Biotechnology executives and investors know the drill: take advantage of robust financing, but prepare for its inevitable decline. As we review in our 31st annual Beyond borders, in 2016, biotechnology companies continued to invest in tomorrow’s treatments even as capital markets in the US and EU dried up, valuations suffered and payers commanded ever more decision-making power. There were geopolitical complexities, too: Brexit; the Trump presidency; ongoing uncertainty about US health care reform.