The pharmaceutical industry is praised as a leader in high technology innovation and the creator of products that increase both longevity and quality of life for people throughout the world, Yet the industry is so reviled for its marketing and pricing practices and even its research and development priorities. The competitive nature of the industry is undergoing change today, with the entry of new firms and products increasing competition at the same time that mergers reduce it. The book employs the tools of economic analysis to explore the conflicting priorities and roles of the industry, from both a US and worldwide perspective. It views the industry both as a manufacturer of products and as a shaper of health-care decisions. The book also analyses the shift in the locus of demand for pharmaceuticals from individual physicians to large managed-care organizations deciding on product access on behalf of hundreds of thousands of patients.