CNS Summit Innovation Index 2021

Written by IDEA Pharma & CNS Summit — 2021-11-09.

About the CNS Summit Innovation Index:

The 2021 CNS Innovation Index is here, our annual ranking of the world’s most innovative biopharmaceutical companies. This is the 5th running of the list, and 2021 saw a number of movers and shakers within the top 10 as well as a roster of smaller companies in the ranks of the top 30, a trend we’ve seen grow in recent years. 

It’s important to understand what we mean here by innovation and the bounds which set the contours of the list. As with a well-designed clinical trial or corporate partnership meant to foster growth, rankings have little meaning without establishing the definitions of the terms of art. And “innovation” has the distinction within the life sciences of simultaneously being the industry’s beating heart and a commonly misconstrued concept.

Innovation for our purposes doesn’t simply mean the discovery of a promising new drug asset or technology. While such advances may be key elements of innovation, they fall more into the realm of invention, which does not assure a tangible return. Innovation, on the other hand, is a new and novel use of technologies and strategic partnerships to create real and realizable value for a company—not an abstract one. An innovative partnership or asset lifts all boats across the biopharmaceutical and health care spheres since the benefits of successful innovation can manifest in both the companies achieving the innovation and the broader market, investor class, and critically, patients themselves.

The CNS Innovation Index has innovated as well- evolving towards a more digital focus this year. The newest iteration of the index has strong continuity with previous years and examines which drug makers are leveraging innovation in three distinct spheres: clinical development which sets the stage for future growth with new technologies and a focus on optimizing clinical trials, commercial partnerships and operations including manufacturing and infrastructure which are critical to the nuts-and-bolts work of drug making, and investment in digital therapeutic and other research into the most promising tech and academic advancements, including the use of incubators and competitions to discover new avenues for growth at the earliest stages. 

Firms must have a strong balance between these three ingredients to succeed holistically in the index. That was a unifying factor of this year’s top trio of Pfizer, Johnson & Johnson, and Novartis. For instance, Pfizer’s discovery of California-based Saama Technologies through a hackathon. The subsequent result? A partnership which helped Pfizer clean up clinical datasets and identify coding errors in less than 24 hours with minimal human intervention, providing the company an immediately-leverageable advance that assisted its COVID vaccine clinical trial design strategy in near real-time.

Other examples abound throughout the top 10 and the rest of the list. For instance, Roche, which slipped several rungs from its top perch last year, grew its commercial mHealth footprint in diverse spaces such as COVID-19 diagnostics and diabetes care management and even created a service which can boil down a consumer’s COVID-19 vaccination and infection status to a personalized QR code which can both inform patients and their doctors while providing a service for indoor businesses and travel (all while using an existing SARS-CoV-2 nasal antigen self-test). Johnson & Johnson, number two on this year’s list, is rolling forward with what it hopes to be a foundational new robotic surgery system that could allow the company to make a bigger splash in the highly lucrative minimally invasive surgery space. Companies ranging from Indianapolis-based Eli Lilly to Germany’s Boehringer Ingelheim continued investments in artificial intelligence and quantum computing to fuel smarter clinical R&D in mass market diseases like diabetes and rare disorders such as lupus alike. 

There is no single investment or focus area that lifts a company to the upper echelons of the index. Rather, the most successful firms which have set themselves up for long-standing growth and value creation are ones that have spread their technological and modernization focus across all three of our commercial, clinical, and research buckets. What follows is a far more in-depth exploration of what 2021’s standout firms did to strike that balance. 

Company performance, Top 10:

1. Pfizer

Pfizer catapulted to the top spot in 2021’s Index, a three-rung improvement on the innovation ladder compared to last year, which saw the company supplant Roche in its 2020 perch. The U.S. drug giant, which is at the forefront of the global battle against coronavirus with its COVID vaccine, had a remarkably well-rounded year across commercial partnerships, clinical development, and research, ranking 4th, 2nd, and 1st in those respective categories.

The sturdiness of those three individual legs underscores Pfizer’s growth potential in the medium- and long-term. While it may be tempting to allow the pandemic to overshadow other areas of innovation, the firm’s ability to leverage remote monitoring technologies in COVID-19 trials is a testament to its strategic focus on fluid data analytics and decentralized clinical studies that can be leveraged in multiple therapeutic categories going forward—especially when combined with a new tranche of artificial intelligence collaborations for drug discovery.

For instance, Pfizer struck a partnership in March with virtual drug design firm Itkos in order to hone small molecule drug discovery and better predict an asset’s chances of successfully crossing the regulatory finish line early in the R&D lifecycle. Pfizer has longstanding AI partnerships for therapeutic development, including with IBM Watson for immuno-oncology research, but has also found newer partners such as Itkos and California’s Saama Technologies.

The latter won a hackathon arranged by Pfizer’s “incubation sandbox” to clean up clinical datasets and identify coding errors in less than 24 hours with minimal human intervention and was an important driver of the drug maker’s COVID vaccine trial design strategy. These underlying technologies were part of the reason Pfizer scored $900 million in first-quarter 2021 profits and could lift the company’s returns well into the future.

2. Johnson & Johnson

As a firm that sprawls the gamut of health care, from everyday over-the-counter consumer goods to medical devices and robotic surgery technologies and a pharmaceutical powerhouse unit that rang in nearly $13 billion in third-quarter 2021 revenues alone, Johnson & Johnson has no shortage of avenues to demonstrate its capacity to innovate. It did so with aplomb in 2021 via a combination of new medical device platforms, AI-driven drug discovery partnerships, and remote patient monitoring collaborations.

Among J&J’s standout achievements this past year? The introduction of a long-awaited robot-assisted surgery system dubbed Ottava, which the company hopes to fuel a consolidated robotic surgery approach across multiple procedures using the device’s six arms built into the operating table. J&J is betting heavily on the system’s success, with validation processes slated to launch this year and clinical trial enrollment beginning in 2022. The seeds of the initiative were sown with strategic partnerships with the likes of Alphabet life sciences unit Verily on Verb Surgical (a space Verily exited in 2019) and the company’s 2019 acquisition of Auris Health and its Monarch surgical platform. Johnson & Johnson wants to leverage technological expertise gleaned from those deals to eat into robotic surgery market leader Intuitive Surgical and its trademark da Vinci robot line’s dominance in the non-invasive surgery niche.

Another factor that helped J&J rise from last year’s number three spot in the Index is a trio of strategic collaborations centered in the massive Chinese market meant to buttress drug discovery and diagnostics. For instance, through the firm’s Asia Pacific Innovation Center, Johnson & Johnson joined forces with Insilico Medicine Hong Kong Ltd to use an AI-based platform for small molecule hits. Specifically, the collaboration is meant to generate novel and fully patentable chemical scaffolds for difficult drug targets in order to reduce the time and cost of identifying promising assets for various therapeutic arenas. That’s in addition to a research collaboration with Diannei Shanghai Biotechnology Co. Ltd. for medical imaging analysis in lung cancer diagnostics and a separate effort with China’s Taikang Online Insurance Co. Ltd. ( to create an insurance package for sports injury diagnostics and surgical treatment.

The stage is clearly set for Johnson & Johnson if its latest earnings report is any indication. The company fired on all fronts in the third quarter with medical device unit revenues up 8%, consumer health sales up 5.2%, and a 13.8% pop in pharmaceutical sales compared to the same period last year.

3. Novartis

Novartis jumped three spots in the 2021 Index to round out this year’s top tier of innovative drug companies. Commercial partnerships and a focus on digital diagnostics, remote patient monitoring, mobile health services, and digitally-enabled care were the primary ingredients for the Swiss drug giant’s clinical strategy going forward.

One standout partnership is Novartis Pharmaceutical UK’s collaboration with digital health care solutions firm Cievert that was fostered by the Novartis BIOME project and with the assistance of National Health Service clinicians and innovation leaders. That specific partnership will focus on collecting patient-reported data to support rheumatology and dermatology care by helping capture patients’ reported symptoms from their homes and consolidating the information under a unified digital health record platform. That, in turn, could help the NHS triage patient appointments based on need while providing more insights to patients themselves as the U.K. prepares a digital innovation spurt following the strains of the COVID pandemic.

With regards to artificial intelligence, Novartis also entered a collaboration last fall with Elsevier to create a risk assessment tool for adverse reactions to promising therapeutic assets that can lead to unexpected safety concerns, a major source of attrition in drug development and especially in later-stage development.

Another innovative new 2021 partnership is with Hewlett Packard Enterprise meant to identify and integrate complex data sources related to health and then apply AI and machine learning to these data in order to expand access to such technologies in remote and developing markets. Among the first initiatives under the collaboration will be creating a disease surveillance framework for Dengue fever in India. Novartis also moved to open a new digital health innovation center in Canada and is working with Ada Health to more quickly diagnose patients with immunological diseases and rare disorders.

4. Eli Lilly

Indianapolis-based Eli Lilly rode a wave of clinical trial optimization efforts and digital care solutions to rise four spots on this year’s innovation Index. The company already had a strategic focus on clinical trial optimization made urgent by the COVID-19 pandemic, including the use of antibody therapies to fight coronavirus.

In the past year, Lilly continued to grow its digital health presence in everything from its flagship diabetes portfolio to COVID-19 symptom tracking to gastroenterology and inflammatory bowel disease. Among the marquee efforts is a collaboration and licensing agreement with WellDoc announced in early 2021 to create a new version of the BlueStar insulin management app in conjunction with Lilly’s connected insulin pen technologies.

That platform is meant to integrate insulin dosing data for several products in the firm’s insulin portfolio and is just one diabetes-focused initiative announced by the company in the past year. Another is a commercialization agreement with Ypsomed that will utilize an insulin pump developed and manufactured by the latter firm, as well as an AI-driven drug discovery partnership with Biolojic for identifying antibody therapies for diabetes treatment.

Lilly also has a powerhouse roster of partnerships with DexCom, Glooko Inc., myDiabby Healthcare, and Roche aimed at diabetes patients in markets outside the United States to bolster app compatibility with its Tempo Pen and in-development Tempo Smart Button technologies.

Lilly’s innovative approach also stretches to manufacturing infrastructure, with the company taking advantage of recent changes to U.S. tax law to pour $400 million into its Indianapolis-based technology center campus to upgrade technologies and create automated facilities that use robotics and data analytics to bolster capacity and efficiency for both existing and future therapies.

5. Amgen

Congestive heart failure afflicted some 6.2 million adults in America alone in any given year and was mentioned in 13.4% of 2018 death certificates in the U.S. The associated costs are astronomical, regularly surpassing $30 billion annually when taking medical costs, missed workdays and reduced workforce productivity, and quality of life into account. To that end, biotech Amgen cracked into the 2021 top 10 (and then some) through innovative collaborations in the heart disease space and clinical trial protocol optimization in disorders such as lupus.

Two cardiac-related initiatives which caught our eye spanned both American and European markets. The first, a study collaboration with New York and Tel Aviv-based Datos Health, will compare congestive heart failure guideline-directed therapies that incorporate digital health data against those which don’t. Datos will provide the automation services to clean up and properly tag patient health data that will drive this effort, which is ultimately meant to improve dosing and titration for the mix of medicines required to treat heart failure. The second is a new digital health app and telehealth service suite for heart attack patient rehabilitation called Rehab+ in conjunction with Liva Healthcare and a mix of European partners.

Furthermore, Amgen completed discussions with the U.S. Food and Drug Administration for a complex innovative trial design pilot program in a planned phase 2 efficacy and safety trial of the company’s experimental efavaleukin alfa for the treatment of systemic lupus erythematosus (SLE). And, underscoring the drug maker’s desire to use such innovations in multiple disease categories, Amgen partner Prostate Health Education Network (PHEN) launched a pioneering digital tool called in late 2020 that can link prostate cancer patients to a variety of treatment options, second opinions, and information about enrollment in ongoing oncology trials and managing bone health in those afflicted with advanced prostate cancer.

6. Roche

Switzerland’s Roche is certainly no stranger to the CNS Innovation Index as last year’s top dog on the list and a perennial top ten player. It slid five spots this year but continued its longstanding commitment to using deep learning and AI to fuel advances across a spectrum of diseases, including cancer, diabetes, Parkinson’s, and more recently COVID-19.

On the collaboration front, Roche sought out partners large and small in the past year. It co-developed an AI-based test with the University of Leeds to hone in on the most effective treatment options for bowel cancer patients and turned to programs such as the Code4Life hackathon to tap into fresh talent pools.

Roche continued to grow its commercial mHealth footprint in diverse spaces such as COVID-19 diagnostics and diabetes care management. For instance, its NAVIFY Pass offering is a digital service that complements the SARS-CoV-2 nasal antigen self-test, which allows everyday consumers and health care professionals alike to remotely store, display, and share COVID-19 test results and vaccination status with the help of an individualized QR code. That has tangible real-world uses for services that require vaccination or COVID testing verification, such as entry into entertainment venues and travel safety clearance.

In diabetes, new connected technologies such as Roche’s mySugar feature will allow patients to control their insulin pumps virtually, while the pilot Roche Diabetes Care Platform (RDCP) initiative in Swansea consolidates blood glucose data over time to identify fluctuation patterns and inform physicians’ discussions with patients.  

7. Boehringer Ingelheim

Boehringer Ingelheim leapfrogged halfway up the innovation Index compared to its number 14 rank last year. And several AI- and quantum computing-centered digital research initiatives helped guide its rise to 2021’s number seven spot.

Two of the most significant developments for BI this past year were a collaboration with Science 37 on virtual clinical trial designs and a quantum computing partnership with Google to simulate molecular dynamics in a groundbreaking drug discovery initiative. With the help of Science 37’s NORA software platform, Boehringer is seeking to expand its remote clinical trial capabilities and facilitate enrollment in studies no matter where a patient is located geographically via mobile health and telemedicine technologies.

Other collaborative highlights include a lung disease AI diagnostics partnership with Tokyo’s M3 and a deep learning initiative with Lifebit that uses natural language processing to keep tabs on global infectious disease outbreaks. This is achieved through the collection of real-world evidence and with the help of information gleaned from scientific journals and open source datasets that can shape R&D decision-making in the fight against emerging pathogens.

Boehringer also joined forces with major academic institutes such as Yale to examine the effect of digital technologies in heart failure patient outcomes and Case Western Reserve University for precision medicine efforts driven by AI.

8. Takeda

The pharma giant of Japan inched further up in this year’s top 10 to nab the number eight spot. Takeda launched everything from incubation platforms in China to wearable device monitoring technologies geared toward newborns. It also happened to make a splash with its digital marketing and patient engagement efforts, winning the company the EURODIS 2021 patient engagement award for its work within the rare disease community.

TakedaSpark, the open incubation platform debuted by Takeda China this year, is geared to accelerate digital innovation in a variety of diseases through competitions that will fund potentially 10 projects for further development by the end of 2021. The newborn wearable initiative is a first-of-its kind project that uses blue light sensor technology to precisely gauge jaundice and bilirubin levels in babies, with neonatal jaundice being a major cause of premature death and brain damage in newborns in low- and middle-income nations.

What makes that particular sensor so unique is its ability to simultaneously track pulse rate and blood oxygen saturation on top of bilirubin levels in real-time, an advance that researchers say has yet to be achieved to date. And Takeda also buttressed its commercial infrastructure by teaming up with cloud services provider Accenture to conduct COVID-19 therapeutic research.

9. AstraZeneca

British drugmaker AstraZeneca is continuing its quest to become a true digital health innovator by partnering with the likes of the MGH Center for Innovation in Digital Healthcare (CIDH) to optimize clinical trials through a pair of studies utilizing AZ’s AMAZE platform.

The first of these studies is a wide-ranging pilot program that pulls in real-world data in order to engage patients and better facilitate communications among medical care teams. Furthermore, AMAZE’s remote monitoring suite will be used to identify high-risk patients in complex settings in order to improve existing clinical practices.

AstraZeneca additionally launched a collaboration with artificial intelligence and medical device specialist AliveCor using the latter’s Kardia-K AI, which can parse ECGs to measure potassium levels without a blood draw. The non-invasive monitoring project is meant to build out new approaches to cardiovascular, renal, and metabolic disease management with the help of a neural network designed in conjunction with the famed Mayo Clinic.

10. Merck KGaA

Germany’s Merck KGaA squeezed out the other Merck to round out this year’s Index top 10 (Merck & Co. landed at number 11, a fall of two spots from 2020).

The company is collaborating with B. Braun and its start-up neuroloop GmbH to test out the viability of neurostimulators in the treatment of diseases with a high level of unmet medical need, including chronic inflammatory diseases. Initial data readouts from that partnership, which involves selectively stimulating nerves, are slated for the end of 2022.

Furthermore, Merck KGaA has struck an AI drug design deal with Itkos that would automatically design virtual novel molecules for targeted uses across a spectrum of diseases. The firm hopes to leverage the initiative to quickly identify assets that can induce bioactivity and shape clinical design strategies.

Get in contact with IDEA Pharma at to discuss further.

Find out more about the CNS Summit

CNS Summit Innovation Index Methodology

The metrics are calculated using publicly available information, examining initiatives and investments that commence or are ongoing between October 2020 to June 2021. The data is used to rank companies by three facets of innovation:

  • Technology Advancement

  • Trial Optimization

  • Innovative Partnerships


The innovativeness of efforts cannot be measured directly, therefore IDEA Pharma deploys surrogate measures to determine potential impact and breadth of each initiative.

Categories used to rank top 30 pharma include (non-exclusive list): 

  • Commercial Digitization

    • Patient Experience

    • Expanding Commercial Reach

    • Applying digital innovation for organizational improvement

    • Mobile Health

    • Sensor and Wearables & Other Devices

    • Social Media / Patient Services

  • Innovation and Digitization in Clinical Development

    • Patient recruitment / retention

    • Remote patient monitoring

    • Data and analytics

    • Logistic and coordination 

    • Trial Design

  • Research and Application of Digital Solutions

    • Forward looking collaboration with Academic and Incubation Hubs

    • Web Platforms / Software

    • AI,  Machine Learning and Digitally enabled research 

    • Innovative Start ups

    • Innovative Industry 

Each of the above are collated for each company and weighted to produce the CNS Summit Innovation index      . 

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