Russian scientists have already demonstrated their successful medical and biotechnological projects to the global scientific community and business. Achieving leadership in this regard means developing broad internal expertise in managing R&D, shaping a culture of development within startups, having sources for their funding, integrating into the global network of joint research projects, developing ones own expertise, and focusing on the international market. A successful triple helix innovation concept has emerged in global practice, which entails collaboration between the government, research centres, and business. Global pharmaceutical and medical companies are increasingly employing a model of open innovation when creating and commercializing new products. What are the most successful models of innovation at pharmaceutical and medical companies? Which of them could be most effectively implemented in Russia? What is the role of the state and development institutions in creating conditions to realize the potential of advanced innovative development? How can investments be raised for Russian developments? What problems do developers and investors face? What are possible solutions?