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Novo Nordisk does the vast majority of their RD in-house. I can’t speak to other companies.

I've read a little about Novo Nordisk's history and it is a pretty interesting story about aligning financial success with human flourishing. The pharmaco is a subsidiary of a anti-diabetes foundation started from proceeds from getting permission to produce insulin.

The foundation has an objective of providing support for scientific, humanitarian and social purposes. . . . In 2024, the foundation distributed a total of DKK 10.1 billion (approx. $1.39 billion) and paid out DKK 6.9 billion ($1.08 billion) in grants. [0]

0. https://en.wikipedia.org/wiki/Novo_Nordisk_Foundation

A drug is almost never acquired that can then be put directly to patients and sold.

Large pharma makes strategic bets on several drugs, some initiated in house, others acquired, but they all just go through further optimization and testing before it is approved.

Huge RnD is required even if drug is “simply acquired”

Having seen AstraZeneca inside, this is not the case. There's quite a lot of development going on. It is all non-fundamental though, the focus is heavily on late stage. No identification of disease mechanisms and such.