Actelion reached profitability in record time by focusing from the start on the development and commercial end of the business. It in-licensed an unusually late-stage pipeline made up of compounds its founders helped develop, and built its own global sales and marketing infrastructure to maximize the value of its projects. Now Actelion plans to leverage growing profits to go back and nurture earlier stage research-a top-down biotech-building model that may prove inspirational to others.

In the second of a two-part series focused on Genzyme's European operations, In Vivo Europe Rx looks at how Genzyme is addressing the challenges facing Renagel's uptake in Europe-cost-conscious reimbursement authorities, cheaper competitors and conservative physicians-in order to secure its most important mid-term growth source.

Sustainable and increasingly focused, mid-sized vaccines companies are leading the way in European biotech, catalyzed by fears of bioterrorism and a re-emerging belief that prevention trumps cure, both practically and pharmaco-economically.