The coronavirus disease 2019 (COVID-19) pandemic response brought forth major changes in innovation policy . This paper takes stock of the key features of the COVID-19 innovation system . Before the pandemic, innovation in biomedical research and development consisted largely of``push"funding from the public sector in support of basic research and``pull"incentives from patents to motivate private companies to invest in clinical trials and develop drugs and vaccines . In contrast, during the pandemic, public funding shifted its focus to late-stage product development and manufacturing . Procurement agreements with governments replaced traditional pull incentives from patents for the major private companies . Non-patent barriers to competition may also have incentivized innovation . The challenges to ensuring diffusion have gained in prominence during the pandemic, though it is unclear what role patents will play in pricing and access . Some aspects of this approach to biomedical innovation may be unique to crises, but others could provide lessons for policy beyond the pandemic . [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript . The final edited version will appear in an upcoming issue of Health Affairs .].