While the COVID-19 pandemic also affected the work of regulatory authorities, the US Food and Drug Administration approved a total of 53 new drugs in 2020, one of the highest numbers in the past decades . Most newly approved drugs related to oncology (34 %) and neurology (15 %). We discuss these new drugs by level of innovation they provide, i.e., first to treat a condition, first using a novel mechanisms of action, and``others ."Six drugs were first in indication , 15 first using a novel mechanism of action, and 32 other . This includes many drugs for the treatment of orphan indications and some for the treatment of tropical diseases previously neglected for commercial reasons . Small molecules continue to dominate new drug approvals, followed by antibodies . Of note, newly approved drugs also included small-interfering RNAs and antisense oligonucleotides . These data show that the trend for declines in drug discovery and development has clearly been broken.