Pharma Industry Eyes 2026 Amid Pricing Pressures, Patent Losses, and Strategic Deals

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The pharmaceutical sector is gearing up for a pivotal 2026, with executives and investors at the annual JPMorgan Healthcare Conference in San Francisco laying out strategies to navigate a complex mix of drug pricing reforms, patent expirations, and dealmaking opportunities. With roughly $300 billion in potential revenue at risk from upcoming patent cliffs, the industry is focused on innovation, collaboration, and regulatory adaptation.

Drug Pricing Reforms Bring Certainty, But Pressure Remains

Several major drugmakers have reached pricing agreements under President Donald Trump’s most-favored-nation policy, aimed at lowering costs for Medicaid patients and boosting affordability through platforms like the upcoming TrumpRx portal.

Executives acknowledge that while the deals reduce uncertainty, they still impact revenue. Sanofi CEO Paul Hudson said the agreements represent a manageable challenge, emphasizing that companies can still execute long-range growth plans. AstraZeneca noted that pricing adjustments affect only specific Medicaid populations and constitute a “low single-digit percentage” of global sales.

Pfizer CEO Albert Bourla highlighted that these agreements could give pharmaceutical companies leverage in European markets, potentially prompting countries like the U.K. and France to raise drug prices to maintain access to innovative medicines.

Patent Expirations and Strategic Deal-Making

The sector faces a wave of patent expirations for blockbuster drugs. Merck’s Keytruda, which generated $29.48 billion in 2024, faces generic competition by 2028. Merck is aiming to offset this loss with new products projected to contribute $70 billion in sales by the mid-2030s, nearly double Keytruda’s expected revenue before patent expiry.

Bristol Myers Squibb is bracing for multiple patent expirations, including the $13.3 billion Eliquis. CEO Chris Boerner emphasized the company’s late-stage pipeline, highlighting 11 data readouts in 2026 across six potential new products and a focused approach on innovative therapies for hard-to-treat diseases.

Novo Nordisk faces patent challenges for semaglutide, the active ingredient in Ozempic and Wegovy, in international markets including Canada and China. CEO Mike Doustdar expects 2026 to be a year of price pressure but plans to mitigate losses through volume growth and strategic business development.

Vaccine Policy and Regulatory Uncertainty

Executives also discussed the implications of recent U.S. policy shifts. Under Health and Human Services Secretary Robert F. Kennedy Jr., the CDC has scaled back routine childhood immunizations, a move executives like Pfizer’s Bourla call politically motivated with no scientific merit.

Despite these challenges, pharmaceutical leaders remain confident in their long-term strategies. Sanofi’s Hudson emphasized that vaccine scrutiny aligns with expectations ahead of the 2024 election and that evidence-based decision-making remains central to company operations.

Investor Outlook and Sector Sentiment

After a volatile 2025 marked by geopolitical uncertainty, investors are optimistic about 2026. Lower interest rates and a renewed appetite for mergers and acquisitions could reopen the IPO window for biotech firms. Executives are actively pursuing collaborations, buyouts, and pipeline expansion to offset patent losses and capitalize on new revenue streams.

The conference revealed a sector adapting to $300 billion in potential patent revenue loss, evolving regulatory landscapes, and strategic deal-making to ensure resilience. With pricing deals, innovative pipelines, and international market negotiations, pharma executives are positioning their companies for growth while navigating one of the most challenging environments in recent history.

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