ABSTRACT
Despite the fact that the global pharmaceutical market revenue appears positive with a 2017 turnover of $934.8 billion, there are increasing concerns about the level of future growth. Within the next five years, there is apt to be a sustained period of flat growth resulting from the likely adoption of price constraints in the U.S. Since the U.S. accounts for approximately 70% of pharma’s net operating income, the imposition of U.S. price constraints will precipitously curtail the industry’s global operating margins. The reasons for this potential change can be linked to the high cost of medicines in the U.S. compared to the rest of the world, the increasing economic burden on U.S. families, mounting criticism from the public and government sectors brought about by the industry’s perceived price-gouging of consumers and taxpayers, pharma’s role in promoting over-medicating consumers in the advanced countries and making life-saving medications unaffordable to millions. Contributing to the growing animosity towards the industry is the significant increase in legal action that authorities worldwide are taking relative to pharma’s violations relating to “off-label” promotion, kickbacks and shady inducements to prescribing physicians. Public consternation against pharma has also increased as a result of the industry’s practice of subverting the channels of scientific and medical communication, together with its controlling sponsorship of patient advocacy groups that creates unethical conflicts of interest among these organizations
