In the past few years, Pfizer has encountered globalization’s new phase. As part of the Indian government’s efforts to make medicine accessible to as many people as possible, in February 2013 India’s Patent Office revoked Pfizer’s patent for the cancer drug Sutent and granted a domestic manufacturer, Cipla, the right to produce a cheaper generic version. India’s Intellectual Property Appellate Board has since set aside the decision and has directed the Patent Office to reassess the case. In China, meanwhile, the government has been slashing drug prices to reduce health care costs. Beijing established price ceilings on essential drugs in 2009 and lowered the ceiling by around 30% in 2011, and it has pledged to expand the list of essential drugs to more than 500 medications by 2014. Such moves pose major risks for a multinational company like Pfizer: Lower prices create disincentives for quality control, and China’s hospitals, which rely on drug sales for profits, are pushing inexpensive locally made products.

A version of this article appeared in the January–February 2014 issue of Harvard Business Review.