What’s in store for pharma in 2026?
Last week I went to a breakfast briefing hosted by multinational bank ING, where Stephen Farrell, Global Lead for Pharma & Healthcare, and Diederik Stadig, Healthcare and Technology Economist, talked about where the pharma industry might be heading in 2026.
Their view was simple: if 2025 was about disruption, 2026 will be when the real effects of Trump’s policies start to show.
As the US pushes for higher global reference prices through renewed most-favoured-nation proposals, Europe is likely to feel the knock-on effects. ING also expects more drug manufacturing to move to the US, encouraged by tariffs and incentives, while most generic production is expected to stay in Asia. R&D spending is likely to remain at around 20% of revenue. The focus, they said, will be on moving investment around rather than increasing it, although cutting back on basic research could weaken innovation over time.
One image from the presentation stuck with me: the “Fab Four” metaphor. Pharma in 2026, ING argues, will look like The Beatles’ White Album — messy, uneven, occasionally self-indulgent, but creative. Even with political chaos, trade friction and policy uncertainty, the sector is still expected to post solid sales growth, and do plenty of deal-making.
Europe faces tougher issues. ING highlighted long-standing structural problems, including fragmented health technology assessments, different national rules, limited funding, and lower prices. Together, these make Europe a less attractive place to launch new medicines or invest in innovation.
This view matches what I hear from people across the industry. Europe has strong science and some leading companies, but much of the financial return ends up in the US. Raising prices alone is unlikely to change that. Instead, clearer regulation, faster decisions and better access to capital are often mentioned as priorities. A key issue for 2026 will be how Europe handles pricing for new, innovative medicines. List prices are expected to rise, but how policymakers respond remains uncertain.
If higher prices are accepted, pressure will increase elsewhere in the system, especially given ageing populations and growing demand for healthcare. If governments cannot or choose not to pay more, fewer new treatments may reach patients in Europe. This would also affect pharma companies, which could see lower uptake of new medicines and greater reliance on markets such as the US. For now, the outcome is unclear.
In the UK, the debate continues. The government is facing criticism over a zero-tariff deal with the US that it has not fully explained. Critics argue that the long-term impact on NHS budgets is unclear, while campaign groups warn that higher drug prices could reduce funding for other services. Ministers say patient access will improve and that costs can be managed within existing budgets. Opposition parties are calling for more transparency and independent review.
2026 may help clarify whether Trump’s pharma policies deliver results, whether Europe can address its structural issues, and whether the UK can pursue trade deals without affecting patient care.
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