Many books and articles have focused on Soviet health-care. But there are no studies of the Soviet pharmaceutical industry, which was a lynch-pin of Soviet medicine, for without therapies physicians and health-care personnel can only diagnose, not treat. The present paper, part of such a study, opens a window onto one small aspect of the Soviet pharmaceutical industry - points of congruence, divergence, and reconvergence in the pharmaceutical sector with an on-again, off-again political and economic rival. This paper briefly reviews the Russian and the Soviet pharmaceutical systems, so that American audiences can make a comparison of them with our own. It then examines American-Russian/Soviet interaction in trade, joint ventures, research and development, product mix, and connections during World War II to illustrate similarities and differences. During the last decade, although the Soviet and American pharmaceutical systems each had a different trajectory of development, ironically their pharmaceutical industries again are finding points in common.