When a firm launches a market-creating innovation, it launches a new product for which there are no close product substitutes. Thus, the new product causes a shift in the existing product-market structure of an industry. This paper reports on the findings of the analysis of 51 large pharmaceutical firms and their market-creating activities. The study suggests that market-creating firms have capabilities in both R&D and marketing. Furthermore, market-creating firms enjoy stronger efficiencies, manage costs better and make more profitable use of their assets.