Yet another survey has been released gauging the mood among big pharma execs and, not surprisingly, most are rather glum. The findings by RolandBerger, a consulting firm, indicate that US profits appear to be in jeopardy, outsourcing will continue unabated, in-house R&D is unlikely to solve industry problems, and cost cutting will definitely continue. Bright spots? Brazil, Russia, India and China, the so-called BRIC countries, which are large and growing quickly.

Here are some of the results: Roughly half of the respondents say their US profits will decline in the medium to long term. About one-third say getting drugs registered is a major problem at the moment. In the EU, lengthy reimbursement procedures and pricing both cause 28 percent of the execs a headache. In Japan and the BRIC countries, about one-fourth say pricing is a problem. The UK is considered to be at the forefront in the areas of market access and reimbursement.

But 22 percent say the BRIC countries are key growth engines. Almost all drugmakers have begun efforts to shape emerging healthcare markets and secure market share. Meanwhile, 45 percent expect to “fundamentally” revise marketing and sales models in the next year or two, with a special focus on payors and clinical differentiation, while more outsourcing is considered an effective way to increase profitability.

In fact, when it comes to ensuring innovation and rebuilding pipelines, 41 percent prefer outsourcing innovation (buying individual licenses or entering into partnerships), and 39 percent think buying whole companies is the best approach, especially in the biotech area. Only 20 percent think in-house R&D is the most efficient source of future innovations.

Over the past two years, cutbacks occurred dramatically - in sales (69 percent), production (59 percent), distribution and logistics (59 percent), marketing (57 percent) and chemical production (41 percent). The largest potential for further cuts is in marketing and sales. About 25 percent of the respondents say that this is even more than 10 percent.

“Many managers still think that they can cut costs fast and effectively by isolated actions. This may give them a short breather, but in the long term, they must examine their entire value chain,” says Aleksandar Ruzicic, a principal at Roland Berger, in a statement.