This survey article discusses European competition law developments in the pharmaceutical sector from January 2021 through December 2021. Section II reviews developments that continue in the wake of the COVID-19 pandemic. Section III covers cases involving competition from generics and biosimilar suppliers. Section IV deals with recent judgments and cases on excessive pricing. Section V addresses developments on the ongoing issue of parallel trade and distribution. Section VI looks at investigations and recent national enforcement regarding cartels and information exchange. Finally, Section VII provides an overview of the scrutiny of mergers by competition authorities. In response to the COVID crisis, the European Commission (Commission) published a Temporary Framework in April 2020 indicating that certain forms of business cooperation among competitors might exceptionally be allowable in order to address the shortage of essential products and services triggered by the ‘rapid and exponential growth of demand’ engendered by the crisis.1 At the same time, the Commission issued its first comfort letter addressed to ‘Medicines for Europe’ (MfE), a trade association of generic and biosimilar suppliers, supporting MfE’s collective response to address medicine shortages caused by a surging demand for treatment of COVID-19 in hospitals.2