[TomK32]

It's all multinational these days. Only 4/10 of the big players are in the US https://www.tharawat-magazine.com/facts/10-largest-pharmaceu... and that's quite logic if you remember that the European market is pretty much harmonized and twice as populated as the US.

[ekianjo]

The EU market is far from being harmonized medecines regulation wise. it always takes longer to get approval across all EU countries vs one approval in the US. Pricing of drugs is not harmonized at the EU level either and thats a hard block for any launch.

[mbesto]

"in the US" is a misnomer. It all depends on if the cost allocation (e.g. HR is pharma's largest cost) has and is attributed to the US.

[aaavl2821]

the US market is the primary market for all big pharma companies regardless of where headquarters are bc it is the biggest

And big pharma companies don't do early stage research. Small companies do. Most of those are in US