The R and D-to-sales ratio is basically a ratio comparing the amount invested in R and D in the country to the amount of total sales at the ex-factory price of patented pharmaceutical products.
Switzerland is basically the exception. It is clear on the graph that there are two major drug companies, Hoffman-La Roche or Roche, and Novartis, located in Switzerland. They have massive investment in R and D in the country, and it's a very small country so the sales are very low. That's the reason you have an R and D-to-sales ratio that is over 100%.