Is it because you're saving time that you're also saving money, or are you doing something more active on this front?

I just spend money—I don't save it. [Laughs] We're trying to do smarter studies. We can save both time and money by making Phase II studies smaller to answer the specific question. We're negotiating smarter deals. We're looking at using organizations like cooperative groups that can often do studies in big numbers of people much more cost-effectively than we can, and also altering geographically where we do the studies.

But throughout everything, I keep coming back to the word quality. We're not prepared to sacrifice either patient safety or the quality of the data to save money. That's a false economy.

In 2001, we were putting nine or 10 small molecules a year into development from discovery. Our discovery colleagues have worked very hard on that productivity, and now we expect to put about 24 molecules per annum into development. That huge increase in output allows us to ask, Do we really need the same number in discovery? If we can continue to drive productivity, do we need the same size and shape of organization?

The second thing is, we did a therapy-area strategy review last year, and we decided to grow certain areas, like infection and diabetes, and we decided a number of other areas would stay the same. But we also decided to exit some areas where we thought we had a dry well or little chance of success. And by doing that, obviously, we ended up shedding some of the people who were very focused on those areas.

And then the third thing we're doing, if you take regulatory and clinical, for example, we're looking at things that are core to our activity and things that are not. So in data handling, what's unique to AstraZeneca is the design of the study and the analysis and interpretation of the data. A lot of the work in between, in terms of handling the data—whether that's electronic or paper records—is, for want of a better word, grunt work. It's a mechanical process. And we can outsource some of that mechanical processing where the overheads are lower and it's more cost-effective.

One of the big news stories this week is that China now has more clinical trials ongoing than India. Over the next five years, where do you see the majority of clinical trials being conducted?

They'll be conducted where the best patient access can be gained and where the highest-quality clinical trials can take place, giving us the better values. That's a bit of a mouthful. We're always going to conduct some of our trials in North America and Western Europe because there are incredibly well-qualified investigators with good patient access in those places, and we are prepared to pay the cost.

But Eastern Europe is a growing area for us. And, in fact, we're starting to look at whether China, Japan, and other Asian countries can actually work together. The Japanese regulatory authorities have recently started to be more open to patients from other Asian countries being counted as essentially Japanese for the registration studies.

But I'm not surprised that China is doing more trials than India—it's a very productive nation with a very large population. And look at the way their population is gathered into hospitals and the way many of their leaders have been trained in the West. Also, on the eastern seaboard they have a standard of living and a quality of life and healthcare not dissimilar from many Western countries.