Every year, thousands of pharma execs, healthcare CEOs, investors, and biotech entrepreneurs descend on the Westin St. Francis hotel in San Francisco. And every year, the scene looks more or less the same: people networking in the lobby, lines snaking out of conference rooms, a sea of men wearing variations of the same suit.

Against this recurring tableau, everyone seemed to want to talk about, well, change. How drugmakers should prepare for and respond to the forces poised to reshape the industry was a popular topic on day one of the 36th annual JP Morgan Healthcare Conference.

See also: 40 Different Ways to Reshape Healthcare

Change is usually a popular theme at conferences — you don’t want to appear as if you’re treading water, particularly when you’re a pharma CEO presenting to a room full of investors — but this year, the talking point had some heft behind it.

2017 was many things, but uneventful wasn’t one of them. In the last few months alone, a major tax overhaul was pushed through Congress, drug approvals hit a record high, and a gene therapy to cure blindness was approved by the FDA.

Below are three areas to pay attention to over the next 12 months.  

The tax bill sets the stage for major M&A activity.

Execs from Eli Lilly, Celgene, Medtronic, and Vertex all expressed their pleasure with the new tax bill. Speaking to a packed room, Johnson & Johnson’s chief financial officer, Dominic Caruso, heaped on more praise, crediting the overhaul for making the U.S. competitive again. “Corporations now have the freedom to access the cash they earn abroad without punitive taxation,” he continued. With all that money in hand, separate reports from EY and Baker McKenzie predict that the biotech industry goes on a spending spree this year. Already, there’s been a flurry of activity, including Celgene’s $7 billion acquisition of Impact Biomedicine.

See also: Amazon sets its sights on healthcare

Amazon’s shadow further encourages consolidation.

The tech giant isn’t getting into the prescription drug business — for now — but that doesn’t mean drugmakers can rest easy. J&J CEO Alex Gorsky is certainly feeling the pressure: “Every one of us should be worrying about how Amazon is going to disrupt our business,” he said, to scattered laughter. He wasn’t joking: “If we’re not,” he continued, “we’re frankly becoming too complacent.”

CVS’s $69 billion acquisition of Aetna was largely seen as a pre-emptive move against Amazon, and rumors are already swirling about the next blockbuster deal. “We should expect to see even more change in the industry going forward,” Gorsky said. “We’re seeing the convergence of a lot of different sectors as we speak.”

Digital health continues to work out some wrinkles.

This one is harder to file under the “change” category. Day one at the conference ended with a panel entitled, “Is digital health at an inflection point?” The takeaway seemed to be, we’re getting there but…no, probably not.  For years, we’ve been hearing that tech investors are finally working with industry experts and playing nice with regulators to build companies that actually understand and work within the healthcare system. But structural problems, including an infrastructure that doesn’t incentivize companies to share data, still prevent progress. And as wearable and sensor technology companies are beginning to find out, data alone isn’t always enough. When it comes to behavioral change, “We know what doesn’t work,” said Glen Tullman, CEO of chronic health management company Livongo Health.

See also: What marketers need to know about tax reform, off-label promotion, pricing

None of this means the inflection point won’t come, or that progress hasn’t been made. (Jessica Mega, Verily Life Sciences’ chief medical officer, pointed to the FDA’s fast track as proof that tech companies and the agency are working together to build a validation framework for digital devices.) But as it stands, there is still more potential than there are blockbuster success stories — much as it’s been for the past few years.

It will be interesting to see whether this softens the flow of money pouring into biotech startups, particularly if we see more trajectories like that of Practice Fusion. The  cloud-based EHR company, which had raised more than $157 million, was just acquired for a mere $100 million by larger health IT firm Allscripts.

Other noteworthy events in pharma:

Novo Nordisk bid $3.1 billion for Ablynx, but was rebuffed.

Shares of Axovant Sciences plummeted after the company announced it was dropping a once-promising drug to treat Alzheimer’s disease after another clinical trial failed. Axovant is scheduled to present at the JP Morgan Healthcare Conference later today.