Multinational pharmaceutical (MNC pharma) companies topped the list of pharma gainers in 2018, leaving larger Indian generic players far behind. Of the top 10 pharmaceutical gainers, six are multinationals. The reason for MNC pharma companies returning on the investors’ radar is the steady sales growth in India as compared to pricing pressures Indian companies face in US market. In addition, the regulatory problems related to good manufacturing practices have constrained the ability of the companies to launch new products in the US market. Further, delays in the launch of limited competition products have squeezed the opportunity available for the companies.