The publication by the UK health technology assessment body NICE (the National Institute for Health and Clinical Excellence) of draft guidance recommending the use of three acetylcholinesterase inhibitors in patients with mild to moderate Alzheimer’s disease, and an NMDA antagonist in patients with more advanced disease, has been widely welcomed as a “courageous decision” and as a “U-turn” on its previous guidance (scripintelligence.com, 7 October 2010).

Shire's latest acquisition, of Canada's BioChem Pharma, is its sixth in as many years, and the clearest sign yet of the shift which the UK-based specialty pharmaceutical company has to make towards earlier-stage research in order to keep up its impressive growth. Behind this growth is its low-risk Search & Development strategy: it seeks out promising, undervalued specialist-market drugs which it develops for new indications, or else finds new formulations for, after which it hands them on to its highly focused marketing and sales teams. A series of acquisitions-bolting on products, development programs and skills-has allowed Shire to quickly expand globally and broaden its portfolio. But as drugs get harder to find and more expensive, the company has had to throw its S&D net wider.