During the last few years, there has been a subtle shift of emphasis in the world of sales force representatives. Nowadays, most new products are being launched into the secondary care and specialist markets such as oncology and cardiology. For example, in 2001, of the top 200 pharmaceutical products by sales, 31 per cent were in the secondary care arena. By 2008 the ratio of products with predicted blockbuster status could be 50:50.