In a culmination of previous trends, this year’s ranking of academic spinouts on the basis of venture capital A rounds in 2016 resulted in a list exclusively of firms based in the United States. Recognizing that innovation is global, we have also listed in Table 1 two topcapitalized startups from Europe and Asia. Overall, US biopharma startups dwarf firms from other areas in terms of capitalization and number (Fig. 1); Ireland and the UK are punching above their weight; European companies continue to be comparatively undercapitalized. Those few biotech firms started in China were funded exceptionally well.