Supporting start-ups helps them beat Big Pharm. Aff inclusion undermines counter-plan competitive advantage described in Bumenthal, 21.

Big Pharma companies have taken over a century to become market leaders. Swiss giant Roche was founded in 1896, opens new tab, while U.S. drugmaker Pfizer has been around since 1849, opens new tab, when typhoid and scarlet fever were among the biggest killers. Both giants came to dominate the industry by making savvy calls on common diseases, like cancer and infectious ailments. M&A is also a critical part of their growth story – witness Roche’s $47 billion takeover of Genentech in 2009, and Pfizer’s $43 billion purchase of cancer specialist Seagen, opens new tab in 2023. But now a new breed of tech-savvy drugmakers, once the obvious prey of their established rivals, are threatening their dominance. Over the past five years, Amgen , Regeneron (REGN.O), opens new tab, Genmab (GMAB.CO), opens new tab and Vertex have added $270 billion to their combined market values. That compares to Big Pharma firms like Pfizer, Novartis, GSK (GSK.L), opens new tab, Sanofi (SASY.PA), opens new tab and Roche, whose aggregate market value has declined by nearly $80 billion in the same period.