The biggest change in pharma in the past 20 years is that the FDA loosened direct to consumer advertising restrictions in 1997. Now 9 out of the top 10 pharma companies spend more on advertising than they do on research.

https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-p...

That's because the nature of drug development has been changing significantly over the last 20 years as the well of small molecule blockbuster drugs runs dry. Large pharmaceutical companies are becoming acquisition machines for startups that show promise in the early stages of drug development instead of spending their own capital on research. They do this to increasingly dump more and more of their risk onto venture capitalists and other institutional investors as the cost of drug development climbs slowly upward. Public numbers for pharma R&D budgets rarely reflect the acquisition costs, focusing only on the follow up approval process.

The consumer advertising change did contribute to this though, by allowing pharma companies to concentrate their core competency on acquisition, distribution, and marketing instead of R&D.

I'd push back against biotech/pharma/medical industry not really changing for 20 years. The advances of computation and biostatistics that leverage increasing computational power are huge waves to hit the industry. The field of pharmacoepidemiology, for instance, which uses computer programs to analyze big pharma data, that barely existed in 1998. Consider all the analysts and researchers using tools never even dreamed of in 1998, whether we're talking modeling of biological processes, advanced microscopy, advances in countless biological fields that make the process of manipulating cells much more easy. It's just not accurate to say the field hasn't changed for over 20 years.

Talk a walk around MIT 20 years ago and this year and there would be a MASSIVE build-out of biotech companies. That alone is evidence to refute your claim.

too unreliable for the purposes of economic growth, tbh.

based on my time in the industry, the typical biotech company lives with one foot in the grave -- and we're talking about the ones which have a product on the market.

Based on my time in tech, every company lives with one foot in the grave unless they're a post-exit giant. Hell, I have a whole sheet in my budget dedicated to what I'm going to do when Uber goes bust or stops subsidizing my transportation.

Data from the Venture Capital Association show that annualized returns from biotech investments were double that of the tech startup scene at 8% to 4% with comparable investment volume. Throw in the biotech companies that have multibillion dollar IPOs with zero revenue and you're just looking at a higher risk, higher reward version of tech.