Since its foundation in 2004, Metrum Research Group has relied on R as the core technology and central framework for all of the company’s biomedical modeling and simulation (M&S) service activities, spanning more than 475 projects with 150+ different sponsors. Projects include pharmacokinetic-pharmacodynamic modeling, quantitative systems pharmacology models, simulation-based trial design evaluations, disease progression and patient population modeling, model-based meta analysis of competitor data, model-based comparative effectiveness assessments, and data management activities, etc., all within a regulated environment. Analyses were conducted in R or via other software tools which are managed via R scripts, functions, or packages. Key deliverables of M&S projects are routinely provided as R packages or interactive simulation applications, driven by R (and R Shiny). R has also been an essential component of Metrum’s vision for Open Science in biomedical M&S, allowing for accessibility and reproducibility of platform models developed for multiple disease areas.