Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 1
Summary
in.
The U.S. pharmaceutical industry has for decades been one of the
m ost profitable and rapidly growing sectors of the American
economy. Its continuing expansions of output, productivity, and
jobs have been achieved alongside price increases that have been
more moderate than the general rate of inflation. Together with
other high-technology industries, it has played an important role in
generating exports and net trade surpluses. Additionally, new
pharmaceuticals have made significant contributions to improved
health and to the control of escalating medical costs.
On the basis of these achievements, the pharmaceutical
industry has maintained an image of immunity from the deterio-
ration of competitive position besetting many sectors of the
American economy, such as automobiles, steel, textiles, an d
consumer electronics. Unfortunately, this image is apparently
exaggerated, and probably false. Data compiled by this study
indicate a clear relative deterioration in the foundation of phar-
maceutical competitive position--the research efforts necessary
for discovery and introduction of new patented drugs.
Persistence of the image of unchallenged American preemi-
nence in pharmaceuticals would appear to be based on two rather
unique features of the industry. In the first place, the time lapse
between strategic decisions by ethical drug firms and the impact
of these decisions on the market is particularly long. The most
critical of these decisions involves investments in discovery of
new patentable drugs, yet basic pharmaceutical research per-
formed today may well not produce marketed products within this
century, and even drugs now being synthesized will on average not
be introduced into the United States until the mid-1990s. As a
consequence, deteriorations now occurring in the relative inno-
vative abilities of American pharmaceutical firms will not be
visible in product markets for several years and not fully felt for
as long as two decades.
1
OCR for page 2
2
A second factor masking the relative decline of U.S. firms is
the inherent potential for growth in the pharmaceutical industry.
This is a time of major advances in the basic sciences of human
health, developments that have opened up significant possibilities
for new drug products and associated sales growth. Given this
progress in basic sciences, U.S. pharmaceutical firms will almost
inevitably be, and in fact are, innovative, growing, and profitable.
The performance of the U.S. ethical drug industry is thus quite
different from those less fortunate sectors of the U.S. economy
that have been damaged by escalating energy prices or that are
threatened by low-wage competition from developing nations.
Comparisons among different sectors of the U.S. economy, how-
ever, are not useful for evaluation of the performance either of
corporate management or national industrial policy, precisely
because the underlying potential for growth or decline in a
particular industry is in large measure uncontrollable. Far more
relevant comparisons may be made among U.S. and foreign firms
within the same industry, all of which have access to similar
t echnological opportunities. From this perspective of relative
U.S.-foreign competitive performance, a declining U.S. share of a
growing industry is as much a concern for U.S. industrial policy as
a declining share of an industry undergoing retrenchment.
Not every reduction in the U.S. market share of an industry, of
course, is indicative of managerial or public policy failures. FOF
example, the almost economy-wide loss of U.S. shares of major
markets to Europe during the 1950s represented the recovery of
those war-damaged economies to normal levels of output rather
than any faltering of American economic achievement. Likewise,
the gradual diffusion overseas of production by those industries
that extensively use unskilled labor has been interpreted as the
basic consequence of free trade and represents efficient realloca-
tion of resources. This report does not address the question of an
appropriate U.S. share of the world pharmaceutical industry.
Nonetheless, several circumstances--the traditional importance of
U.S. firms within this industry, the excellence of American
research in basic biomedical sciences, the enormous expenditures
of the U.S. government to fund this basic research, and the gen-
eral importance of high-technology industries for the U.S. trade
balanc - - ll suggest that the relative decline in U.S. pharmaceu-
tical competitive position should be cause for further inquiry, if
not concern.
FINDINGS ON THE U.S. COMPETITIVE POSITION
Because 14 or more years can separate the synthesis of new
ethical drugs and the ultimate marketing of these substances,
OCR for page 3
3
available data at various stages in the pharmaceutical develop-
ment process allow the examination of the expected evolution of
competitive position over the near-term future. The foundation of
national pharmaceutical competitive advantage lies in successful
innovation. Thus current research efforts provide a forecast of
future sales, earnings, and jobs in the industry. By examining
different segments of the innovation proces§-from RHO expen-
diture, to drugs entering clinical trials, to marketed drugs, to sales
and market structure for new drugs--the existing and expected
future competitive patterns may be simultaneously compared.
The basic findings on the U.S. position at various stages of the
pharmaceutical innovation process are summarized below an d
discussed in detail in the second chapter of the report.
.
The U.S. share of world pharmaceutical RED expenditures
has fallen from greater than 60 percent during the 1950s to less
than 30 percent in 1982.
· Else number of new drugs entering U.S. clinical trials and
owned by U.S. firms has steadily dropped from a yearly average of
60 in the mid-1960s to about 25 per year in 1982. In contrast, the
number of foreign-owned drugs undergoing comparable trials has
remained almost constant at about 20 per year.
· The U.S.-owned share of new drug introductions has
remained roughly stable in most major markets, with generally a
60 percent share of U.S. introductions and a 22 percent share of
worldwide introductions.
· Th e percentage of world pharmaceutical production
occurring in the United States has fallen from 50 percent in 1962,
to 38 percent in 1968, to 27 percent in 1978.
· The share of pharmaceutical sales by U.S.-owned firms fell
slightly in major markets during the 1960s and has been roughly
constant since. In our domestic market, the share of U.S. firms
was 87 percent in 1965 and 80 percent in 1982.
· Smaller U.S. pharmaceutical firms self-originate fewer new
drugs than before 1960 and are increasingly dependent on foreign
firms for licensed new products, though licensed products still
account for less than half of drug introductions by small firms.
· During the 1970s, European pharmaceutical firms established
a broad multinational base in the (J.S. domestic market that will in
the near future be used for direct marketing of European
pharmaceutical innovation.
· The U.S. share of world pharmaceutical exports has fallen
from greater than 30 percent before 1960 to less than 15 percent
today.
OCR for page 4
4
An overview of these trends indicates a marked drop for the
U.S. presence in world pharmaceutical markets around 196 0,
followed by stability in the U.S. share of new drug introductions
and sales (outputs of the innovative process). In contrast, the U.S.
share of R&D expenditures and drugs entering clinical trials
(inputs of the innovative process) has continued to decline,
strongly suggesting an eventual further decline in U.S. shares of
introductions, sales, and exports.
DETERMINANTS OF NATIONAL PHARMACEUTICAL
COMPETITIVE ADVANTAGE
Sources of these trends in competitive postion can be segregated
into two categoric - -those factors that generally affect the entire
U.S. economy and those factors that have unique impact on the
pharmaceutical industry. Numerous studies have documented an
almost economy-wide deterioration in competitive position for
American firms against their foreign counterparts. As is di s-
cussed in the third chapter of this report, many of the declines in
U.S. pharmaceutical competitive position listed above can be
attributed to whatever factors have led to the relatively poorer
performance of the U.S. economy in the aggregate.
Two aspects of pharmaceutical competitive position, however,
are atypical from the general U.S. industrial experience. The first
unique feature has been the precipitous drop in the proportion of
world drug production located within U.S. boundaries, a decline
wholly unmatched in other segments of the chemical industry.
Foreign non-tariff trade barriers such as discriminatory safety
regulations and pricings by public health authorities are apparently
the predominant cause of this divergent trend. Second and even
more significant for the future economic strength of U.S. ethical
drug firms, the steady decline in the American share of world
pharmaceutical R&D efforts is markedly more severe than com-
parable changes in world RED shares for other U.S. industries.
Again, factors specific to the ethical drug industry should be
invoked to explain this distinctive performance. Factors that have
contributed to this important trend are (in no particular order):
Foreign non-tariff trade barriers, mentioned above.
U.S. Food and Drug Administration (FDA) regulations,
imposing significant costs and delays on the research efforts of
U.S. firms.
· Patent laws, differing among developed nations in the
extent of market protection provided to innovators. In this
regard, U.S. patent policy is more restrictive than that of certain
nations, but more generous than that of some others.
OCR for page 5
· Li ability regimes for consumer product claims that are
more cumbersome and risky in the United States than in certain
competitor nations.
· Antitrust policies that may prevent attainment of
economies of scale in pharmaceutical research through mergers
among U.S. firms.
· Tax incentives for conduct of research.
Determination of the specific relative importance of each
factor is beyond the scope of this study. The basic conclusion to
be drawn, however, remains that the overall balance of several
(possibly conflicting) government policies provides a relatively
more favorable environment abroad for pharmaceutical research.
Careful evaluation of these and other government policies with
the goal of encouraging innovation is needed.
OPTIONS FOR AMERICAN POLICY
The study identifies a variety of policy options to counteract the
causes of decline in the competitive position of the United States
pharmaceutical firms.
Trade Options
FDA policy prohibiting the export of unapproved new drugs, and
thus requiring United States companies to manufacture these
products abroad, should be revised by regulation to permit the
export of pharmaceutical chemicals for such use. The prevalence
of foreign trade barriers that favor domestic products over
American drugs should be investigated to determine an
appropriate United States response.
Domestic Economic Options
Le. gislation should be enacted to restore the amount of patent
time lost as a result of FDA regulatory requirements. Antitrust
policy should be reconsidered to determine whether it discourages
mergers that would make U.S. pharmaceutical companies more
effective competitors on a worldwide scale. Research tax credits
should be expanded to include research-related expenditures not
now eligible for the investment tax credit. Research and develop-
ment expenditures incurred in the United States should be allo-
cated solely to the United States income of the taxpayer. The
OCR for page 6
6
impact of product liability on the pharmaceutical industry should
be studied in an attempt to reduce this disincentive to research.
Regulatory Options
The recommendations of the recent report of the Commission on
the Federal Drug Approval Process should be implemented by FDA
through administrative changes in current regulations as rapidly as
possible. Adoption of these recommendations would expedite the
IND and NDA review process, thus reducing the size of the
investment needed to develop new pharmaceutical products and
increasing the return on such investment. Improvements in the
drug approval process can be made without any reduction in public
health protection and can be expected to result in more rapid
availability of important new drugs to combat serious diseases for
which effective drugs are not currently available.
Representative terms from entire chapter:
world pharmaceutical