By 2030, 50% of all deaths are expected to be caused by oncology, or cardiovascular diseases. Research and development therefore continues to evolve in these areas to provide a better answer to complex medical needs. As a consequence, the definition of innovation is evolving, going from therapeutic drugs with a new mode of action to novel biotechnologies, biological therapeutics, and vaccination. OBJECTIVES We aim to investigate how therapies for oncology and cardiovascular diseases are expected to evolve in future into technologies that transform the concept of innovation. METHODS Data were extracted from Citeline to assess the scale of therapies in development including: vaccines, stem cells, antibodies, reformulation of combination therapy, gene therapy and RNAi.   RESULTS In oncology, across the selected novel therapies, there are over 670 trials in preclinical to phase 3 of development. Vaccines have a higher rate of development with over 200 products in preclinical development to phase 3. Other areas of development include antibodies, and gene therapy, with over 30 therapies in phase 2 trials alone. Meanwhile, cardiovascular disease has fewer ongoing ‘novel therapy’ trials compared to oncology (around 75% fewer trials). The main areas of development include reformulation of fixed dose combinations, and stem cell research (a total of 60 trials, and 53 trials in preclinical to phase 3 respectively). The trend in innovation for cardiovascular disease instead tends to be focussed on integrated technology and medical devices. CONCLUSIONS While we are fairly acquainted with the current evaluation methods and relevance of clinical and economic evidence of traditional therapies, the emergence of new technologies creates uncertainties around how they will be assessed by payers. For example, demonstrating the value of vaccines (which avoid illness) is difficult to express. Industry must now consider factors outside of the current remit to prepare for successful market access.