1. Analysis of the drug value chain

The pharmaceutical industry, structured around treatments for major diseases, has undergone several profound transformations over the past two decades:

• several waves of mergers and acquisitions have led to a concentration of pharmaceutical companies, which have refocused on their core business: the research and development of pharmaceutical specialties. The top five groups worldwide will have a 20% market share in 2023, and four of them are American;

• longer research and development (R&D) times, leading to increasingly high costs for finding new treatments: on average, it takes just over 10 years of R&D, followed by 3 years of administrative procedures before a drug can be brought to market;

• an increase in the number of subcontractors in emerging...