This paper explores how Front End Innovation (FEI) is supported among companies of different nationality within the context of Pharmaceutical R&D. The present study is carried out in order to contribute to the development of a clearer understanding of active facilitation of innovation management and front end innovation in theory and practice. I aim to show how different aspects of company size, type and nationality affect the way innovation management and FEI is supported within organizations. This is examined through an in-depth case study of the Danish pharmaceutical company, H. Lundbeck A/S, and a comparative study including seven European and American Biotech and Pharmaceutical companies. The findings from the study reveal a number of similarities and differences in innovation management and FEI support among the different companies and present propositions of important aspects to consider in facilitation of FEI in general and in multinational pharmaceutical companies. In addition, proposals are made for a global study of innovation management and FEI support including Chinese and other Asian pharmaceutical companies.