements in the medical value chain, which, in turn, means that marketers are going to have to adjust their strategies to target increasingly educated, sophisticated consumers.

With 78 million Baby Boomers hurtling toward their chronic illness years, the pharmaceutical industry is expecting skyrocketing demand for prescription drugs in the next decade. To prepare, drug companies spent some $26 billion in 2000 to invent drugs that do everything from lower cholesterol to remove unwanted facial hair, according to the PhRMA, the industry trade association. But will the investment pay off?

David Smith, vice president at Technology Futures Inc., an Austin, Texas-based firm, believes that while there will be a spike in demand for all kinds of health therapies, new biological and genetic technology will transform the health-care marketplace. Smith is a technologist and futurist. For more than 30 years, he's helped organizations such as the CIA, Coca-Cola, Motorola, and Sun Microsystems prepare for what's coming next in technology.

In the field of health care, the next five years should bring an end to "mass medicine," Smith believes. Thanks to coming technological breakthroughs, pharmaceutical companies will laser target medicine to cure ailments, taking into account each person's specific genetic profile, medical history, lifestyle, and environment. If Smith is right, this could have enormous implications for health-care marketers. American Demographics asked him to discuss the technological innovations that may transform health care, and what it all means for consumers.

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