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With approximately 90% of phase I compounds failing to reach the market (Nat. Rev. Drug Discov.15, 379–380; 2016), high attrition rates remain a major obstacle for the biopharma industry. To help tackle this challenge, many companies are looking to the discipline of translational medicine (TM). To understand the progress that has been made, we conducted a survey of TM leaders from 25 of the top 50 pharma and biotech companies in the United States and Europe. We adopted a broad view of TM, and included all efforts from preclinical to late clinical development. TM practices integrate scientific (for example, biomarkers), technological (for example, in vitro testing modalities) and methodological (for example, in silico trials) advances to both enable more effective decision-making in R&D and enhance coordination not only among functions within a biopharma company but also with various industry, academic and government players.