In the early, heady days of disease management (DM), pharmaceutical companies leapt into the area with high hopes of making profits that would rival those from their products. Today, few companies still provide DM services, and the 'prefab' DM programme has all but disappeared. Speaking at the 2nd Annual Disease Management Leadership Forum*[Baltimore, Maryland, US; November 2000], Mark Zitter, chairman of the Zitter Group, US, explained why DM still presents opportunities for the pharmaceutical industry, and what shape pharma industry's future involvement in DM is likely to take.