For the pharmaceutical industry as a whole, several issues impact the availability and affordability of safe and effective medicines. While research and development technology is evolving rapidly, taking a product from concept to market is very time-consuming and costly for pharmaceutical companies, and once a drug hits the market, all that remains is window of a few years to get a return on investment before this drug's patent expires and it can be manufactured and sold as a generic. Once brand exclusivity is lost, generic alternatives typically come to market at around 70% of the cost of the branded drug in the first six months, and after twelve months they drop to 15 to 20% of the cost. cost of brand drug. named medication (Zimmerman, 2013). U.S. pharmaceutical companies are also at a disadvantage, particularly because as industry leaders, they bear the brunt of R&D costs. The American population also pays more for medications because there are no drug price controls in this country as there are in many others (Williams & Torrens, 2008). Unless a new drug is completely unique or otherwise differentiated from similar drugs in utility/purpose, health plans and/or pharmacy benefit managers that develop formularies will generally choose to exclude the most expensive new drug at the profit from cheaper drugs or generics used for the same purpose. Young (2013) notes that "pharmaceutical companies' revenue problems will be directly related to drug approval difficulties, reimbursement problems, patent expirations, weak product pipelines, and failed business models." » (p. 20). Vogenberg (2012) notes that for pharmaceutical companies to successfully achieve PBM formulary status, they must...... middle of article ......can Journal of Public Health, 103(5) , e10 -e14. doi:10.2105/AJPH.2013.301239Teevan Burke, B., Miller, B.F., Proser, M., Petterson, SM, Bazemore, AW, Goplerud, E., & Phillips, RL (2013). A needs-based method for estimating behavioral health staffing needs of community health centers. BMC Health Services Research, 13(1), 1-12. doi:10.1186/1472-6963-13-245Vogenberg, R. (2012). The P&T community is considering the economic goals of health care and pharmacy reform. Formulary, 47(12), 433-434. Williams, S. and Torrens, P., (2008) Introduction to Health Services, 7th edition, Thomson-Delmar Learning, 2008. Young, P. (2013). Pharmaceutical and Biotechnology Industry Financial Report 2013: The industry's rotating compass – north, south, everywhere. Pharmaceutical Director, 33(12), 16-20.Zimmerman, A. (2013). Finding more value in pharmacy benefits: five trends that matter. Benefits Magazine, 50(6), 28-33.