One day in the future, clinical studies may routinely be carried out in the virtual world, with patients mostly staying put at home instead of traveling to trial sites. For now, sponsors are experimenting with new models for drug development and taking it one step at a time.

In an exclusive interview, Alexion R&D head John Orloff takes In Vivo on a tour around the company’s rejuvenated pipeline and explains how the business is innovating to pre-empt the Soliris-shaped hole in its balance sheet.

Europe’s patchwork of reimbursement agencies make it a daunting place for a small US biotech to do business. Traditionally large pharma partners or CMSOs have provided an experienced hand to hold, but as a new wave of gene therapies and orphan drugs get the EMA green light, smaller drug developers are applying innovation to commercialization and choosing to go solo.