Napkin mathing here since available data isn't great, but the US definitely doesn't lead the world in healthcare R&D spending relative to our size. We're spending something like 0.22% of GDP on healthcare R&D, putting us at about #7 globally. In comparison, Denmark spends 0.93% of GDP on healthcare R&D. And that list is missing data from other countries that probably rank above us, like Cuba.

Sources: https://www.oecd-ilibrary.org/docserver/sti_scoreboard-2009-... https://www.who.int/observatories/global-observatory-on-heal...