With a point-of-care electrodiagnostic device for the diagnosis of neuropathies, NeuroMetrix has set out to change how primary care physicians provide patient care. That means it faces the challenge of achieving market coverage on the scale of a pharmaceutical sales force, while at the same time providing the kinds of training and support that go hand-in-hand with a device business. This is a tall order for a small company. Fortunately, NeuroMetrix's timing is great. Over the years, it has expanded its testing platform from the diagnosis of carpal tunnel syndrome and low back pain to the detection of diabetic neuropathy. It thus finds itself the sole purveyor of a technology that can, at the point of care, detect diabetic neuropathy even before symptoms develop, and it has come to market just at the time when Eli Lilly and others getting close to market with drugs that treat not only the symptoms of diabetic neuropathy, but influence its course. .

The FDA sees pharmacogenomics as a key tool for optimizing both the development and clinical utility of drugs. But most of the visible examples to date of pharmacogenomics have been in specialty areas like oncology and virology. The Vioxx situation raises an inevitable question as Pharma looks to improve R&D efficiency and clinical utility. What is the role of pharmacogenomics in assessing the safety and efficacy of primary care drugs?

In the past two years, Inverness Medical Innovations has paid a total of roughly $500 million to buy five rapid point-of-care (POCT) diagnostic testing businesses, which now lie at the heart of its effort to expand in the POCT realm. These have laid the ground work for four subsequent transactions and related financings, all aimed at making Inverness a world leader in women's health and pregnancy testing. But what's of interest isn't so much the women's health play per se as the company's management tream, which has twice before built up POCT companies, then sold them for significant premiums.

Deal activity in diagnostics has been way down in 1999 and while a few strategically sound deals are getting done, the scale has been very small. With financing and M&A options drying up, smaller diagnostics companies are more squeezed than ever. A plucky few have snared good deals. Here's how.