Unsurprisingly, most of the approved NMEs in pharma pipelines come through mergers and acquisitions. For example, in 2009 Pfizer acquired another pharmaceutical giant founded in 1860, Wyeth bringing in a large portfolio of drugs. 2009 was a big year for M&A. Same year, Roche acquired Genentech, which had a celebrated portfolio of NMEs several of which came through Genentech's strong internal biology capabilities. So naturally, the top three leaders in M&A over the past two decades were Pfizer, MSD and Roche.