State-Company Institutional Complementarities on Biomedical R & D in the US and Its Global Consequences

Financial accumulation and technological dominance by transnational biopharmaceutical companies ― and its global consequences ― have been an important research topic at innovation economics, institutional economics, and international political economy literature. The United States is a privileged field for investigation, as it is home both for the companies that control the core of this industry and for the highest State-led investments on biomedical research and development (R & D). New analytical approaches that focus on State-Company interactions identify dysfunctional relations on risks and rewards. However, a neglected angle on this debate is the geopolitical dynamics surrounding market concentration, knowledge control, and technological asymmetry in the biopharmaceutical sector. This paper combines a qualitative analysis of State-Company institutional complementarities in the biopharmaceutical sector, comprised by analysis of selected official documents, review of empirical data and a case study, with a theoretical investigation inspired on the institutional thought of Torstein Veblen, the structuralism of Susan Strange and the realistic approach to international political economy of José Luis Fiori. We propose a new analytical framework in which State-Company interactions in the US are seen as symbiotic, taken under the systemic functioning of a “medical-technological-financial-complex”, what suggests “biopharmaceutical geopolitics” as an important field for future studies. The big circles represent the investments made by the selected government agencies (U$39.4 billion), by the eight largest US-based pharmaceutical companies (U$44.4 billion) and by small and medium US-based companies (U$45 billion). The small circles represents government funding through direct contracts, SBIR/STTR funds, NIH “extramural” grants, etc. The line represents joint development efforts, collaboration and technology transfer agreements, through CRADAs, NIH licenses, etc. The small triangles represents mergers & acquisitions (M & A).