Patent expirations in the U.S. hurt sales as well, where sales represented 40% of total revenue in the third-quarter, compared with 44% in the year-ago quarter.

FORBES: Pfizer Beats Estimates, Raises Forecast

Online sales still bring in a piteous 7% of total revenue.

FORBES: Magazine Article

Genzyme, for its part, has made acquisitions a key part of its growth strategy, with sales from products bought in from the outside generating 38% of total revenue in 2006, not to mention 50% of revenue growth, according to a research note by biotech analyst Geoffrey Porges at Sanford C.

FORBES: Genzyme Eyes Isis Drug

The London-based drug giant is the world's second-biggest drug company in terms of total sales, but it has had trouble delivering revenue growth and may feel it needs even more heft to compete with Pfizer after that company merges with Pharmacia (nyse: PHA - news - people ).

FORBES: Bayer Faces Reality

Like Dentsply, the seven companies in the table below have foreign sales that account for at least 35% of total annual revenue.

FORBES: Falling Into Favor