Pharma as an industry has matured. And the rate of new drug discoveries has dropped significantly. Most of this due to the technology reaching its limits. The days of drenching a body in chemicals are nearing the zero marginal returns.
The new wave is designing delivery methods that target the drugs to where they need to go or using methods based on genetic engineering. And triggering the immune system to do the work. there are a number of new methods that in initial testing have achieved near 100% cures in cancer and chronic diseases. There is also a lot of work on repairing tissues or growing new organs.
Regulation IS a big deal though. Two decades ago tort reform in the General Aviation industry brought a dead industry back to life. Congress did the same thing for the rocket launch industry about 10 years ago and a number of US firms have done very well - with three having costs to orbit much lower than even the Chinese.
The US is poised for a manufacturing resurgence in the next five years as wage costs in Asia coupled with agency costs reach parity with US costs. I know two owners of machine shops here in the US who can produce a number of medium sized items that work every time at a cost that is competitive with any of the Asian tigers.
