Dear Readers,

When politics and pharma collide, the fallout can be far-reaching. On the surface, bringing pharma manufacturing back to American soil sounds appealing. It promises jobs, economic growth, and national security in our medical supply chains. Who wouldn't want life-saving medications produced domestically rather than relying on foreign nations?

But as this issue’s lead feature reveals, the economics of pharmaceutical manufacturing are far more complex. New manufacturing facilities can take 5-10 years to become operational and cost billions of dollars. These aren't switches that can be flipped overnight. And even when complete, higher domestic production costs inevitably translate to higher prices for medications.

Beyond the wave of political headlines, a broader theme emerges for the industry: transformation under pressure. Whether it’s the evolving sophistication of real-world evidence, the push to revive stagnant brand campaigns without compromising quality, or the recalibration demanded by the EU’s sweeping HTA reform, the message is clear – the industry must adapt or risk falling short.

So, whether you’re in market access, a commercialisation expert, or just curious about how therapies make it from lab to life, I hope this issue helps paint a picture of where we are today and where we could be tomorrow. There’s a lot to unpack.

Happy reading. 

Eloise McLennan
Deep Dive editor