The pharmaceutical industry is increasingly turning to low Earth orbit for drug development, capitalizing on the unique advantages of zero gravity. Companies like SpaceMD and Varda Space Industries are at the forefront, exploring how space conditions can enhance drug formulation and delivery. SpaceMD has created the PIL-BOX, a specialized micro-laboratory that has successfully flown 54 units to crystallize proteins in orbit, testing 37 drug compounds with major pharmaceutical partners. The absence of gravity allows for the production of more uniform and stable drug crystals, improving administration methods and potentially reducing costs associated with storage and transport. Merck's previous experiments on the International Space Station led to the development of a new injectable version of its cancer drug Keytruda, which received FDA approval in 2025. Meanwhile, Varda is working on autonomous satellites to manufacture active pharmaceutical ingredients, aiming to streamline the production process. With the UK recognizing the benefits of space-manufactured medicines, the landscape for pharmaceutical development in space is rapidly evolving, promising to reshape how drugs are formulated and delivered.