The United States and Europe have long been centres of biomedical innovation, accounting for ~90% of all new molecular entities (NMEs) approved between 1990–2014 (Drug Discov. Today 20, 500–504; 2015) and home to most of the top 25 biopharma companies globally. Previous studies have evaluated emerging centres of life science innovation, in particular China and South Korea (Nat. Rev. Drug Discov. 13, 646–647; 2014). This article analyses the biomedical landscape across Asia, Europe and the United States to evaluate trends shaping global life science innovation over the past decade. The analysis could help guide geographical capital allocation for biopharma investors and companies.