Illness is a serious business

A fear of injections was the least of an invalid's worries in Elizabethan England. The average life expectancy was 38 years, and 30 per cent of children died before the age of 10. Pneumonia and plague were prevalent, and doctors had few effective medicines.

Today, we have antibiotics and anaesthetics, and soon even the dreaded jab may become a thing of the past: pharmaceutical companies are exploring new ways of enabling diabetics to take insulin, including oral spray, inhaled powder and transdermal patches. "The discomfort of self-injection is thought to deter many people from starting insulin treatment," says Dr Richard Barker, director general of the Association of the British Pharmaceutical Industry (ABPI).

It takes 10 to 12 years, and around £500m, to produce a new medicine. There is intense competition between pharmaceutical companies, and no one company has more than 10 per cent of the market. Once sufficient research has been conducted to prove that a company can produce a safe medicine in significant amounts, it can apply for a patent.

The patent has a 20-year life and the race is on. During that time, the experts are at work. However, they are not all scientists in white coats. Only 20 per cent of a company's staff might work in laboratories. According to an HR spokesman for the pharmaceutical company AstraZeneca, "We have 64,000 employees worldwide, and around 12 per cent are in R&D [research and development]".

Working in pharmaceuticals is not for anyone who has objections to animal testing. Oxford University's controversial new £18m biomedical research lab, for example, has provoked both threats from extremist animal-rights groups, and a wave of support from those who believe that animal testing is a necessary part of medical research, including many students from Oxford and elsewhere. (Some people in the field remain cautious, hence the few surnames in this article.)

Pharmaceutical companies offer jobs in pharmacology and analytical chemistry. They also employ life scientists - biochemists and molecular biologists, pathologists and toxicologists. But the manufacturing process requires input from other disciplines, too.

The three arms of the pharmaceutical industry are R&D, engineering and the supply chain, and they take the product from small-scale development to large-scale manufacture. Between them, they offer employment to quality-controllers and chemical, electrical, mechanical and process engineers who design and maintain plants and equipment.

There are also the business-support jobs of any large company - administration, finance and customer service - and some jobs requiring analytical skills but not necessarily a scientific background, such as patent attorney work and regulatory affairs.

Caroline, for example, is an associate regulatory affairs manager with AstraZeneca. She describes her work as a combination of the technical and the legal. "My role varies according to whether a product is in the development or maintenance phase," she explains. "At the development stage, I might be making applications for clinical trials, marketing authorisations granted by different countries, or line extensions for new uses based on continuing research.

"For instance, we might find that a breast-cancer treatment drug can also be applied to prostate cancer. Licences come up for renewal, and also need to be maintained. I may also submit changes to labels to reflect new information on the safety profile of a drug."

Caroline needs to tackle legislation and have a good grasp of its implications. Her job doesn't require technical expertise, but she must, she says, "have an overview of the product and understand what I am putting in a submission".

A significant proportion of a pharmaceutical company's staff work in sales. Trainees often begin here, promoting products to GPs, practice nurses and pharmacists through meetings, conferences and one-to-one meetings. Most companies do not restrict their intake to science graduates. Take Merck Sharp & Dohme. A spokeswoman says: "Social and commercial skills are important but trainees must also have a good class of degree and be capable of understanding both products and disease areas."

Some people make a career in sales, others use sales as a stepping-stone. One medical sales rep says: "Building relationships is key. GPs are under a lot of pressure, but if you have mutual respect and they see that a product can add value to patients' treatment, they make time to see you."