Every three or four decades, there are signs that the conventional wisdom about the working and management of the economy is beginning to change. Such signs were evident, for example, in the first half of the 1930s, and were followed by the dominance of what came to be known as 'Keynesian economics'. The emphasis laid by this school of thought on maintaining full employment, using fiscal policy to manage the aggregate demand for goods and services, was the keynote for economic policy following World War II, and continued to be so through the 1950s and 1960s. But the next decade began to see signs of disillusion or discontent with the Keynesian conventional wisdom, and in the 1980s and 1990s economic policy came under the prevailing influence of other objectives. Among these, two were prominent. The first was that governments should be concerned primarily with controlling inflation rather than trying to maintain full employment. The second was to remove obstacles to the free functioning of markets, not only from within economies but also from trade between them. This was seen as essential for improving the efficiency with which the economy operated. Viewed from the standpoint of the second decade of the twenty-first century, it cannot be denied that the first of these objectives has been successfully realised. Indeed, its success even generated some fears that inflation would actually be replaced by deflation as a problem that policymakers might have to deal with. If curbing inflation led to rising unemployment, that was a problem that would be solved by the freer market for labour, which was part and parcel of the second objective. The pursuit of this second objective has also been successful in the sense of widening freedom of choice for many individual consumers, and also for owners of capital, although the extent of these gains is hard to measure. However, the drive for freer and more global markets was also based on the claim that the resulting pressure of increased competition within and between economies would be a stimulus for increased economic efficiency. But the first two decades of the twenty-first century have seen a rather different result: the annual rate of growth of the productivity of labour has been slipping well below what previously had become normal. The appearance of this unexpected phenomenon is clearly observable in the UK and the USA, but is not confined to these two economies. Is it, then, a development which casts doubt on the new faith in free markets and globalisation?

2 Structured AbstractMedical policy analysts and oncologists have cautioned against the high price of anticancer drugs. They argue that the current drug development model that relies on patents and short-term shareholder value is proving unsustainable, since the cost of the new generation of drugs puts many of them out of reach for the average consumer. The high price of cancer drugs is especially troubling in the context of middle and lower-income countries, where the burden of cancer carries disproportionately impact. To analyze the pricing of anticancer drugs, we examined legal controversies, regulatory treaties and documents, as well as the history of pricing data in India. We also conducted interviews with policy consultants, and surveyed financial data filings of major global and Indian pharmaceutical corporations. Our research revealed that global trade agreements have become key barriers to lowering anticancer drug prices. This article argues that in the shadow of the WTO and with TPP imminent, serious policy changes are necessary to ensure the survival of generic production in the market for anticancer drugs.