To understand the current state of investment in this innovation ecosystem, we conducted interviews with 25 leaders and decision-makers in pharma R&D to evaluate critical areas of investment, and perceived ROI, today and in the near term (over the next3 years). Our discussions reveal that companion diagnostics, genomics research and diagnostic tools, clinical trial enablement solutions, and informatics / AI are the areas of greatest pharma investment and perceived ROI today and are expected to remain so in the near future, with liquid biopsies and real-world data also playing increasingly important roles in drug development.