The United States continues to hold its position as the global capital for innovation and an important market for companies worldwide, maintaining significant year-on-year growth despite external pressures and shifting global dynamics. 2018 was a record year for generic drug approvals, exceeding the FDA’s previous record set in 2017, and exciting discoveries in the biotech space are driving the industry further towards precision therapies and cures. Nevertheless, the industry’s trajectory for the year ahead is somewhat unclear. As we move through 2019 and into the 2020 presidential election, the pressure already seen on drug pricing will likely be amplified, and CFIUS’ increased scrutiny on foreign investment could be detrimental to deal flow and investment dynamics, with the U.S.-China relationship particularly in the spotlight. In an increasingly multifactorial environment, executives are faced with more complex decisions as they define their strategies.