Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic and organisational sustainability. We take that angle in an in-depth study of four prominent ADDCs. Our findings indicate that there are clear similarities in the way sustainable centres are organised, managed and financed. We also identify factors in the frameworks of academia and research funding affecting their performance.