The US companies inherently had a home field advantage. Yet non-US companies were willing to jump through the hoops to follow the US drug funding model. If their original funding and development mechanism were sufficient or better, why go through the trouble? Why did all of them do it?
I don’t understand what are you referring to. Big pharma companies are multinationals that will adapt to the regulatory requirements and commercial practices of the different markets where they want to operate. Why would European companies renounce to be present in the principal drug market?