The criticism of gene therapy has been continual and consistent. But in fact, at least some delivery systems do work. It is true, however, that not all vectors work in all diseases, and the challenge for gene delivery start-ups is figuring out which ones work where.

Zars Inc. aims to increase the effectiveness of transdermal drug delivery with its self-activated heated patch system called CHADD (controlled heat-aided drug delivery). CHADD works through oxidation and can be used to pulse, increase or decrease the amount of drug in the bloodstream. The company's initial market focus is pain management.

NewBiotics Inc. is harnessing the power of the thymidylate synthase (TS) enzyme. TS, which is involved in DNA synthesis, normally is overexpressed in tumor cells, leading to resistance to chemotherapeutic agents. NewBiotics is designing prodrugs that are activated by TS inside the cell, leading to programmed cell death instead of chemoprotection.

If 1994's $61.3 billion in health care mergers seemed to put the health care industry on the road to a world of acquisition-hungry mega-merged drug, device and service companies, 1995, with its $63.7 billion in acquisition activity, has been the year of the unexpected: both in terms of what happened and what didn't.