Stroke remains a devastating disease that isn't adequately addressed, but the pharmaceutical industry remains wary of the field, having been stung in the past by extremely expensive clinical disappointments. Nevertheless, the opportunity is too enticing for the industry to ignore completely. Two pharma-sponsored major clinical trials are underway for treatment of acute ischemic stroke, foro example. The emerging companies with stroke therapies profiled here, however, are cautiously pushing forward on several fronts, of which the stroke market may or not be the first and foremost application of core technology.

ACOs have been one of the most hyped innovations in the US health care sector this decade. The buzz may be overdone, but ACOs are now established as a different—and confusing—new customer segment for pharma. How is industry adjusting?

Pharma companies are building long-term value propositions that should appeal to Accountable Care Organizations into some go-to-market strategies for new drugs and to repositioning efforts of already marketed drugs that have hit snags. The rationale might seem straightforward—for example, more convenient dosing that improves compliance and cuts down hospitalization rates--but the nuances can be complex. Moreover, even when their products appear to have compelling cases for value, companies have not by and large made ACOs a distinct target for their commercial operations.