The United States is by far the world's leading center of medical innovation.

Judged as of 2019-07-18. True: standard measures of medical innovation around 2015–2019 (e.g. share of new drug approvals or originated new molecular entities, biomedical R&D spending, medical patents, clinical trials, major medical prizes or citations) show the US clearly first, with a large lead over the next country on most of them (e.g. well over double the share of the runner-up, or the largest share by a wide margin). Mostly true: the US ranks first on most measures, but its lead is clear rather than overwhelming on some. Mixed: the US leads on some major measures while another country or region matches or leads on others, so 'by far' is doubtful. Mostly false: the US is among the leaders but its lead is narrow or contested on most measures, making 'by far' an overstatement. False: another country leads the US on most standard measures of medical innovation.

Set before the research began.

1. E1 How Europe Lost Global Biopharmaceutical R&D Leadership to the United States: Lessons for Today | Perspectives on Innovation | CSIS Center for Strategic and International Studies (CSIS) · 4 November 2026

   “However, from 2001 to 2010, the U.S. share jumped to 57 percent, while France, Germany, Switzerland, and the United Kingdom saw their share of new drug approvals drop to 33 percent.”

2. E2 How Europe Lost Global Biopharmaceutical R&D Leadership to the United States: Lessons for Today | Perspectives on Innovation | CSIS Center for Strategic and International Studies (CSIS) · 4 November 2026

   “Since 2012, 85 percent of new medicines have been launched in the United States, compared to less than 40 percent, on average, across more than 20 European countries.”

3. E3 Survey on New Drug Discovery Companies (Originator) from the Perspective of Drug Development Pipeline by Drug Discovery Modality | OPIR Views and Actions | The Office of Pharmaceutical Industry Research Japan Pharmaceutical Manufacturers Association (JPMA), Office of Pharmaceutical Industry Research

   “In all modalities, U.S.-based companies lead the world in drug discovery, accounting for about 40% of all small molecule drugs and about 60% of all nucleic acid drugs.”

4. E4 Survey on New Drug Discovery Companies (Originator) from the Perspective of Drug Development Pipeline by Drug Discovery Modality | OPIR Views and Actions | The Office of Pharmaceutical Industry Research Japan Pharmaceutical Manufacturers Association (JPMA), Office of Pharmaceutical Industry Research

   “In terms of the number of discoveries, U.S.-based companies lead in all modalities, but Chinese and Korean companies are also making their presence felt in the creation of gene-cell therapy and cell therapy.”

E1 (CSIS) reports that the US share of new drug approvals was 57 percent in 2001–2010. France, Germany, Switzerland and the UK together had 33 percent, so the US led those four major European countries combined by a wide margin. E3 and E4 (JPMA survey) find that US-based companies lead drug discovery in every modality, with about 40% of small-molecule drugs and about 60% of nucleic acid drugs. However, the survey does not give the runner-up's share, and it notes that Chinese and Korean companies are gaining ground in cell and gene therapy. E2 measures drug launches rather than where drugs came from, and none of the evidence covers 2015–2019 exactly or other measures such as R&D spending or prizes. The evidence therefore shows the US clearly first, but a dominant lead is only partly shown.