Marys Medicine

Most companies default to the same approach for executing Finding the Right Path each new strategy. Here's a framework for your journey. by Laurence Capron and Will Mitchell Included with this full-text Harvard Business Review article: Idea in Brief—the core idea Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.
Finding the Right Path Idea in Brief
The typical firm relies on one chief path to growth. Some companies develop most resources internally, others focus on licensing or joint venturing, and others are M&A specialists.
When firms fail at resource development, they tend to see it as an implementation problem. But research shows that the mode of acquisition is crucial to success. What's more, companies acquiring resources in multiple ways are 46% more likely to survive the next five years than those relying mainly on alliances, 26% more likely than those focusing on M&A, and 12% more likely than those sticking with internal development. To select the right mode for the situation, ask three basic questions: Are the resources you have relevant to the ones you want? If so, opt for internal development; if not, go outside the company.
How easy is it to agree with resource providers on the value of what they have to offer? You need a shared understanding of value to make a purchase contract work effectively. Otherwise, consider an alliance or a business acquisition.
How close a relationship do you need to ALL RIGHTS RESER have with your provider? If generating the resources you want requires the involvement of many people and units, M&A may be a better solution than a partnership.
BUSINESS SCHODRAV OPYRIGHT 2010 HARC Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.
Most companies default to the same approach for executing each new strategy. Here's a framework for your journey. Finding the Right Path by Laurence Capron and Will Mitchell Executing a new strategy nearly always in- of problems—in particular a lack of people volves acquiring new resources and capabili- and skills (67%) and a poor ability to integrate ties. Since firms can't possibly get everything acquired businesses (50%).
they need through internal development, it By blaming implementation rather than seems reasonable in theory to expect that looking at corporate-development strategy, they'll often turn to licensing agreements, alli- companies leave a lot of value on the table.
ances, and M&A as well.
Our study demonstrates conclusively that firms ALL RIGHTS RESER Surprisingly, however, the typical firm re- using all the resource acquisition methods out- lies overwhelmingly on one chief way of ac- perform those with a narrow approach. Specif- quiring resources. In a 10-year global study of ically, firms acquiring resources in multiple 162 telecom companies, we found that only ways are 46% more likely to survive over a five- one-third actively use all the methods avail- year period than those relying mainly on alli- able to them. Some still develop almost all re- ances, 26% more likely than those focusing on sources in-house; others focus on licensing or M&A, and 12% more likely than those sticking joint ventures; others are M&A specialists.
with internal development. It's also worth not- When a firm does add a string to its bow, it's ing that 54% of managers who haven't paid usually just one: for example, M&A to com- close attention to the tactics they've used re- plement internal development. What's more, port a high failure rate in resource acquisition, when asked to explain why they struggle to compared with only 20% of those who have build new resources and capabilities, few of looked at the full range of options and made the managers in our sample seemed to sus- careful choices about which ones to explore.
pect that it's because they're doggedly apply- Here, we provide a framework to help you ing the wrong approach. More than half become a more strategic decision maker when flagged implementation as the primary cause acquiring resources. We outline three ques- OPYRIGHT 2010 HARC harvard business review • july–august 2010 Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.
tions you'll need to consider, in sequence, to se- has happened in many telecom companies, lect the best tactics for the situations you face.
where voice traffic departments have been In deciding whether to develop existing re- loath to relinquish power to data traffic depart- sources internally, ask yourself if they are rele- ments: "In some firms, investments and re- vant to your new needs. If not, it makes sense source allocations [in] data technologies have to pursue a contract or some other arrange- been postponed or limited due to this internal ment with an external provider. Figure out which way to go by gauging whether all parties For this reason, having technical or commer- have the same understanding of the resources' cial knowledge that seems functionally relevant value. Unless everyone is in agreement, a con- isn't enough to enter a new business. Firms that tract won't work—and you must then sort out require different organizational models often what depth and scope of relationship you want fare better if they import new systems rather so you can choose between engaging in a stra- than adapt what they have. When market pres- tegic partnership and making an outright ac- sures (notably in the case of acquisitions) pro- quisition. (See the exhibit "Finding Your Way vide momentum, the firm can integrate the to the Resources You Need.") new resources with some degree of buy-in from Our framework builds on our formal re- employees and other stakeholders.
search over the past decade and on extensive Let's look at the British medical-imaging discussions with managers at established and pioneer EMI and the Indian IT-consulting emerging firms in multiple product and service firm Infosys. EMI attempted to develop a industries throughout the world. By following new-generation CT scanner internally when this approach to acquiring new resources, you its first device began to face competition. But can prime your company for growth.
its efforts were derailed by internal conflictsover resource use, technical trade-offs within its Question 1: Do You Already Have
multiple labs, and disagreements among mar- keting personnel. In retrospect, the company Developing new resources internally is faster would have been better off identifying and ob- and more effective than acquiring them from taining technology outside the firm. Indeed, it external parties when your firm's existing re- could have turned to the established X-ray sources are similar to the ones you need and equipment maker Picker, which was lagging in when you outshine competitors in the tar- the market despite its strong technical capabili- geted area. Obviously, this means that most in- ties and seeking a partner or even a buyer.
cremental advances are best undertaken in- Infosys, by contrast, in-licensed new software house. But internal development can jump- technology when it began to offer health-sector start major initiatives, as well. The Israeli services, even though the new services called pharmaceutical firm Teva, for instance, has for tech-development skills similar to those ap- begun producing proprietary drugs in addi- plied in its existing business. The company tion to its generics by building on existing re- chose an external source because health care search skills, both within its labs and through consulting required a substantially different or- its long-term relationships with academic sci- ganizational structure. By entering a licensing entists. Similarly, Neuland Laboratories in agreement, it created an immediate presence India has used its established technical and in the new market segment, bypassing the or- production base to expand beyond commodity ganizational conflict that would have arisen if production of active pharmaceutical ingredi- the company had attempted simply to adapt ents and create a contract research and manu- its existing offering.
One caveat: Conflict isn't always something Even when developed internally, new re- to avoid. You may be able to use it to generate sources and capabilities that threaten to make insights that will help you build stronger re- ofessor at Insead in current ones obsolete will meet with resistance sources. Be selective, though, because even Fontainebleau, France, and the research from anyone invested in the old practices, cul- productive conflict takes substantial time and director of the Insead-Wharton Alliance. ture, and processes. People may even shun the effort to manage. If internal debates will yield development of new resources in order to pre- benefits that you couldn't obtain from external is a professor at Duke University's Fuqua serve existing values and retain power. As one sources, use them—but bring them to a close School of Business in Durham, North of the managers in our study pointed out, this after the insights emerge.
harvard business review • july–august 2010 Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.
Also, choosing between internal and exter- However, purchase contracts work only nal approaches is not a once-and-for-all deci- when the parties craft a transparent agree- Choosing the Right sion. Smart companies revisit the question all ment. They fail when partners don't start
the time as they build their competitive posi- with a shared understanding of the re- Way to Acquire
tioning in new businesses. When General Elec- sources' value. If one side knows less about tric entered the CT scan business, for instance, that value than the other, it will be reluctant When deciding whether to develop it licensed technology from the early entrant to negotiate a contract for fear of being resources internally or obtain Disco because GE believed that its existing ra- taken advantage of. Bosch, a German auto- them through purchase contracts, diography skills provided an inadequate motive and industrial technology company, alliances, or acquisitions, you'll knowledge base to thrive in the new market.
considered using a purchase contract to ob- need to weigh three criteria: the But after GE had expanded that base, it contin- tain air-conditioning technology from the relevance of existing resources to the ued with internal development of highly suc- Japanese firm Denso but decided not to, be- organization's new strategic needs, cessful CT instruments.
cause Denso had far more knowledge about the level of shared understanding the value of the resources.
with third parties (such as potential Question 2: Do You and Your
It's even more common to struggle with as- licensing partners) about the value Provider Have a Shared
sessing a contract's value because the exchange of resources they will provide, and Understanding of Value?
of resources has unquantifiable effects. The the desired depth and scope of If internal development doesn't seem sufficient, former Swedish drug company Astra and the relationships with those outside a contract such as a licensing agreement may be U.S. company Merck explored using a simple a sensible route, because it's the simplest way of license to introduce Astra's anti-ulcer drug obtaining resources externally. Pharmaceutical Prilosec to the U.S. but quickly realized how firms, for instance, commonly license the rights complicated that would be: They'd need to to register and market other companies' drugs conduct extended clinical tests and create a in particular geographic markets.
new form of pharmaceutical marketing in the Finding Your Way to the
Resources You Need
Go after new resources in the simplest way that IDENTIFIED RESOURCE GAP
will satisfy your strategic goals. For instance, when deciding whether to develop them inter-nally or externally, tweak the ones you already K INTERNAL DEVELOPMENT OR
have if they're highly relevant to what you seek. AS EXTERNAL SOURCING?
Business acquisition is your most complex op- RELEVANCE OF THE FIRM'S
tion; reserve it for when it really pays to have a EXISTING RESOURCES TO
close relationship with your provider.
harvard business review • july–august 2010 Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.
U.S., all of which was difficult to reduce to a R&D and marketing partnerships to freestand- dollar amount for a license.
ing joint ventures. They allow firms to create When the present or future value of the new governance mechanisms that protect the part- resources is elusive, the two parties will strug- ners from opportunistic behavior. Such mech- gle to agree on terms and to enforce them to anisms are often imperfect but provide greater both sides' satisfaction. Coordination will be- security than arm's-length purchase contracts, come time-consuming and costly over the long and they can establish systems for coordinating run. Such problems will be attenuated or am- ongoing exchanges between the partners as plified depending upon the skills of the firm the value of the resource transfer becomes looking for resources. As one manager ex- clear. For instance, Astra and Merck commer- plained to us: "The more data skills you have, cialized Prilosec in the U.S. through a joint the less intangible this know-how becomes.
venture, AstraMerck. The partnership accom- The more qualitative insights and feelings you plished what a licensing agreement couldn't: It have, the more you reduce the risk of not com- established a framework for transferring tech- manding the intangible aspects of the technol- nical knowledge needed for clinical trials, de- ogy you buy." In other words, you need to pos- veloping a new approach to retailing in the sess certain competencies before you can U.S. gastrointestinal medical market, specify- acquire a technology effectively.
ing the financial commitments and rights of If you lack those competencies, you must each partner, and coordinating and adapting consider whether to engage in some kind of activities over time.
broader alliance with an external provider. Al- Alliances are most effective when relatively liances can take many forms, ranging from few people and organizational units from each In Practice: Eli Lilly
Good corporate development involves cultivat- partnerships. Lilly created the Office of Alliance ing the full range of resource-acquisition capabil- Management to help figure out when partner- ities: nurturing internal development, negotiat- ships make sense and to oversee the ones the firm ing contracts, managing partnerships, and chooses to pursue. The company now uses alli- buying other businesses. ances to develop products and technologies that Take Eli Lilly. Several thousand people are en- draw on the partner organizations' combined ca- gaged in an extensive set of internal development pabilities. It has undertaken more than a hundred projects at Lilly Research Laboratories in the U.S., such partnerships during the past 20 years. China, Singapore, Spain, and elsewhere. The Lilly relies on M&A when relationships between company decides whether to invest in such independent partners would be too intricate to projects by determining which ones will build on manage. It has an active acquisition-evaluation its existing capabilities. Around 80% of its major team that includes senior corporate leaders. The projects focus on three core therapeutic catego- company has acquired around a dozen firms in ries: cancer, diabetes, and neurological disorders.
the past 20 years, for more than $14 billion. In Lilly also actively pursues purchase contracts. 2007, for instance, Lilly paid more than $2 billion Over the past two decades, it has secured ap- for ICOS, its partner in the development of Cialis. proximately 200 in-licensing agreements. These (Almost half of Lilly's acquisitions involve prior confer rights to compounds, products, delivery partners.) The reason for the acquisition? The re- technologies and devices, development and pro- lationship between Lilly and ICOS had evolved so duction processes, software, and geographic that joint activities needed substantial integra- markets. Lilly uses basic licenses only when it tion, partly to commercialize and develop new can negotiate focused agreements to cover the dosages of Cialis and partly to investigate addi- primary contingencies. tional uses for its active ingredient, such as treat- But when development and commercialization ing pulmonary arterial hypertension. relationships are somewhat complex, the com- The ability to go after resources in the right pany typically forms alliances, ranging from stand- ways and effectively implement its choices under- alone joint ventures to cross-site collaborative lies Lilly's successful growth and transformation.
harvard business review • july–august 2010 Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.
party need to work together to coordinate the often costly and disruptive for the merging joint activities. That was the case in the As- firms. But they do allow the resource-seeking traMerck venture. Similarly, General Electric's company to control coordination of targeted aerospace business and the French firm Snecma and current resources, form a more stable have maintained a long-term aircraft engine knowledge platform for future developments venture, CFM, that rests largely on independent than alliances would offer, and gather more activities by the two partners. Little contact is encompassing resources than discrete licenses required to coordinate technical and marketing would provide. Johnson & Johnson, for in- activities in different geographic markets.
stance, has long followed a strategy of buying A classic example of an alliance that failed businesses and then, over time, reconfiguring because it was too broad in scope: the attempt and integrating the targets with the company's by Renault and Volvo to integrate their devel- other business units. In this way, J&J has cre- opment and marketing efforts while remain- ated and commercialized many important ing independent companies. The carmakers products, from Tylenol to drug-coated stents.
created a complex set of governance and man- M&A needs to be the final choice in the de- agement groups to coordinate activities. Their cision sequence because acquiring and inte- joint work managed to produce a few vehicle grating your target firm requires so many fi- offerings but quickly foundered as conflicts nancial and managerial resources. Keep in arose between the firms. The alliance was far mind that overreliance on acquisitions adds to Smart companies keep too complex for two independent, presumably your overall risk and may stretch your M&A in- revisiting the question of equal parties to manage. Renault learned its tegration capabilities too thin. In some cases, a lesson, though. It insisted on taking the strate- difficult alliance may be preferable to one ac- how they should develop gic lead in its alliance with Nissan, essentially quisition too many.
new resources. acquiring control of the Japanese company.
Firms using M&A regularly must be disci- plined about selling off the resources they do Question 3: How Deeply Involved
not need, lest they become overloaded with ex- Do You Have to Be with Your
cess baggage. J&J sheds businesses when it has extracted what it wants. General Electric di- Suppose that a partnership won't take you far vests as often as it purchases, after reconfigur- enough toward your goals—or that generat- ing its targets.
ing the resources you want will require the in- It's not hard to see why firms tend to focus volvement of many people and organizational on just one mode of resource acquisition. Each units. Corporate acquisition might be your approach calls for different selection skills and best alternative, especially if the relationship implementation capabilities, which in turn call between your firm and the resource provider for different cultures and organizational struc- would involve highly strategic assets.
tures, and these all take time to build. Al- For instance, when trying to find new though sticking with one mode may work in uses for the active ingredient in the erectile- the short term, the long-term risk is that the dysfunction drug Cialis, Eli Lilly decided to company will end up doing the wrong things purchase cocreator ICOS rather than con- really well, lagging more broadly capable com- tinue with the firms' partnership. It became petitors, and, quite likely, becoming targets clear that the new development efforts would call for too much coordination overtoo long a time period for the alliance to keep working effectively.
To order, call 800-988-0886 or 617-783-7500 Of course, business acquisitions are a crude means of obtaining specific resources. They are harvard business review • july–august 2010 Made available by Laurence Capron, INSEAD and Will Mitchell, Duke University. Further posting, copying or distributing is copyright infringement.


Issue AUGUST 2015 STAFF NEWS SHOP TALK Continued We are very sad to announce that Giles Andrew McQuade MVB – Veterinary promotion. Dion is now the owner of a Stihl and Rosie will be retiring at the end of Surgeon. chainsaw, so there'll be no excuse for a lack of the year. They have played a significant


PD Dr med WP Bieger NeuroStress Guide EINLEITUNG Der vorliegende NeuroScience-Guide ist als Anleitung für Patienten, Ärzte und Therapeuten gedacht. Er soll einen Einblick in die Funktionsweise des Neuroendokriniums und in die Grundlagen neuroendokriner Funktionsstörungen und deren Behandlung vermitteln. Die von uns entwickelte „NeuroStress"-Diagnostik wird vorgestellt und physiologische Behandlungsformen besprochen. Schon lange gibt es hochwirksame Substanzen für die natürliche Behandlung psychoneurovegetativer Störungen, die allerdings durch die Entwicklung der modernen Psychopharmaka verdrängt wurden. Die unbefriedigenden Ergebnisse der Antidepressiva haben die traditionellen Behandlungskonzepte jedoch wieder ins Bewusstsein gerückt. Unser aktuelles ganzheitliches diagnostisch-therapeutisches Konzept greift die bewährten Verfahren auf und verbindet sie mit innovativen Diagnose- und Behandlungsformen aus den USA. Eingangsüberlegungen: 1. Die Zahl neurovegetativer Störungen und psychischer Krankheiten nimmt weltweit stark zu. Damit auch die Nachfrage nach neuen diagnostischen Möglichkeiten und effzienten, gut verträglichen Behandlungen. Seit Jahren steigt die Zahl psychischer Störungen in den westlichen Industrieländern. Man geht davon aus, dass bis zu 60% der Krankheitsfälle in der täglichen ärztlichen Praxis psychischer Natur sind bzw. eng mit psychischen Belastungen verbunden sind. Schon heute entfallen viele Krankheitstage auf psychische Störungen, ihre Zahl nimmt ständig zu, während die Gesamtzahl krankheitsbedingter Fehltage seit Jahren zurückgeht. Besonders gravierend ist die Zunahme der Depressionen. Während Herz-Kreislauferkrankungen, Herzinfarkt, sogar die häufigsten Krebserkrankungen (Lungen-, Brust- und Prostatakrebs) seit einigen Jahren abnehmende Tendenz zeigen, nimmt der Anteil von Depressionen ständig zu. Die WHO geht in einem ihrer jüngsten Gesundheitsberichte (2006) davon aus, dass bereits in den nächsten 5-10 Jahren Depressionen die zweithäufigste medizinische Krankheitsursache überhaupt sein werden. 2. Psychopharmaka werden heute in enormem Maße eingesetzt, sie sind mit >65 Mrd € die umsatzstärkste pharmazeutische Präparategruppe. Ihre Wirksamkeit, vor allem die der Antidepressiva, ist jedoch begrenzt. Die Nebenwirkungen sind zahlreich und zum Teil lebensbedrohlich. Immer wieder werden Zweifel am Aussagewert von Psychopharmakastudien geäußert, die Publikation von klinischen Studien mit Antidepressiva erfolgt offensichtlich nach willkürlichen Kriterien (NEJM, 2008). In einer kürzlichen Metaanalyse wurde die fehende Wirksamkeit von Antidepressiva bei leichten bis mittelschweren Depressionen konstatiert (PloS Medicine, 2008). Nur bei schweren Depressionen findet sich ein Vorteil von Antidepressiva gegenüber Placebos. 3. Die Neurobiologie psychischer Störungen wird seit Jahren intensiv untersucht, neue Untersuchungsverfahren wie MRT, PET, SPECT, Immunologie oder Molekulargenetik haben das Verständnis der zentralen Prozesse enorm verbessert. Neue Diagnose- und Behandlungsverfahren können daher stärker auf Wissen und weniger auf Zufallsbeobachtungen wie bisher basiert werden. STRESS Als eines der zentralen Geschehen gilt chronischer Stress, der vielfach zu bleibenden psychovegetativen Störungen führt. Ein kürzlich erschienenes Buch des Bonner Psychiaters Prof. Benkert (2006) hat den Begriff der „StressDepression" geprägt und damit „Stress" als ganz wesentlichen Grund für psychische Störungen einschließlich Depressionen in den Mittelpunkt