Biopharma innovation has significantly improved patient outcomes, yet R&D productivity remains stagnant despite increased investment. To address this, companies are focusing on personalized medicine, leveraging digital and analytics for innovation, and improving R&D efficiency. Three transformation approaches—asset-centric, operating-model, and functional—are being explored, with a holistic, outcomes-based approach recommended for sustainable impact. Key outcomes include aligning R&D with a 'North Star', creating a stable R&D backbone, enabling continuous improvement, fostering a culture of agility, and building a holistic capability system. Successful transformations require full organizational commitment, dedicated resources, and a focus on speed and effectiveness over cost.