Patient Capital and ESG Performance in the Pharmaceutical Sector: A Pathway to Sustainable Development

As global sustainable development progresses and the United Nations Sustainable Development Goals (SDGs) gain increasing prominence, pharmaceutical manufacturing firms face mounting challenges in implementing environmental, social, and governance (ESG) practices; these include high environmental compliance costs, limited drug accessibility, and governance inefficiencies. Patient capital, characterized by long investment horizons and high tolerance for risk, is well aligned with the long-term nature of ESG-oriented activities in this industry. Using a sample of pharmaceutical manufacturing companies listed on the Shanghai and Shenzhen A-share markets from 2015 to 2024, this study systematically examines the impact of patient capital on corporate ESG performance and explores the underlying mechanisms. The empirical results show that patient capital significantly improves ESG performance among pharmaceutical manufacturing firms. These findings remain robust across a series of robustness checks, including alternative variable measurements, sample adjustments, propensity score matching, instrumental variable estimation, and changes in the sample period. Further analysis reveals that patient capital enhances ESG performance through two primary channels: alleviating financing constraints and increasing R&D investment intensity. By focusing on the pharmaceutical manufacturing industry, this study extends the literature on patient capital to a highly regulated and socially sensitive sector, providing empirical evidence on how long-term, value-oriented capital can support sustainable development and improve ESG performance in industries with strong public welfare attributes.