This edited collection, which is based on a workshop that took place in London in 2003, examines the ways in which scientific knowledge has co-evolved with firm growth, industry structure and the broader socio-economic environment, by focusing on the case of pharma-biotech. Why pharma-biotech? Because, in the editors' words, as a sector of the economy in which the role of science has been more direct and immediate than in most others, ‘it is a fascinating industry to study’ (p. 416), not only in the light of the recent changes that have taken place in the underlying knowledge bases and the institutional regimes governing innovations, but also in view of the importance of the industry for health, agriculture and food production (p. 1).

Knowledge Accumulation and Industry Evolution is well constructed, with a conclusion as well as an introduction, and twelve chapters grouped thematically in three parts: Part One on ‘Innovation and industry evolution’, Part Two on ‘Firm growth and market structure’ and Part Three on ‘Policy implications’. It contains a selection of high-quality, thought-provoking contributions, which engage the reader with current policy issues related to the biomedical sciences and the pharma-biotech sector. The broad question upon which it aims to cast light is this: ‘what determines the observed rates of innovation across firms?’ (p. 7), and, more specifically, ‘what is the effectiveness of either strong or weak patent protection on innovativeness and industrial growth?’ (p. 415). This issue is all the more relevant since, despite the promise of the so-called ‘biotech revolution’, innovation in the pharmaceutical industry appears to be slowing down (p. 420).

In order to explore its question, the book includes a variety of approaches, drawn from economics, innovation studies and science policy studies, many of them quantitative, others more qualitative. Where there is reflection on the history of the pharmaceutical industry and related biomedical disciplines and technologies (especially in Part One, and in Chapters 8 and 14), references are made to authors and concepts familiar to business historians and historians of technology, in particular Joseph Schumpeter and his theory of ‘creative destruction’ (Chapters 2 and 5, by Frank Lichenberg and Louis Galambos respectively), and Alfred Chandler and his concept of the ‘industrialization of R & D’ (Chapter 3, by Paul Nightingale and Surya Mahdi).

As the book's title suggests, the main focus is the process of accumulation that has dominated the production and use of knowledge in the industry. Nevertheless, the collection also highlights major discontinuities. One of these was Sir James Black's discovery of beta blockers, which in the 1960s helped to usher in a new era of drug development, informed by the understanding of disease targets at the molecular level (pp. 80, 154). Another major discontinuity occurred in the 1980s, when it became possible to patent genes, as in the case of genes for breast cancer. This represented a significant break with the prevailing intellectual property rights (IPR) doctrine, and – as Fabienne Orsi, Christine Sevilla and Benjamin Coriat convincingly argue in Chapter 11 – has posed a serious threat not only to the future of research but to the entire public health system (p. 342).

The great merit of Knowledge Accumulation and Industry Evolution for historians of science is therefore that it places the study of scientific knowledge in the context of one of the most innovative science-based sectors, and of some of the most burning policy issues of today, particularly in connection with changes in IPR and their potential impact on science, medicine, and public health and welfare. However, in my opinion it does not pay enough attention to another very important aspect of the policies that have shaped the evolution of pharma-biotech – drug safety regulation – and of the institution that has played a defining role in connection with it – the American Food and Drug Administration (FDA). Indeed, more than any other institutional policy, drug safety regulation has helped to fashion not only the modes of knowledge production and use, with which most of the essays in this collection are concerned, but also the content of the knowledge itself, which they tend to take as a ‘given’, and about which they say far less. Furthermore, in my view, the power and authority of the FDA reflects the American hegemony that developed after the Second World War in medical science and industry, as discussed in John Krige's American Hegemony and the Postwar Reconstruction of Science in Europe (Cambridge, MA, 2006) (see p. 624), as well as the growing importance of the American market for medicines in what came to be called ‘the American century’ (pp. 145–6).

In this connection, these essays are predominantly America-centric, although European perspectives are sometimes included, especially in Part Three, on ‘Policy implications’. These lead the different authors to point out that, whereas European countries have been converging towards the United States in matters of IPR (p. 327), in terms of governance structures and policy processes there has been divergence (pp. 397–8). The complex relationship between Europe and the USA and its impact on knowledge accumulation and industry evolution is not analysed further; nevertheless, in the final chapter, the editors draw a number of significant conclusions. Echoing the economist Paul David, they argue that ‘open science’, which has been responsible for ‘the productive, yet serendipitous, two-way feedback between innovations and scientific knowledge’ characteristic of pharma-biotech, is a fragile system that may be threatened by the ‘experiments in patent laws and practices’ that have occurred in recent years (as in the case of the right to patent genes), as well as by the universities themselves, ‘with their new, profit-seeking goals’ (pp. 418–19). Mostly, though, they ask questions for further research and reflection, not least about the level of health to which individuals and society as a whole should have access, even though that level is ‘constantly redefined by the interaction between technological opportunities [and] expectations … as well as its costs’ (p. 427).

In sum, Knowledge Accumulation and Industry Evolution is an excellent book which provides a most helpful macro socio-economic background for more detailed studies in the history of biomedicine and pharma-biotech. It has the added benefit of engaging the reader with relevant contemporary policy issues, which all too often are absent from historical work.