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. 

“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.”

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…