The biopharmaceutical industry is undergoing a striking transition. In developed markets, one-size-fits-all medicine is being replaced with higher-efficacy treatments for targeted populations. In emerging markets, a burgeoning middle class and larger public investments in healthcare infrastructure are resulting in rapid growth of the pharmaceutical sector. In some developed and emering markets, reimbursement lists favor domestically produced pharmaceuticals, making local manufacturing a requisite for market entry. Smaller target markets for each molecule; volatility in regulatory and political environment in emerging markets; and stronger payer influence in developed markets are resulting in more frequent changes in commercial decisions. All of these trends are stepping up pressure for speed, flexibility and reliability in the pharmaceutical supply chain.