Corporate R&D Location Strategies, Institutional Frameworks, and Innovation in the Pharmaceutical Industry: Policy Implications for Italy

This paper examines how multinational pharmaceutical firms allocate r&d and clinical research activities across countries with a specific focus on the investment decisions of foreign multinational enterprises (mnes) and discusses the policy implications of these dynamics for Italy. It argues that the geography of pharmaceutical innovation is increasingly shaped by competition among national innovation ecosystems, in which scientific excellence, regulatory efficiency, market-access conditions, and institutional credibility jointly determine location attractiveness. Building on the literature on multinational location strategies and innovation ecosystems, the paper develops a conceptual framework to interpret the determinants of research hub localization, clinical trial allocation, and r&d-related investment in the pharmaceutical industry. Against this background, it documents the progressive weakening of Europe’s position in pharmaceutical r&d and clinical research, alongside the growing centrality of the United States and China. The Italian case reveals a structural mismatch between strong industrial and scientific assets and a still inadequate institutional environment for research-intensive investment. Italy benefits from substantial manufacturing depth, recognized clinical excellence, and strong regional clusters, yet its attractiveness is undermined by fragmented governance, long trial start-up times, organizational bottlenecks, and regulatory uncertainty. The paper concludes that strengthening Italy’s role in pharmaceutical innovation requires a coherent industrial strategy integrating health policy, innovation policy, and regulatory reform.