As rheumatoid arthritis treatment improves in the biologics era, patients need fewer joint replacements. Instead, they now require more closely monitored, agile care, in the face of a growing shortage of qualified rheumatologists. These demands help propel digital health applications, bioelectronic devices and novel imaging modalities into the medtech spotlight.

deCODE Genetics has emerged from bankruptcy with a streamlined, diagnostics-oriented business model. In the near term, the privately held firm expects to offer its genomics discovery capabilities on a service basis, echoing the original genomics platform specialists of the late 1990s, including deCODE itself, which did largely unsuccessful technology deals focused on using genetic insight to generate therapies. The difference? It is now using genetic information to assess disease risk and better manage patient health, a strategy it thinks will succeed as the field of personalized medicine diagnostics continues to gain traction.

In the fast-growing chemistry services market, Albany Molecular has proven itself a steady and, in recent times, superlative performer. Albany Molecular is capitalizing on its growing revenue stream and strong market performance by building up chemistry capabilities to provide one-stop, albeit specialty, shopping. But the company's growth and above-average margins stem largely from its one major royalty deal, on Allegra--and the company has been spending its time on services, not on at-risk deals.Recent acquisitions position Albany Molecular to provide more proprietary technologies: the key is whether the company's management is willing to take the financial risk of deals in which it has to fund its own early development in order to win an important piece of a product's upside and thus boost it service-company margins.

After 20 years and the efforts of thousands of researchers working on the problem structures have only been revealed for about 20,000 proteins out of 500,000 known protein sequences. When combined with the latest experimental and computational techniques, sequence and structural information provide some useful guidelines. Pharmaceutical companies are using it to sift from massive amounts of sequence information a more manageable number of biologically relevant targets; the undertaking is now known as structural genomics. Today this field is a hotbed of activity for new companies that offer improved X-ray crystallography techniques, nuclear magnetic resonance spectroscopy, annotated protein databases, computational algorithms, and combinations of all of the above.