Innovation requires vision, leadership and architecture. The myth that innovation is expensive, takes a lot of people, must be big, and takes a lot of experience are excuses that keep us from innovating. Innovation leaders not having enough time to think is a disaster. The key elements of innovation and how to create breakthrough, innovative capabilities are addressed. There are only 2 questions that matter: Is this disruptive and why? Marginal innovation is expensive, while breakthrough innovation is much cheaper. The leadership’s role is to move the firm from its present status to a strategically desirable future. The innovation architecture needs seekers, market readers, and technology drivers. Innovation happens at the boundaries of disciplines, where silos break down. Breaking down silos can spark innovation in unexpected ways; however, not all silos need to be broken down as not everybody need to innovate. Trends in the Biotech Industry are: immunotherapy, antibody drug conjugates, gene and cell therapies, drugs for CNS diseases, drug re-purposing, innovative routes of administration, faster and more reliable DNA and pathology tests. Biotechnology hubs will expand. They need to be close to universities (intellectual proximity, internships) where (1) academia can learn entrepreneurship and successful business development, (2) the industry revitalizes its innovation platform with new ideas from young talent, (3) the local economy grows and shares prosperity.