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Comparative analysis of the R&D efficiency of 14 leading pharmaceutical companies for the years 1999–2018 shows that there is a close positive correlation between R&D spending and the two investigated R&D output parameters, approved NMEs and the cumulative impact factor of their publications. In other words, higher R&D investments (input) were associated with higher R&D output. Second, our analyses indicate that there are "economies of scale" (size) in pharmaceutical R&D.