Unrealised potential: Japan's post-war pharmaceutical industry, 1945-2005.

Japan's existing pharmaceutical industry was devastated in the Second World War. But the industry recovered quickly, and in 1963, Japan had become the second largest producer of pharmaceuticals after the United States. Unlike its automobile or electronics industries, however, Japan's pharmaceutical industry did not become a global leader. Japan remains a net importer of pharmaceuticals and few Japanese drugs are found outside of Japan. The global pharmaceutical industry is led by firms from the United States, the United Kingdom and Switzerland, rather than those from Japan. This thesis traces the development of the Japanese pharmaceutical industry after 1945, and offers several explanations for why it did not become a world-leading industry. It uses two classes of medicines, antibiotics and anti-cancer drugs, as case studies for exploring the overall history of the Japanese pharmaceutical industry. These case studies were selected because of their importance to health outcomes in post-war Japan. In the immediate post-war period, the leading causes of death in Japan were infectious diseases such as tuberculosis, but in later decades, cancer morbidity and mortality rose. Japan was found to be much more successful at developing antibiotics than anticancer drugs. This thesis shows that, while the Japanese pharmaceutical industry had caught up with its Western counterparts by the mid 1970s, it did not exploit its potential to become a global leader. A few of Japan's leading pharmaceutical firms did develop blockbuster drugs and expand overseas, but most firms remained domestically oriented. The major reasons why Japan did not develop a strong pharmaceutical industry lay in the lack of R and D incentives, the government's protectionist policies, industrial structure, and Japanese medical culture. Other reasons of secondary importance included the industry's historical origins in import houses, national differences in patterns of disease, Japan-specific drug standards, and barriers to entrepreneurship among university academics