The high number of research and development (R&D) spin-outs in the pharmaceutical industry during the last 10 years focusing on drug development or offering specialised services demonstrates that pharmaceutical companies believe, through doing this, they can improve R&D performance. In a study, 43 European drug development as well as service oriented R&D spin-outs were analysed with regard to background, impact, realisation and the underlying strategy of the pharmaceutical parent companies. Spin-out creation can help to refocus the company strategy. Following a merger or simply complementing a strategic realignment on core areas, spin-outs provide a valuable option to leverage assets of low strategic importance, or under-exploited assets in their parent companies. Key aspects are strengthening the entrepreneurial spirit, a clear focus on core activities, performance-oriented controlling through cash-driven key indicators, high identification with the company, and appropriate financial incentives for management and staff.