Novo Nordisk, Pfizer execs weigh in

Drug pricing. Looming patent cliffs. Dealmaking. The first year of Trump 2.0.

Those are among the themes 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 weighed on dealmaking during the first half of 2025, investors and drugmakers sounded optimistic that 2026 may mark a turning point for the sector. Investors are beginning to see signs of recovery in U.S. biotech so far this year after years of volatility, betting that lower interest rates and a renewed appetite for deals will reopen the IPO window.

The conference lacked the splashy, high-dollar acquisitions that typically take center stage there. But big pharma made it clear it is on the hunt for potential buyouts and collaborations as it looks to make up for roughly $300 billion in possible lost revenue as patents for blockbuster drugs expire toward the end of the decade. 

Some concerns around President Donald Trump’s health-care policy agenda have eased after more than a dozen major drugmakers ended 2025 with landmark drug pricing deals and three-year reprieves from tariffs.

When asked about whether he still held to his prediction last year that Trump will be a positive for the sector, Pfizer CEO Albert Bourla told reporters last week, “Yes,” even though “I got scared big time” along the way.

Still, investors are trying to understand how the drug pricing agreements will impact businesses, and parse out the implications of policy changes like softer U.S. vaccine recommendations. 

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

Some executives said the recent drug pricing deals – part of Trump’s “most-favored-nation” policy – reduce uncertainty and will likely have a modest impact on their businesses. 

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

“I don’t want to give the impression that there’s no impact from [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-range plan? We feel, so far, we can.”

Sanofi and several other companies with pricing deals could outline how they expect the agreements to affect their businesses when they release their 2026 outlooks in the coming weeks.

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

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

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

“Do you reduce [U.S.] prices to France’s level or stop supplying France? You stop supplying France,” Bourla said. “So they will stay without new medicines … because the system will force us not to be able to accept the lower prices.”

Pharmaceutical companies were confident they can offset losses from upcoming patent expirations of popular drugs, and zeroed in on dealmaking as a critical tool to add new revenue. Cheaper generic versions of brand-name drugs typically enter the market after their patents expire, leading to significant price drops and a loss of market share over time due to increased competition.

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

Merck raised its outlook for new products, saying those items will contribute a projected $70 billion in sales by the mid-2030s. That is almost double what Wall Street expects Keytruda to record in 2028 before its patent expires. Keytruda generated $29.48 billion in sales in 2024, which was nearly half of Merck’s total revenue for that year.

Davis indicated that Merck may not be done with dealmaking, especially for later-stage or already-approved products. 

“If you look from a dollar perspective, we’ve been looking in that up to $15 billion dollar range,” he said. “We’ve been very clear that we’re willing to go larger than that, but we only will do so following the exact same logic and discipline.”

Bristol Myers Squibb has the highest exposure to the upcoming loss of exclusivity 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 raked in $13.3 billion in sales in 2024, making up more than a quarter of the company’s revenue for the year.

But in an interview on Jan. 13, Bristol Myers Squibb CEO Chris Boerner said the company has the potential to deliver up to 10 new products by the end of the decade.

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

Boerner highlighted 11 late-stage data readouts in 2026 across six potential new products. Boerner said the company is “casting a wide net” for its business development.

He added that Bristol Myers Squibb is hoping to build on the core therapeutic areas it knows well, look across different phases of development and focus on “the best, most innovative science that we can find” to tackle difficult-to-treat diseases. 

This year, Novo Nordisk is also facing patent expirations for semaglutide – the active ingredient in its blockbuster diabetes drug Ozempic and obesity counterpart Wegovy – in certain countries, including Canada and China. 

Novo Nordisk CEO Mike Doustdar said 2026 “will be the year of price pressure” due to generic competition in some international markets and its U.S. drug pricing deal. He added that Novo Nordisk aims to offset price cuts with volume growth and will be active in business development to see what “can complement our own pipeline.” 

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

Some executives reiterated concerns about the administration’s changes to U.S. immunization policy under Health and Human Services Secretary Robert F. Kennedy Jr. – a prominent vaccine skeptic – and his appointees. That includes the Centers for Disease Control and Prevention’s recent move to roll back the number of immunizations routinely recommended for children. 

“I’m very annoyed. I’m very disappointed,” Pfizer’s Bourla said, adding that “what is happening has zero scientific merit and is just serving an agenda, which is political.” 

He added, “I think we do see that there are reductions in vaccination rates of kids and that will raise diseases, and I’m certain about that.” But Bourla said he doesn’t believe the recent changes to the childhood vaccine schedule will impact Pfizer’s bottom line. 

He said the pressure the administration is putting on immunizations “is an anomaly that will correct itself.” 

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

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

“I just hope that the evidence is enough in the end with all these things,” he added.