This report reviews the pharmaceutical industry during the year 2003. Patient care has changed significantly over the past 25 years. Medicines now exist to treat conditions that had no treatment a quarter century ago. At that time, lengthy hospital stays, surgery, and time away from family and jobs were common for many patients. Health insurance focused more on reimbursing than on controlling the cost of care, though then as now Medicare did not pay for beneficiaries' prescription medicines. Drug development was a simpler, less expensive process.