| Summary: | Pharmaceutical products have contributed to longer life expectancy and better quality of life in Latin America and the Caribbean. However, they often account for a significant share of household expenditures, especially among the poor and those facing catastrophic health shocks. And they are not always accessible, as dramatically exposed by the Covid-19 pandemic. This mixed record can be linked to the workings of the pharmaceutical sector, an issue that has not received much attention in policy discussions. This paper identifies the sector's key domestic and foreign players, and analyzes its local output, international trade, and price levels. It also documents government policies, including intellectual property rights, regulatory oversight, and public procurement. An important contribution of the paper is to show the significant scientific capacity of the region, especially in relation to biological products - including vaccines - whose intrinsic heterogeneity challenges intellectual property rights protection. Based on this diagnosis, the paper flags three sets of issues for policy makers to consider. Relatively uncontroversial measures include strengthening regulatory authorities, promoting the use of generics, and upgrading public procurement. Other areas, such as supporting R and D and regulating prices, involve tradeoffs. Finally, there are strategic choices to be made, with some countries in the region favoring stringent intellectual property rights, while others support national champions or rely on state entrepreneurship
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