JPM 2026 Recap: Who’s Winning, Who’s Catching Up, and Who’s at Risk?

The 44th Annual J.P. Morgan Healthcare Conference, held January 12-15, 2026, in San Francisco, revealed a pharmaceutical sector at an inflection point. With major blockbusters facing patent expirations, industry leaders such as Eli Lilly, Novo Nordisk, Bristol Myers Squibb, AbbVie, Bayer, Pfizer, Novartis, Roche, Merck, Gilead Sciences, GSK, AstraZeneca, and others demonstrated balanced strategies combining aggressive pipeline expansion, selective dealmaking, and the adoption of emerging technologies, particularly artificial intelligence. 

The JPM 2026 conference generated approximately $8.3 billion in announced deals, with emphasis on oncology (particularly PD-1/VEGF bispecifics and antibody-drug conjugates), obesity market expansion, and neurodegenerative disease therapeutics. The overarching narrative: proven pipeline depth can deliver sustainable growth through the 2030s, provided execution remains flawless.

Let’s dive deep into the key highlights from the JPM 2026

The Mega-Cap Movers: Defensive and Offensive Strategies

Eli Lilly: The Obesity Empire and AI Innovation

Eli Lilly CEO David Ricks articulated a company increasingly bullish on its long-term growth trajectory, projecting 5-7% annual sales growth for the back half of the decade. The company’s competitive advantage extends well beyond its blockbuster GLP-1 therapies. LillyDirect, the company’s direct-to-consumer pharmacy platform, now serves over 1 million patients globally and is expanding internationally, a strategic moat comparable to the out-of-pocket market penetration Pfizer observed with Viagra.

​Most significantly, Lilly announced a landmark $1 billion joint investment with NVIDIA to establish an AI innovation lab specifically focused on accelerating drug discovery. This partnership builds on an earlier collaboration to create a pharma “supercomputer” capable of training AI models on millions of experiments to identify potential drug candidates. The message is explicit: Lilly is betting that AI-driven compound identification will materially compress development timelines and improve success rates in early-stage programs.

Novo Nordisk: Commercial Execution Over Scientific Innovation

Novo Nordisk CEO Mike Doustdar openly acknowledged what investors already knew: 2024 was a difficult year for the company, ceding obesity market leadership to Eli Lilly despite technological parity. The strategic response at JPM 2026 was refreshingly candid: the company would focus ruthlessly on commercial execution rather than pursuing additional scientific breakthroughs.

​Novo’s oral GLP-1 formulation, WEGOVY’s pill form, launched in early January 2026, provided the company a narrow window of competitive advantage before Lilly’s oral competitor arrived. However, Doustdar’s framing of the market opportunity proved instructive: with approximately 100 million obese Americans and Novo/Lilly combined capturing only 10-15 million patients, the addressable market remains vast. Rather than compete solely on drug efficacy, Novo aggressively repositioned itself in the cash-pay channel, a market segment with consumer patterns similar to those of Viagra, where consumers are willing to self-pay despite insurance coverage.

​The company relaunched its online pharmacy and forged partnerships with Ro Health, Weight Watchers, and Costco to ensure direct-to-consumer accessibility. Doustdar explicitly stated: “Mastering this cash channel to us is really, really important.”

Novartis: Dealmaking as Strategic Imperative

Novartis announced two major licensing agreements totaling $1.65 billion in upfront payments, signaling aggressive portfolio expansion. The first, a $1.6 billion collaboration with SciNeuro Pharmaceuticals, targets Alzheimer’s disease with a de novo amyloid beta antibody, entering a crowded neurodegenerative space but one with proven Phase 3 validation via BioMarin/Eli Lilly’s donanemab.

The second agreement, a $50 million license for Zonsen PepLib’s peptide-based radioligand therapy for oncology, complements Novartis’s existing leadership in the radioligand therapy space. Novartis’s PLUVICTO generated $2.3 billion in 2025 sales, and the radioligand market is projected to grow significantly by 2034, a compelling secular tailwind justifying selective acquisition in this space.

​Novartis positioned itself as a company that builds approximately 60% of its R&D pipeline and total drug sales through partnerships, emphasizing disciplined yet aggressive external innovation rather than relying solely on internal R&D productivity.

AbbVie: Oncology as the New Growth Engine

AbbVie kicked off the JPM conference with its largest transaction: a $5.6 billion licensing agreement with China-based RemeGen for RC148, a PD-1/VEGF bispecific antibody targeting advanced solid tumors. This deal signals management’s explicit recognition that HUMIRA’s loss-of-exclusivity cliff, now three years behind, requires acceleration of newer assets.

The strategic rationale merits analytical attention. PD-1/VEGF bispecific antibodies represent the hottest competitive space in oncology, following Summit Therapeutics’ Phase 3 victory over Merck’s KEYTRUDA in Chinese lung cancer patients, the first time any therapy has beaten KEYTRUDA on progression-free survival. By acquiring RC148, AbbVie positions itself to combine the dual immune checkpoint and anti-angiogenic mechanisms with its existing ADC pipeline, potentially creating synergistic combinations that overcome mechanisms of treatment resistance and limit the limitations of current immunotherapies.

AbbVie’s 2027 guidance provides transparency on the HUMIRA transition: successor products SKYRIZI and RINVOQ are projected at $20 billion and $11 billion, respectively, representing a meaningful but not complete replacement of Humira’s peak revenue. The RemeGen deal represents management’s view that oncology must become the incremental growth driver in the 2030s.

Pfizer: The Metsera Gamble and Obesity Pivot

Pfizer CEO Albert Bourla’s most provocative statement: the company had underestimated the size of the out-of-pocket obesity market during its Metsera acquisition negotiation. Bourla explicitly compared this market opportunity to Viagra, a therapy for which consumers willingly self-pay despite insurance availability, creating a profitable cash-pay market independent of traditional reimbursement constraints.

​Bourla committed Pfizer to initiating 10 distinct late-stage obesity studies from Metsera by year-end 2026, including studies commenced in November 2025. The message is unambiguous: Pfizer views obesity not as a traditional chronic disease but as a lifestyle/wellness category with vastly larger addressable markets than conventional epidemiological estimates suggest.

However, Pfizer faces a particular challenge: it lacks current market leadership in obesity. The Metsera acquisition signaled aggressive capital deployment, but execution risk remains material, particularly given Novo’s and Lilly’s entrenched positions and ongoing price deflation in the GLP-1 market.

Roche: The Oncology Rejuvenation Play

Roche CEO Teresa Graham articulated a three-pillar strategy: maximizing the on-market portfolio (17 blockbuster drugs currently generating $44.5 billion in year-to-date sales through September 2025) to sustain growth until 2028, delivering key launches in 2026-2027, and preparing wide entry into novel disease areas, including Alzheimer’s and obesity via new molecular entities.

The oncology pipeline represents the strategic linchpin. Giredestrant, a next-generation selective estrogen receptor degrader (SERD), is expected to advance the ER-positive breast cancer standard of care by combining superior efficacy with synergistic combinations with PI3K inhibitors and CDK4/6 inhibitor alternatives. Roche targets up to 3 new molecular entity filings in 2026, with 10 Phase 3 initiatives launched in 2025, including pegozafermin in metabolic dysfunction-associated steatohepatitis (MASH).

The Challenged Champions: Confronting Patent Cliffs

Bristol Myers Squibb: Patent Cliff Mitigation Through Portfolio Depth

Bristol Myers Squibb CEO Chris Boerner delivered what may be the conference’s most strategic articulation of big pharma’s patent cliff problem: the company faces exclusivity losses on blockbuster drugs (OPDIVO, ELIQUIS) but has deliberately constructed a diversified portfolio capable of delivering 10+ new product launches by 2030.

​The 2025 portfolio performance validated this thesis. The Growth Portfolio (excluding legacy assets) expanded 17% year-over-year, with four assets annualized at greater than $1 billion in sales. In clinical development, BMS has 11 late-stage programs across six distinct therapeutic areas, with multiple Phase 3 readouts anticipated in 2026, including trials for Alzheimer’s psychosis (the Adept program for Cobenfy).

​Notably, BMS has embraced cell therapy as a strategic pillar. The company acquired Orbital Therapeutics to expand its cell therapy capabilities beyond blood cancers into autoimmune diseases, recognizing that late-stage development timelines increasingly favor modalities with differentiated mechanisms and meaningful clinical advantages that can support premium pricing.

Merck: KEYTRUDA Lifecycle Management

​Merck faces a singular strategic challenge: KEYTRUDA, the company’s crown jewel, generates approximately $25 billion in annual revenue but faces increasing competition from PD-1/VEGF bispecifics and next-generation checkpoint inhibitors. Management explicitly acknowledged that KEYTRUDA’s patent cliff is being planned and confirmed active M&A to offset anticipated revenue losses.

The company is “seeking acquisitions to offset patent cliff” with oncology remaining the core focus. However, Merck has been notably absent from the most transformative recent M&A activity (notably the PD-1/VEGF bispecific rush), potentially indicating either selective discipline or diminished capacity for mega-acquisitions following recent capital deployment.

Bayer: A Narrow Escape from the Patent Cliff

Bayer is using indication expansions of existing drugs to soften the impact of major US patent expiries but acknowledges this tactic is not a long‑term solution. At the J.P. Morgan Healthcare Conference 2026, pharma head Stefan Oelrich highlighted how new US indications for NUBEQA (advanced prostate cancer) and KERENDIA (heart failure with LVEF ≥ 40%) are helping to offset revenue gaps created by the loss of exclusivity for XARELTO in 2025 and the upcoming Eylea patent expiry in 2027, with XARELTO alone costing an estimated €1–€1.5 billion in 2025 sales.

​To rebuild growth, Bayer is leaning on five key assets, including continued 2026 EU launches of BEYONTTRA (acoramidis) for ATTR‑CM, menopause therapy LYNKUET (elinzanetant), and the oral anticoagulant asundexian, which the company aims to get approved for secondary stroke prevention by end‑2026. Oelrich said these products, together with the NUBEQA and KERENDIA label expansions, should allow revenues to stabilise in 2026 and deliver mid‑single‑digit growth from 2027–2030 despite the patent cliff.

​However, Bayer concedes that “re‑entering” key assets into the US under new indications cannot be repeated indefinitely, since the same products cannot be relaunched twice. The company therefore, plans to increase deal‑making for early‑stage and preclinical assets, but this push depends on reducing debt and improving its credit rating to increase balance sheet flexibility for transactions.

Emerging Opportunities: Platform Plays and Niche Leadership

Gilead Sciences: Virology Diversification Beyond HIV

Gilead CEO Daniel O’Day positioned the company as operating from a “position of strength” in dealmaking, a confidence rooted in undisputed leadership in HIV treatment and prevention. The company’s twice-yearly injectable PrEP, YEZTUGO (lenacapavir), generated $150 million in preliminary 2025 sales and achieved 85% payer coverage in the US with $0 copay availability on certain policies.

The strategic pivot: diversifying beyond HIV into respiratory viruses, emerging viral threats, and pandemic preparedness. CEO O’Day’s seven-candidate HIV pipeline offers varied dosing schedules and administration routes (daily oral, weekly oral, long-acting injectables), creating an ecosystem locking in patients through optionality.

In oncology, Gilead is pursuing “direct tumor cell targeting” through its ADC platform and Kite Pharma’s cell therapy subsidiary. TRODELVY (sacituzumab govitecan) was highlighted for potential first-line metastatic breast cancer labeling, though the drug recently failed to improve progression-free survival in a Phase 3 trial, raising questions about commercial trajectory despite mechanistic rationale.

GSK: Respiratory and Oncology Rejuvenation

GlaxoSmithKline has positioned 15 launches, potentially generating more than $2 billion in peak-year sales in the years ahead. Most notably, an RNA-based hepatitis B medicine developed with Ionis Pharmaceuticals has shown efficacy in two late-stage trials, with full data expected at the EASL Congress in May 2026. The company emphasized 10 Phase 3 programs with 5 potential new products featuring established proof of concept, and a portfolio construction that acknowledges that late-stage clinical data provides investors with substantially greater visibility into commercial potential than early-stage science.

AstraZeneca: AI-Driven Oncology Acceleration

​AstraZeneca announced the acquisition of Modella, an AI platform company, to accelerate oncology R&D. The strategic rationale aligns with industry-wide recognition that AI-driven target identification and patient stratification can compress development cycles and improve Phase success rates. Additionally, AstraZeneca committed $570 million in Canadian investments to expand clinical trials, indicating geographic diversification of development infrastructure and potential tax/regulatory optimization.

Conclusion

The JPM 2026 conference confirmed that big pharma has substantially improved its preparedness for the patent cliff compared with historical precedent. Portfolio depth across oncology, immunology, metabolic disease, and virology offers meaningful defensive positioning. However, execution risk remains material, price deflation in obesity markets may exceed consensus expectations, and the industry’s overarching growth targets presume consistent Phase 3 success rates that historical data suggests may prove optimistic.

For healthcare investors and pharmaceutical industry participants, 2026 will serve as a critical inflection point: the year when portfolio rejuvenation strategies are tested against real-world clinical data and commercial execution. The companies that successfully navigate this inflection, balancing growth portfolio expansion with disciplined capital deployment, will establish dominant competitive positions for the next decade.