Novo Nordisk and Pfizer executives discuss the matter

Drug pricing. Patent rapids loom. Make deals. The first year of Trump 2.0

Those are among the topics that dominated conversations last week as drugmakers of all sizes met with investors to map out their plans for 2026 and beyond at the annual JPMorgan Healthcare Conference in San Francisco.

After geopolitical uncertainty affected dealmaking during the first half of 2025, investors and drugmakers appeared optimistic that 2026 could represent a turning point for the sector. Investors are beginning to see signs of recovery in the US biotech space so far this year after years of volatility, betting that lower interest rates and renewed appetite for deals will reopen the IPO window.

The conference lacked the flashy, high-dollar acquisitions that usually take center stage there. But big pharma has made it clear they are looking at potential buyouts and collaborations, as they look to make up for nearly $300 billion in potential lost revenue as patents on blockbuster drugs expire at the end of the decade.

Some concerns about President Donald Trump’s health care policy agenda eased after more than a dozen major drugmakers ended 2025 with landmark drug pricing deals and three years of tariff relief.

When asked if he still stood by his prediction last year that Trump would be positive for the sector, he replied: Pfizer “Yes,” CEO Albert Bourla told reporters last week, although “I got scared for a long time” along the way.

However, investors are trying to understand how drug pricing agreements will impact companies, and analyze the implications of policy changes such as relaxed US vaccine recommendations.

Here’s what we heard from pharma executives about the year ahead.

Some executives said the latest drug pricing deals — part of Trump’s “most favored nation” policy — reduce uncertainty and are likely to have a modest impact on their business.

The agreements include lowering the prices of certain products for Medicaid patients by tying them to the lowest prices abroad, and agreeing to sell certain drugs at a discount on direct-to-consumer platforms, including the administration’s upcoming TrumpRx website.

“I don’t want to give the impression that there is no impact [the most-favored-nation deal,] Because there is” Sanofi CEO Paul Hudson told reporters at a media event Wednesday morning. “The question for us is: Can we manage that and deliver an attractive long-term plan? We feel we can so far.”

Sanofi and several other companies with pricing deals can outline how they expect the agreements to impact their businesses when they issue their 2026 forecasts in the coming weeks.

AstraZeneca It expects the initial impacts of its drug pricing deal to be limited and manageable, because it applies so far to a specific Medicaid population and represents a “low single-digit percentage” of the company’s global sales, CFO Aradhana Sarin said during a Jan. 13 presentation.

Meanwhile, Bourla told reporters on January 12 that the deals would help companies pressure European countries to increase what they would pay for drugs, similar to how the United Kingdom agreed in December to raise drug prices as part of a trade deal with the United States.

He said companies could stop supplying medicines to some countries that refuse to pay more.

“Are you reducing? [U.S.] Prices to France’s level or stop supplying France? “They have stopped supplying France. So they will be left without new medicines… because the system will force us to not be able to accept low prices,” Bourla said.

Pharmaceutical companies were confident that they could recoup losses from upcoming patent expirations on popular drugs, and focused on dealmaking as a crucial tool for adding new revenue. Cheaper generic versions of brand-name drugs typically enter the market after their patents have expired, resulting in significant price drops and loss of market share over time due to increased competition.

During a presentation on January 12, Merck CEO Rob Davis said his company hopes to “grow through” the upcoming loss of exclusivity in its best-selling cancer immunotherapy Keytruda.

Merck raised its expectations for new products, saying these items will Contributing to an expected sales of $70 billion by the mid-2030s. That’s roughly double what Wall Street expects Keytruda to score in 2028 before its patent expires. Keytruda had sales of $29.48 billion in 2024, roughly half of Merck’s total revenue for that year.

Davis noted that Merck may not finalize deals, especially for later-stage or products that have already been approved.

“If you look from a dollar perspective, we were looking at a range of $15 billion,” he said. He added: “We have been very clear that we want to go further, but we will only do so by following the same logic and discipline.”

Bristol Myers Squibb It is most vulnerable to losing exclusivity next cycle, with blockbuster drugs such as the blood thinner Eliquis set to face generic competition, according to a note from JPMorgan analysts in late December. Eliquis had sales of $13.3 billion in 2024, accounting for more than a quarter of the company’s revenue for the year.

But in a January 13 interview, Bristol-Myers Squibb CEO Chris Boerner said the company has the potential to introduce as many as 10 new products by the end of the decade.

“We feel really good about the backbone we have in late-stage development, and the mid-stage pipeline is progressing well as well,” he told CNBC.

Boerner highlighted 11 late-stage data readouts in 2026 across six potential new products. Boerner said the company is “looking to a broad network” to develop its business.

He added that Bristol-Myers Squibb hopes to build on the core therapeutic areas it knows well, looking at different stages of development and focusing on “the best, most innovative science we can find” to address difficult-to-treat diseases.

this year, Novo Nordisk It also faces patent expiration on semaglutide — the active ingredient in the blockbuster diabetes drug Ozempic and its obesity counterpart Wegovy — in some countries, including Canada and China.

Novo Nordisk CEO Mike Dustedar said 2026 “will be a year of price pressure” due to generic competition in some international markets and the US drug pricing deal. Novo Nordisk aims to offset price cuts through volume growth and will be active in developing the business to see what “can complement our own pipeline,” he added.

The comments come after Novo Nordisk lost a heated bidding war with Pfizer last year over obesity biotech Metsera.

Some executives reiterated their concerns about changes the administration made to U.S. immunization policy under Health and Human Services Secretary Robert F. Kennedy Jr. — a prominent vaccine skeptic — and his appointees. This includes the recent move by the Centers for Disease Control and Prevention to reduce the number of vaccinations routinely recommended for children.

“I’m very upset. I’m very disappointed,” Pfizer’s Bourla said, adding that “what is happening has no scientific basis and only serves a political agenda.”

He added: “I think we see that there are decreases in child vaccination rates and this will lead to an increase in diseases, I am sure of that.” But Bourla said he doesn’t think recent changes to the pediatric vaccine schedule will impact Pfizer’s bottom line.

He said the administration’s pressure on the fortifications “is an anomaly that will correct itself.”

Meanwhile, Sanofi’s Hudson said scrutiny of vaccines by the Trump administration is in line with what the company expected ahead of the 2024 election.

“I’ve had conversations with Kennedy, and we’re just trying to stick to the facts of the evidence,” Hudson said. “There’s not much we can do.”

He added: “I just hope that the evidence will be sufficient in the end regarding all of these things.”