It has all gone horribly wrong for the A dozen or so manufacturers that make up "big pharma". The withdrawal of high-profile drugs, growing suspicion among consumers about drug companies' ethics, and arguments with regulators and customers have all dented what until recently was one of the least-tarnished of industries. A string of books has attacked the marketing tactics used by the industry, while lamenting the diminishing returns from its much-touted search for new drugs. Some observers have questioned whether a business model that was once capable of producing huge and reliable profits has been irreparably damaged. The industry is struggling to come to terms with a changing environment in its biggest and most lucrative market, America.
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