In a year of global political and economic volatility, the waters of biomedicine have stayed relatively calm. No 'occupiers' pitched tents in hospital hallways, no major scientific leaders have been overthrown and chased abroad, and, although funding from the US National Institutes of Health has remained flat since 2004, at least it's not dipping as low as the stock market on bad trading days. In fact, there might even be some reason to celebrate: as Nature Medicine went to press, the US Food and Drug Administration had approved 29 new drugs in the 2011 calendar year, the highest number in the past six years.

But this ship has rocks to dodge yet. The end of 2011 witnessed two blockbuster drugs falling off the so-called 'patent cliff', and more medicines hang on by a finger, including the blood thinner Plavix (clopidogrel), made by Sanofi and Bristol-Myers Squibb, and Pfizer's Viagra (sildenafil) for impotence, both scheduled for generic manufacturing next year. And, in June 2012, the US Supreme Court is slated to weigh in on whether the federal government can mandate that all citizens pay for insurance—a requirement that anchors President Barack Obama's healthcare bill. The effects of that ruling will ripple out to affect drug pricing and revenue, though the jury is still out on exactly on how.

Before we walk the plank into 2012's circling sharks, let's take a breather and review this past year while the fish are still biting and the sun is out.