Indian pharma’s US business is back on strong footing again. In the 9MFY24, the US segment grew by an average 22 per cent across the top five companies against a 7 per cent YoY increase last year. There have been structural shifts behind the performance which is reflected in the stock returns as well. The sector indices (Nifty Pharma or BSE S&P Healthcare) have returned more than 60 per cent in the past year with valuation premium at 20 per cent (one year forward PE against past five-year average).