Established companies are working to succeed in the current market while also preparing for a future that is very different from the business that characterized past decades. The challenges are profound in maintaining excellence in an existing business while also transforming the very industry where one is successful. New entrants have more freedom to use new technologies and business models to define the future. But they must also learn how to manufacture or obtain products on a global scale that are reliable and safe and comply with decades of accrued regulatory structure.