Gilead and GSK are noteworthy climbers into the top 10, but their rise is less stratospheric than those of BI and Eli Lilly, climbing more than 20 and a dozen places respectively. For Eli Lilly, its highest ever revenue has come at the cost of the greatest R&D spend-to-revenue ratio of the top 10 in the Innovation Index; for Boehringer Ingelheim, 2022 brought four breakthrough therapy designations and four fast-track designations, but with commercial performance still largely driven by older products. 

Two notable newcomers to the top 10 of the Invention Index are Regeneron and Vertex: for Regeneron, Dupixent continues to innovate through novel indications, while the Libtayo approval aims to take a slice of the lung cancer market; for Vertex, successes in cystic fibrosis and renal disease have driven the company’s inclusion. ​

​This year’s data shed light on the difference between success in R&D financial and operational efficiency versus ultimate financial return. Although Novartis had the lowest R&D cost per approval over the last five years – and amassed 12 approvals last year – approvals in the last five years account for less than 10% of their revenue. Contrast this with Pfizer, who had the second lowest R&D cost per approval – and nine approvals last year – but where more than 60% of its revenue has been gained from approvals in the last five years. This is a reminder that leaner R&D alone is not a good index of company performance: Pfizer’s success has coupled efficient R&D spend with a more successful recent pipeline, where patent cliffs are a more distant concern.​

After a torrid year for biotech funding, Spring 2023 has started to see a more acquisitive market, with larger companies hunting for assets and companies to bolster their pipelines, eager to spend their reserves at a time of relative low cost for their targets. The 13th Invention and Innovation indices in 2024 may be lucky for some, as we start to see the impact of these deals on company performance.