Nearly half of the publicly quoted US biotechs have less than a year#8217;s cash left. With financing and valuations at rock-bottom, these companies face bleak outcomes and likely bankruptcy. What are their options? Pharmas still require products, so those with good technologies and products have the opportunity to partner, which they need to do fast, though they will face valuation issues. A common strategy is hibernation. But here, the companies at risk are often those that have been drip-fed financing. The biotech game is about risk and failure, so all such companies need funds to spread that risk and take products to the next-value inflection point. Clearly, cash-strapped companies are a higher risk then cash-rich ones, and those that have adopted a dual service/R&D model also have a higher chance of survival, as they have cash sources independent of equity. The basic message is that they need to appraise their cash flow strategies.