When Gilead Sciences agreed to acquire CV Therapeutics for $1.4 billion in cash, the prize was Ranexa, the first totally new anti-angina drug approved for first line therapy in 30 years.

Gilead believes Ranexa can boost its cardiovascular business as it gathers itself to launch its hypertension drug Darusentan, which looks solid late in Phase III.

But unlike other pharmaceutical players that are using acquisition as a primary growth strategy, Gilead also generates growth internally.

California-based Gilead has been on Fortune’s list of Fastest Growing Companies for 3 out of the last 4 years. Its stock has doubled since 2004, and it’s down only 10% since the Feds played Russian roulette with Lehman Brothers and the chamber turned out to be loaded.

The S&P has dropped 47% since then.

The secret to Gilead’s success is a trio of HIV treatments which drove nearly 90% of its $5.3 billion revenues in 2008.

These drugs all leverage Gilead’s proprietary compound, tenofovir, which is prescribed in one form or another for 80% of new HIV patients in the US, and nearly that many in the EU.

New HHS guidelines now list these drugs, and no others, as the preferred backbone therapy for HIV/AIDS.

Patients find Gilead’s one-a-day combo pills, Truvada and Atripla easier to manage, so they’re more likely to stick with the plan and that drives better outcomes.

Gilead also stands to benefit from evidence-driven public policy shifts towards earlier detection and treatment of HIV which will increase the size of the treated population and the duration of therapy.

“Gilead identified the importance of convenience, less frequent dosing, and combination pills earlier than anyone else,” said Geoffrey Porges, an analyst at Sanford Bernstein.

Last month Steve Jobs Who-is-Apple acknowledged that, 5 years after being treated for a rare neuroendocrine tumor of the pancreas, he’s not altogether well.

Jobs emailed employees to say he’d be taking a 6-month leave from the company. His “health-related issues are more complex” than he’d known previously, and he’s cool with Tim Cook being “responsible for Apple’s day-to-day operations” while he’s gone.

Jobs Who-is-Apple also made it clear he’s coming back and he’s still CEO.

So now Tim Cook, Apple nation turns its lonely eyes to you.  Cook, Apple’s COO, has been running the show for years, but always with Jobs Who-is-Apple there to provide context not to mention the fairy dust.

Most people figured Cook would never cut it as Apple’s CEO, that he was an ops guy and not a visionary like Jobs Who-is-Apple.

But under these circumstances no one makes sense as a stand-in more than the guy who already oversees customer support, sales, the online store, the Macintosh division, and telecom relations not to mention operations.

But can he like, really do it all by himself?

“The company already has coalesced around (Cook),” a top Apple executive told Fortune, on condition of anonymity.

“Tim does almost nothing that would make you disrespect him, which you can’t always say about Steve,” he added.

The Great Economic Crisis of 2008 affects companies capriciously, just as a tornado might flatten one home while leaving the neighbor’s untouched. The Crisis has decimated cash-starved small biotech companies for example, while their larger counterparts have sufficient revenues to weather the storm and Big Pharma—flush with cash as always—is hunting for bargains.

The same phenomenon is unfolding in tech. Oracle, Microsoft, Cisco, HP and the other technology behemoths know the Crisis threatens smaller firms in the Valley, so they’re getting ready for a shopping spree the likes of which no one has seen in that sector since the dot com bubble burst in 2001.

“We are better positioned than our peers to do well in tough times,” Oracle’s Larry Ellison is reported to have said at his company’s October annual meeting.  “Acquisitions we have been looking at for some time are more attractive.”

But actions speak louder than words, so on a day the market tumbled 750 points, Oracle dropped $300 million cash to buy Primavera Software, a project-management company. HP followed suit by acquiring Lefthand Networks, a storage company for $360 million and Intel snapped up NetEffect for $8 million.

Many small tech companies are cash-strapped and don’t have a choice. “In this environment, it turns into a fire sale,” Emergence Capital’s Jason Green told Fortune magazine.

So what companies are most likely to be sold? It’s the ones with little or no revenue that are heading for a financing round just to survive, as well as later-stage companies that had planned for an IPO only to see activity in that space grind to a complete halt amid the credit squeeze.

Or, as Network Appliance CEO Dan Warmenhoven told Fortune, “Technology that would have cost me $100 million a year ago but might go for $11 million today. Deals like that.”

This week’s Fortune magazine includes its annual list of the 50 most powerful women in business. The remarkable people on the list include Sunoco’s Lynn Elsenhans, the first woman to run a major US oil company and Google’s Marissa Mayer, who at 33 oversees thousands of engineers and is the youngest woman ever to make the list.

Congratulations to the women in health care who made the list:

Angela Braly, President and CEO of Wellpoint
Susan Desmond-Hellmann, President, Product Development, Genentech
Colleen Goggins, Worldwide Chairman, Consumer Group, J & J
Carrie Cox, EVP and President Global Pharmaceuticals, Schering-Plough
Melanie Healey, Group President, Global Feminine and Health Care, P & G
Dierdre Connelly, President, Lilly USA, Eli Lilly
Sherilyn McCoy, Worldwide Chairman, Surgical Care Group, J & J
Gail Boudreaux, President UnitedHealthcare, and EVP UnitedHealth Group