How do companies develop a strategy that is both low-cost and differentiated without becoming squeezed in the middle? Describes how Teva, Israel's first and largest multinational, achieved its globally dominant position in generic pharmaceuticals, an industry that has undergone significant change over the last 20 years. Examines its strategies to defend itself against both low-cost competitors from India and other emerging markets as well as Big Pharma companies, which are adopting increasingly aggressive tactics in genetics.