title: US pharmaceutical innovation in an international context.
abstract: OBJECTIVE
  We explored whether the United States, which does not regulate pharmaceutical prices, is responsible for the development of a disproportionate share of the new molecular entities (NMEs; a drug that does not contain an active moiety previously approved by the Food and Drug Administration) produced worldwide.
  
  
  METHODS
  We collected data on NMEs approved between 1992 and 2004 and assigned each NME to an inventor country. We examined the relation between the proportion of total NMEs developed in each country and the proportion of total prescription drug spending and gross domestic product (GDP) of each country represented.
  
  
  RESULTS
  The United States accounted for 42% of prescription drug spending and 40% of the total GDP among innovator countries and was responsible for the development of 43.7% of the NMEs. The United Kingdom, Switzerland, and a few other countries innovated proportionally more than their contribution to GDP or prescription drug spending, whereas Japan, South Korea, and a few other countries innovated less.
  
  
  CONCLUSIONS
  Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation were significant contributors to pharmaceutical innovation.
authors.affiliation: Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1077, New York, NY, 10128, USA. salomeh.keyhani@mountsinai.org
authors.forename: Salomeh
authors.initials: S
authors.lastname: Keyhani
authors.forename: Steven
authors.initials: S
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Hebert
authors.forename: Daniel
authors.initials: D
authors.lastname: Carpenter
authors.forename: Gerard
authors.initials: G
authors.lastname: Anderson
mesh_terms: D001315:Australia; D001317:Austria; D003604:Czechoslovakia; D003718:Denmark; D016527:Drug Costs; D004345:Drug Industry / Q000191:economics / Q000706:statistics & numerical data*; D015507:Drugs, Investigational / Q000191:economics; D004467:Economics / Q000706:statistics & numerical data; D006801:Humans; D007723:Korea; D009664:Norway; D012109:Research Support as Topic / Q000191:economics / Q000706:statistics & numerical data; D013030:Spain; D014481:United States
chemical_list: D015507:Drugs, Investigational
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