In the middle of the 20th Century, pharmaceutical companies were highly respected and patients depended on their physicians to make healthcare decisions. Drugs were a key part of a physician’s ‘toolkit’. As we entered the era of the blockbuster drugs, most were small molecules made by chemical synthesis, but biotechnology was starting to emerge as a possible source of new therapeutics. Meanwhile, direct-to-consumer pharmaceutical advertising began to empower patients. Fast forward to today, and we see pharmaceutical companies suffering degraded reputations and values, patients further empowered by the Internet and social media, and average life expectancies increased by a decade. Digital health technologies are poised to explode and the top 10 pharmaceuticals by sales will soon all be biologicals!