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John Chambers, CEO of Cisco Systems says that he possesses a “healthy paranoia”. He is paranoid that Cisco may grow too far from its customers, partners and employees. Andy Grove of Intel first wrote about paranoia in the book, “Only the par

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

anoid will survive.” Company should not just be paranoid about survival, it should also be paranoid about healthy growth.

John Chambers grew Cisco from 1995 to become a super growth engine, which fuelled the burgeoning demand for computer

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

networking. Its sales revenues grew from $2.2 billion in 1995 to $18.9 billion in 2000. The profits grew from $0.84 billion in 1998 to $4.3 billion in 2000. Without Cisco routers, there would be no World Wide Web. By year 2000, over 75 pe

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

rcent of all Internet traffic traveled over Cisco products and the future appeared bright and expected to grow from 275 million to 1 billion by 2005.

However late in 2000, the US economy went sour and by early 2001, the high-growth Cisco Sy

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

stem was in trouble. It was forced to write off billions of stocks and laid off 7,900 employees. The stock fell and Cisco Systems fell from its pedestal of growth. Chambers was always mindful that Cisco’s bubble might burst, although he was

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

taken by surprise too by the sudden turn in Cisco’s fortunes. Faster than most other CEOs under similar circumstances, Chambers restructured Cisco by putting stress on profit and cash flow performance. He put emphasis on focus, execution,

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

productivity and taking only calculated risks. The company did subsequently show signs of improvements.

Another example is Donald Trump’s corporate empire. He was acquiring and growing very rapidly from real estate, hotel, casino and airlin

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

es. When the real estate market crashed in New Year in the late 1980s, Trump was almost bankrupt. Like the proverbial Phoenix, he emerged from the ashes and became a comeback kid in the 1990s. Both John Chambers and Donald Trump had learnt

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

a bitter lesson that a company must emphasise on getting healthy first before growth and expansion.

The 1980s and 1990s were decades of growth by merger and acquisition. However, the successes had been far and few. Also, companies that wen

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

t through growth by merger and acquisition were highly geared and paid dearly for their overburdened debt situation. As a result many are still digesting their acquisition or prevented from further acquisitions. In the 2000s, growth will b

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

more organic rather than through pure acquisitions. Companies will plan more for real growth through internal development and expansion. Branson has risen to this challenge by building his businesses through organic growth rather than acq

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

uisition. Growing and starting new companies enables him to stretch his people and he enjoys providing opportunity for his employees. At the risk of overplaying his image, this strategy fits his concept of the organisational family, one th

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

at grows by progeny rather than by adoption.

One also ought to be paranoid if the company is not growing. The market, the staff, the creditors and the shareholders demand growth. The bank interests, inflation, wage increase, returns on inve

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

stments are all expected to grow and therefore the company must also grow correspondingly. Chances are that if you are not growing, your competitors are growing at your expense. Companies need to have sustainable growth, otherwise they are

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

dying. Similarly, a person who totally retires is heading for the grave and need to grow mentally in order not to become senile.

Even in so-called mature and competitive industries, companies are growing. For instance, Dell Computers is st

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

ill growing despite the very tough and mature personal computer market. Many old companies such as Coke, Proctor and Gamble and Gillette are still growing in the markets with hundreds of similar brands. Growth is always possible no matter

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

what the age is. Thomas Alva Edison deemed mentally slow by his teachers patented a total of 1,033 inventions! His work spanned a lifetime and grew with age, with the first patent issued at age twenty-one, his last at age eighty-one. For bot

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

h corporate and individual, the lesson is never to stop growing.

However, top line growth per se is useless, as evidenced in the demise of many dot.com companies in the world and construction companies in Singapore. If the growth is not a

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

ccompanied by attention to costs, productivity and efficient use of resources then the growth is not sustainable and can spell more troubles.

However, companies need to have a healthy and balanced view of growth. If growth is done artificia

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

lly to please the stock market and shareholders, then it cannot sustain. This happens to companies that go on an acquisition binge and they get indigestion. Therefore, one should target for healthy growth, which is based on a solid foundatio

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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