A competitive pharmaceutical industry is integral for the continued improvement of any country’s social and health resources and can be a source of sustained economic growth. As South Korea faces economic slowdown and increased social and health costs from an aged population, it is necessary to examine the current state of the industry’s competitiveness to determine how its global position can be enhanced. The following study identifies the determinants of South Korea’s competitiveness by applying the Generalized Double Diamond Model and conducts a comparative analysis with the globally competitive country of Japan. As the pharmaceutical industry is highly globalized, the study explores both domestic and international variables at the country and industry level ranging from 2015 to 2019. The results indicate that although South Korea almost matches Japan’s level of domestically determined competitiveness, there are significant international strategic differences that are hindering South Korea from becoming as globally competitive as Japan.