Out on the stump, the Democratic and Republican Presidential candidates often sound virtually indistinguishable when it comes to the topic of the pharmaceutical industry. The only question is: Which one hates you more? As they fight over this or that slogan about "change" or "reformer," the two men place Big Pharma second only to Big Tobacco or Big Oil in their long lists of foes.

But there are differences between the two candidates' positions on matters of import to pharma as it faces a future as uncertain as the nation's. Without getting into the many intricacies of what may be the most significant issue—their different plans for healthcare reform (go to the Kaiser Foundation's http://health08.org/ for that)—Pharm Exec offers this comparison-lite of where Obama and McCain stand on issues ranging from drug reimportation to scientific integrity.

In their official statements, the two men sound, oddly, petty much the same, though Obama is as heavy on specifics as McCain is light. That may be why Big Pharma itself can't make up its mind. At press time, the $18 million in drug industry campaign contributions (from both individuals and PACS) was split almost evenly between red and blue. Of course, inside the voting booth, you only get to pick one—but this year we have plenty of other urgent, non-pharma issues to get all worked up about. —Walter Armstrong

Obama: Will repeal the ban preventing government negotiations with drug companies for lower prices.

McCain: Will add a VA-like requirement that drug companies compete against each other to provide drugs.

Rx Drug Reimportation

Obama: Will allow the reimportation of drugs if they are safe and cost less.

McCain: Will allow the reimportation of drugs if they are safe.

Generics

Obama: Will eliminate reverse-payment agreements that keep generics out of markets.

McCain: Will encourage faster introduction of generic drugs into markets.

Biosimilars

Obama: Will support legislation both allowing FDA to approve generic biologics and establishing the shortest possible period of market exclusivity for brand name drugs.

McCain: Will also support both aspects of the same legislation.

Health Information Technology

Obama: Will invest $50 billion in e-medical records and other health IT.

McCain: Will encourage the deployment of health IT through market forces.

Comparative Effectiveness

Obama: Will establish an independent institute to guide reviews and research on comparative effectiveness.

McCain: Will support the private-sector development of national standards for determining treatments and outcomes.

Transparency

Obama: Will require transparency regarding quality and costs from hospitals, providers, and health plans.

McCain: Will require drug companies to reveal the price of their drugs, and will support transparency on treatment options and provider performance.