Early stage R&D is the part that typically happens outside of big pharma, though all the big companies have their own proprietary early stage efforts/portfolios

Early stage R&D is the part that typically happens outside of big pharma, though all the big companies have their own proprietary early stage efforts/portfolios. Even then govt funded stuff is mostly preclinical. Start ups mostly cover anything from animal studies to phase 1 / 2. Late stage R&D, manufacturing, and marketing is extremely capital intensive and complex and is mostly done by large pharma companies, who either license the asset or enter some sort of partnership with the IP holder. And I am including regulatory approval, demonstrating value to payers, etc under marketing (e.g. it is not just advertising).