The flagship CRIB project originated from efforts to create a census of all active ingredients from FDA-approved medicines.  At project initiation, this information was not readily available and in the course of gathering this information, additional efforts identified scientific basis and clinical application of these medicines as well as the organizations that contributed to their research and development. Altogether these findings detailed the history of the modern drug discovery enterprise, which started in earnest in the 1940s. Changes in the clinical application and mechanistic action of new medicines were among the findings from this initial study. Whereas infectious diseases (and anti-bacterials) dominated the early decades of the modern pharmaceutical era, these have now largely fallen out of favor, and have been replaced with emphasis upon oncology and drugs targeting orphan indications.     Our studies also demonstrated that the mechanistic basis of FDA-approved medicines has favored a surprisingly narrow range of target types.  For example, a mere three families (GPCRs, ion channels and nuclear receptors) encompass more than half of all approved medicines. Trends within different disease categories revealed less innovation in terms of target choices that might have been anticipated given our ever-widening knowledge of the molecular basis of disease.