Historically, the global pharmaceutical industry has focused almost exclusively on the established regional markets of North America (particularly the US), Europe (particularly the ‘big 5’ West European nations), and Japan. For an industry whose business model is founded on charging premium prices for novel therapies, these markets possess the scale and wealth to generate the profits required to support expensive, high-risk development programs. The rest of the world (or “ROW”) was generally treated as an afterthought.

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