Historically, many breakthrough products did originate with large pharmaceutical companies, but the innovation process in biomedicine has changed fundamentally.

从历史上看，许多突破性产品确实起源于大型制药公司，但生物医药领域的创新过程已经发生了根本性的变化。

The United States needs a new strategy for drug innovation that recognizes the new reality of the biomedical innovation process, and the true, limited role of Big Pharma.

美国需要一种新的药物创新策略，以认识到生物医学创新过程的新现实，以及大型制药公司的真实而有限的角色。

Instead of ushering in an era of Schumpeterian creative destruction, it will serve as a reminder that large incumbents currently control the innovation process, what some call creative accumulation.

它不会迎来一个熊彼特式的创造性破坏时代，而是会提醒人们， 大公司目前控制着创新过程，有人称之为创造性积累。