Outlook2025:

KeyTrends

&Insights

Explorethetrendsshaping

2025withexpertinsightsonR&D,deals,policy,andbeyond.

Foreword

Foreword

Aswelookaheadto2025,the

pharmaceuticalindustryispoisedfor

transformationonceagain.Theincreasing

integrationofAIacrossallfacetsofthe

industryissettorevolutionizedrug

discovery,development,and

commercialization,andthepharmaindustrymustbereadytomaximizetheopportunitiesitcanbring.Theindustrymustalsonavigatetheverytangiblelandscapeofgeopolitical

risk.Regionalinstabilityalongwithnew

regulationcoulddisruptsupplychainsandimpactglobaloperations,necessitating

robustriskmanagementstrategies.

Withglobalelectionsnowinthe2024

rearviewmirror,canthepharmaand

medtechmarketsturntowardstablegrowththathasstagnatedmarqueeM&Ain2024?Therapyareassuchascancerandobesity

aredrivingthisgrowth.Advancesinoncologyareparticularlynoteworthy,withinnovative

treatmentsofferingnewhopeforpatients

throughradiopharmaceuticals,

combinations,andneoadjuvanttherapies.

Thefocusonobesityisintensifying,and

pharmaisinvestingintheclinictofindnew

waysoftacklingthisage-oldproblem.Expecttoseemorestudyresultsandpatientoptionslaunchedin2025.

ThiseBookdivesintothekeytrendsand

challengesshapingtheyearahead,from

geopoliticaluncertaintiestocutting-edge

innovationinAI,oncology,andweight-loss

therapies.ItispartofInVivo’s

comprehensiveOutlook2025report,offeringcriticalinsightsintotheforcesthatwilldefinepharmaandmedtech’sroadahead.

ToaccessthefullOutlook

2025reportandaccess

thousandsofin-deptharticles,podcasts,infographics,and

more,startyour

1-weekfreetrialtoInVivo.

TELINE

Contents

Contents

Outlook2025:WillGeopoliticsDampenPharma’sComebackParty?

TheScrip100:ChangesAtTheTopOfTheLeaderboard

TheGood,TheBad,AndTheUncertain:Trump’sSecondAdministrationAndTheRxIndustryBiopharmaPlumpsPipelineWithHealthyWeightLossCandidates

HowToCreateOrganizationalReadinessforAI

Outlook2025:

WillGeopoliticsDampenPharma’sComebackParty?

Thefinancialmacroenvironmentmaybelooking

morefavorablefor2025,butwillpharmagrowthbe

mutedbyelementsbeyonditscontrol?In

Vivodiscussestheheadwindsanddriversfor

pharmainthecoming12months.

Outlook2025:

WillGeopoliticsDampen

Pharma’sComebackParty?

Thisyearhasposedsubstantialchallenges

forglobalmarkets:aprolongedperiodof

highinterestrates,ongoinggeopolitical

instability,democraticuncertainty,andan

unprecedentednumberofnationalelectionsa?ectednearlyhalfoftheworld’spopulation.Thepharmaceuticalindustryhasrespondedtothismacroenvironmentwithless

dealmaking,insteadcherry-picking

necessarypartnershipswhileitwaitstoseehowgeopoliticalupheavalshapesthe

environment.

Dealmakingandinvestmentin2025

While2024startedoutindynamicfashionfor

dealmaking,withNovoNordiskparentcompanyNovo

HoldingsannouncinginFebruaryitsintentiontobuy

Catalentfor$16.5bntosupplementitsGLP-1production,theyearsoonfizzledout.Largedealsin2023,withPfizerandAmgenwritingchecksfor$43bnand$23bn,

respectively,made2024lookcautiousbycomparison.

“Overall,themarkethaspickedupinthelast12months,”JamesWest,managingdirectorofhealthcareM&Aat

investmentbankLincolnInternational,toldInVivo.

“Investmentintobiotechandfundingraisedtodeployinbiotechmarketshasnotablyimproved.Therewillbealagbeforethisfundinggetsdeployed,andthenanother

delaytospendontheoutsourcedproviderswhoarepartneringwiththebiotechcompanies.”

“Comingoutofthe2024LondonHealthcareConference,therewasasharedoptimismthattheUScapitalmarketswillreturn,andwebelievetherewillbeasteadystreamofIPOandfollow-onfinancingactivityin2025,”Courtney

Thorne,partnerinthelawfirmCooley,toldInVivo.

WhilethefundingenvironmentforM&Ahasbeen,and

continuestobe,trendingupwardswithQ3seeingbothVCinvestmentandIPOsupcomparedtoQ2,significant

dealmakinghasnotmaterialized,withAbbVie’s$8.7bnCerevalbuyanoutlier.“Quiet”wasthewordusedby

manyattherecentEuropeanBIOconferencetodescribethepharmadealmakingenvironment.

Willthiscontinueas2025getsuptospeed?WestexpectsnextyeartobeamorefavorableenvironmenttoengageinM&A.“Majorcontributorsincludethekeypolitical

electionsthathavetakenplace,aslightsofteningin

interestratesandin??ation,andamorebuoyantpharmaindustryoverallwithimprovedinvestmentlevels.

Acquirersandinvestorsgenerallyfavorstabilityinmarkets,”hesaid.

Pluggingahole

FrancesStocksAllen,apartneratthelawfirmCooley,

expectstoseeapartneringmarketdominatedbya

smallernumberofmarqueedeals,“wherethe

fundamentalsoftherelevantprogramcreateastrong

atmosphereofoptionality,withmanagementabletoplayo?apartneringopportunitywithotherpartnering

opportunitiesaswellaspossiblyanM&Aorapublicmarketsopportunity.”

ThisviewisunderlinedbyJe?eriesannualHealthcareTemperatureCheck,itssurveyofbiopharmaceuticalinvestorsentimentforthecomingyear.Ofthe500

respondents—whichspaninstitutionalandprivateequityinvestorsaswellasexecutivesfromcorporates—72%

expectedM&Atobehigherin2025,dominatedbycorporate-leddealmaking.

Pharmacontinuestobehungryforcompellingproductcandidatesintherightareaandattherightstageof

developmenttofilltheirpipeline.LossofexclusivityforblockbusterproductscontinuestoplayapartinBig

Pharmathinking.Between2025and2029,$250bnworthofrevenueisatriskfrompatentlosses,sopharmaisinneedofmanyassets.

CompaniesthatwilltakethehitthehardestareBristol

MyersSquibb,Merck&Co.,andJohnson&Johnson,withRevlimid(lenalidomide),Eliquis(apixaban),Opdivo

(nivolumab),Keytruda(pembrolizumab),andStelara

(ustekinumab)alllosingpatentprotectioninthenextfouryears.

Thesecompanieswouldbenefitfromhistoric

underinvestmentintheobesitymarketbytheindustry,

fromVCsandprivateequitythathascreatedan

undervaluedcompanyset,andamaturingunderstandingofthetreatmentofthischronicdisease.

Cardiometabolicdrugdevelopmentwasamajorfocusforthebiopharmaindustryuntiltheearly2010s.However,

mostcompaniessignificantlyscaledbackR&Dinthis

areaduetodecliningpricingpowerandaslowdownin

innovation,shiftingfocustooncology,immunology,andrarediseasedrugs,wherepricingpowerremainedrobustandscientificadvancementswerethriving.

Anumberofupcomingcatalystsfromsmallerdevelopersinobesitywilladdtothedynamicmarketandmay

triggeracquisitionactivityin2025.Clinicaltrialswereexpectedtobegininlate2024or2025forAltimmune,StructureTherapeutics,Terns,VikingandZealand

Pharma.

Securingtheirplaceinthemarket,NovoNordiskandLillyareexpectedtobeatthefrontofM&Aactivity,withnewobesityplayersJohnson&JohnsonandMerck&Co.

mostlikelytofollowsuit.Privatecompaniessuchas

NodThera,Corteria,andDiasomehaveagreaterthan

50%probabilityofbeingacquired,accordingto

Pitchbookdata.WhilepotentialpublicacquisitiontargetsStructureTherapeutics,VikingTherapeutics,Zealand

Pharmaceuticals,AltimmuneInc.andFractylHealth

couldmakesensetoaBigPharmabuyerlookingtoplugholesintheirpatentcli?.

Traditionally,USelectionyearsarenoticeablyslowerfor

M&A,witharoundan8%-10%dropindealvalueand

volumerecordedsince1996,becauseofuncertainty

surroundingchangeinpolicyandthecompositionof

Congressaftertheelection.However,pharmadealmakersmayproduceapost-electiondealmakingbounce,

supportedbyPresident-electTrump’sdecisiveactiononkeyindustrynominations.

Trump2.0

Ofcourse,wecannotlookto2025withoutmentioningthesecondpresidentialtermforDonaldTrump.Potential

advantagesofaTrumpadministrationcouldincludetherepealoftheMedicarenegotiationprovisioninthe

In??ationReductionAct(IRA),reducedscrutinyfromtheFederalTradeCommissiononacquisitions,andthe

continuationoflowercorporatetaxes.

Conversely,Trump’spickofRobertF.KennedyJrasheadoftheUSDepartmentofHealthandHumanServices

(HHS)willbringunpredictablechallengesforthehealthcareindustry,shouldhebeconfirmed.Knownforhis

controversialviewsonvaccinesandpublichealth,Kennedy’sleadershipcouldintroduceconsiderableuncertaintyandpotentialchallengesforthesector.

NomattertheroleKennedyisgiven,hecouldbeawildcardfortheFDAanditsabilityto

operate.

Oneareaofconcernisvaccinepolicy.Kennedy’s

skepticismtowardsvaccinesmightleadtostricter

regulatoryscrutinyandpotentialdelaysintheapprovalofnewvaccines.Thiscouldimpactcompaniesheavily

investedinvaccinedevelopment,suchasModerna,Pfizer,andBioNTech.Additionally,hisin??uencecouldresultin

reducedfederalsupportforvaccinationprograms,

potentiallya?ectingpublichealthinitiativesandvaccineuptake.

Beyondvaccines,Kennedy’stenurecouldalsobring

changestodrugpricingandhealthcareregulations.Hisstanceonpharmaceuticalpricingmightleadtoincreasedpressureondrugmanufacturerstolowerprices,a?ectingprofitmarginsandinvestmentinR&D.Furthermore,his

environmentaladvocacycouldresultinstricter

regulationsonpharmaceuticalmanufacturingprocesses,potentiallyincreasingoperationalcostsforcompanies.

President-electTrumphasbeenquickerthanpast

presidentsinnominatinghispickforUSFoodandDrugAdministration(FDA)commissioner,namingJohns

HopkinssurgeonMartyMakaryasakeyplayerinhiselectionpromiseto“MakeAmericaHealthyAgain”.

Thisnominationcouldsetupaclashbetweentheagencyandindustryovercompoundingpolicies,particularly

relatedtoGLP-1s.Makaryisthechiefmedicalo?cerofSesame,atelemedicinecompanythathelpspatients

obtaincompoundedsemaglutide,acopycatofNovo

Nordisk’sWegovyandOzempic.HeisalsoamemberoftheboardofdirectorsofHarrow,whichownsImprimisRx,aproducerofcompoundedophthalmologydrugs

registeredasanFDAoutsourcingfacility.HarrowhasinrecentyearshasexpandedintotheFDA-approved

productspacebyacquiringthecommercialrightsto

brandedophthalmicdrugs.

WhilethefullimpactoftheKennedyandMakary

nominationsonthebiopharmaindustryremainstobe

seen,theirinvolvementwouldcertainlyintroducealayerofunpredictabilitythatcompanieswillneedtonavigatecarefullyinthecomingyears.

“Aquickandconclusiveelectionresult,andan

appointmentofanykindreducesuncertaintybut,giventhe[Trump]administration’semphasisondisruption,itishardnottoexpectmovementswhichwillbothcreate

opportunityandchange,”commentedStocksAllentoInVivo.“Aseverinaparadigmofuncertainty,those

companiesbestabletobenimbleandrespondquicklytoopportunityarethemostlikelytotakeadvantageof

thosedevelopments.”

Geopoliticsmakesitsmark

IntheJe?eriessurvey,40%ofits500respondents

identifiedgeopoliticalriskasthebiggestthreatin2025,upfrom26%thatidentifiedthisasthebiggestrisklastyear.Fundingandpricingcutscontinuetobeaconcerntotheseinvestorsandwereanarrowsecondchoicebyrespondentsasthegreatestrisktothesector.Private

In2025,thepharmaceuticalindustryfacessigni??cantgeopoliticalrisksthatcoulddisruptglobalsupplychainsandmarketstability.

equityisparticularlybearishonfundingandpricingcuts,with55%selectingitasthebiggestthreat.Only2%see

cybersecurityasthebiggestrisk.

“Geopoliticaltensionscontinuetotopthechartaswhatkeepslifescienceexecutivesupatnight,withvaluationsandanabilitytofundstillgivingexecutivesheartburn(asexpectedinourindustry).Itshouldbenotedthatwe

expectactivityonthecapitalmarketsandM&AsidetocontinuetotakeplacepredominatelyintheUS,”ThornetoldInVivo.

In2025,thepharmaceuticalindustryfacessignificant

geopoliticalrisksthatcoulddisruptglobalsupplychainsandmarketstability.Tensionsbetweenmajoreconomiesthreatentoimposenewtradebarriersandtari?s,

complicatingtheimportandexportofcriticalrawmaterialsandfinishedpharmaceuticalproducts.

Thesedisruptionscouldleadtoincreasedproduction

costsanddelaysindrugavailability,ultimatelyimpactingpatientaccesstoessentialmedications.Additionally,

politicalinstabilityinkeymanufacturingregionsmay

exacerbatethesechallenges,ascompaniesnavigateanunpredictableregulatoryenvironmentandpotential

sanctions.

Moreover,theindustry’srelianceonaglobalizedsupply

chainmakesitparticularlyvulnerabletogeopolitical

shifts.Forinstance,theincreasingtrendtowards

protectionismandnationalisticpoliciescouldforce

pharmaceuticalcompaniestorethinktheirmanufacturinganddistributionstrategies,withtheBIOSECUREAct

makingitsmarkonboththeRxando?-patentindustries.Mightthisleadmanufacturerstodiversifysupplychainsorrelocateproductionfacilitiestomorepoliticallystableregions,inspiteofthesignificantcostsandassociated

logisticalupheaval?

Growthdriversin2025:solidtumorsandmetabolicdisorders

Despitethegeopoliticaltumult,accordingtoEvaluate

data,nextyearwillsee$995.64bnworthofprescription

sales,withtheanticipated$72bnincreaseinsales

comparedto2024markingthelargestannualgrowthinRxandover-the-counter(OTC)salesinadecade,excluding

thespikedrivenbyvaccinesandantiviralsin2021.

Ofthe$72bnforecastinannualnetgrowth,morethan

$54bnisexpectedtobedrivenbythetop10therapeuticareas.Unsurprisingly,themostsignificantcontributors

aretreatmentsforsolidtumors,metabolicdisorders,anddiabetes,whichcollectivelyadds$34.5bningrowthfor

theyear.

ThecontinuingsuccessoftheGLP-1drugclassforboth

obesityandtypeIIdiabeteshasdevelopedintoa

$200bnmarket,accordingtoPitchbook,ofwhich68%willbesalesfromweightlossindicationby2031.WhileNovoNordiskandEliLillyaretheobviouswinnersinthis

particularrace,nextwavecardiometabolicpipelinesarefillingup.

Pitchbookforecaststhat16newobesitydrugscouldlaunchby2029,withroughly$70bnoftheGLP-1marketcoming

fromthesenewchallengersby2031.Late-stageclinical

trialsarecertainlyaddingheattoanalreadysteamyareaofcompetitionasothercompaniestrytoerodesomeofNovoNordiskandLilly’sholdonthemarket.

CommentingoninvestingintheGLP-1therapyarea,

TommyErdei,Je?eries’jointglobalheadandEuropean

headofhealthcareinvestmentbanking,said:“In2023,atourconference,[GLP-1s]wasthetalkoftheconference.Alotofthefocusisnowontheoralsideandtheprogressofsomeoftheoralversionsofthoseproductscomingtothemarket.Willthatincreasethepie?Willittakeawayfromsomeoftheexistingplayers?”

NovoNordisk’sRybelsus(semaglutide)receivedUSFDAapprovalin2019fortypeIIdiabetes,followedby

approvalsinEuropeandJapanin2020,establishingthefirstpresenceoforalGLP-1agonistsinthemarket.WhilethegrowthofRybelsushasbeen“steadyratherthan

explosive,”accordingtoDatamonitorHealthcareanalystTimBlackstock,ithasalreadyachievedblockbuster

status,highlightingthemarketpotentialfororalalternatives.Withseveralothercandidatesin

developmenttomeettheincreasingdemand,Novo

Nordiskisaimingtoreducetheimpactoffuture

competitionbyintroducingahigherdoseofRybelsus.

Currentlythemostadvancedoralcandidate,Lilly’s

orforglipron,asmallmoleculeGLP-1agonist,isbeing

evaluatedinthePhaseIIIATTAINprogramfortypeII

diabetes,andinPhaseIIIACHIEVEtrialsforobesity.

Top-linedatafromthefirstdiabetestrialsareexpectedinthesecondhalfof2025andpotentialmarketentryis

anticipatedasearlyas2026.StructureTherapeutics’

GSBR-1290isanothersmallmoleculeGLP-1agonistin

developmentwithPhaseIIinvestigationsongoing.Pfizer

andRochearealsodevelopingoralGLP-1candidates,buttheseassetsareinearlierphasesofdevelopment.

NovoNordisk’soralsemaglutideisbeingevaluatedforobesityinthePhaseIIIOASISprogramwiththefirst

datasuggestingithasweightlosse?cacynearthatofWegovywithasafetyprofileconsistentwiththeclass.

ThecompanyfiledmarketingauthorizationapplicationswithEUregulatorsin2023andcouldseeapprovalin

2025.However,NovoNordiskhasreportedthatlaunchplansare“contingentonportfolioprioritizationsand

manufacturingcapacity.”

Blackstockaddedthat,“itisworthnotingthatthelatestinjectableGLP-1agonistsaredosedweekly,andthe

latestdevicesarelargelysimpletousewithlittlepain.

ManypatientswithtypeIIdiabeteshavemultiple

comorbiditiesandahighpillburdenandmayprefernottohaveanothertablettotake.Nonetheless,therisk-

benefitprofileoftheclassandmoreandmoreresearchshowingnewbenefitssuggestsneworalGLP-1agonistswillsustaingrowthinthemarket.”

Oncologyleadslaunchesin2025

Ofthenewlaunchesanticipatedin2025,oncologyisthemostrepresented,with14di?erenttumortypeslikelytoseeimportantnewtreatmentoptionsduring2025.

Severalinnovativetherapiesarepoisedtoenterthe

market,notablythefirst-in-classbispecificantibody

targetingPD-1andVEGF,ivonescimab.Summit

Therapeutics'ivonescimabisanticipatedtoinitiallytarget

non-smallcelllungcancer(NSCLC)andlaterexpandintobreastcancer.Afirst-in-classbispecificantibodytargetthattargetsPD-1andVEGF,itiswidelythoughttobe

Keytruda’sblockbustersuccessor.

Thislaunchwillcoincidewithothersignificant

introductionsforcancer,includingAstraZenecaand

DaiichiSankyo’santibody-drugconjugate(ADC)Dato-DXd(datopotamabderuxtecan)andGenentech’sItovebi(inavolisib),aswellasalabelexpansionforthe

establishedstandardofcare,Enhertu(trastuzumabderuxtecan).

Itisnotjustlargepatientpopulationsthatwillbenefitfromdruglaunchesin2025.Thebeginningof2025willbringnewhopetothosesu?eringfromrarediseases.

StealthBiotherapeutics’elamipretide,thefirstmarketedtherapyforBarthsyndrome,isunderreviewwitha

JanuaryFDAactiondate,makingitoneofthefirstdrugs

Itisnotjustlargepatientpopulationsthatwillbene??tfromdruglaunchesin2025.Thebeginningof2025willbringnewhopetothosesu?eringfromrarediseases.

tolookoutfornextyear.NeurocrineBioscienceswas

hopingforgoodnewsfromtheFDAinlateDecemberforitsCRF1Rantagonistcrinecerfontwhich,ifapproved,

wouldbecomethefirstnewtreatmentin70yearsforclassiccongenitaladrenalhyperplasia.

PTCTherapeutics'Upstaza(eladocageneexuparvovec),aimedatcorrectingthemutationresponsibleforAADCdeficiency,issettolaunchintheUSin2025,followingitsEuropeandebutin2022.

TELINE

TheScrip100:ChangesattheTopofthe

Leaderboard

PfizercontinueditsreignastheScrip100leaderforathirdyear,whileLillyandNovoclimbedhigher.

TheScrip100:

ChangesattheTopofthe

Leaderboard

PfizerandAbbVieheldontotheirnumberoneandtworankingsontheScrip100inOutlook2025evenasbothcompaniesfacedsteep

declinesin2023pharmaceuticalrevenues.Butsomedrugmanufacturersinthetop20rankingsmovedeitherupordownonthe

leaderboard,whichcanbeseenatthebottomofthisarticle.

PfizerandAbbVieconfronteddi?erentheadwindsin

2023.ForPfizer,asharpdeclineinpharmaceutical

revenuesto$58.5bnwascausedbylowersalesof

COVID-19productsafterapandemicboom,whileAbbVieexperiencedthelossofHumira(adalimumab)to

biosimilarcompetitionintheUSforthefirsttime.The

resultforbothwasaslideinrevenues,thoughtheywereabletomaintainpositionsatthetopoftheleaderboard.

PharmaceuticalrevenuesintheScrip100arebasedon

datafromEvaluatePharmaandexcludelicensing

revenuesandroyaltystreams.Asaresult,thedataare

reporteddi?erentlythaninprioryears,whichcouldresultininconsistenciesacrosshistoricalcomparisonsinthe

Scrip100.

AbbViebarelyheldontoitsnumbertworankingwith

$53.84bninpharmaceuticalrevenueswithMerck&Co.

andJohnson&Johnsonbothclosebehindwith$53.58bnand$53.27bnin2023pharmarevenues,respectively.

TheimpactofHumirabiosimilars

AbbVie’stotalrevenuesfell6.4%in2023to$54.32bnduetolowersalesofHumira,mainlydrivenbylowerprices.

FollowingthelaunchofAmgen’sAmjevitainJanuary

2023,thefirstHumirabiosimilartoreachthemarket,

AbbViewasabletomaintainmostoftheHumirabrand’sUSprescriptionvolumesharethroughout2023,evenasmorebiosimilarslaunched,usinghigherrebatesandbytyingrebatestootherpopularproducts.

Morerecently,inthesecondhalfof2024,Humira’s

erosionhaspickedup.Inthethirdquarter,Humirasalesdeclined37%to$2.23bnandAbbVie’srisingimmunologygrowthdriver,Skyrizi(risankizumab),usurpedHumiraasthecompany’stopsellingdrug,generating$3.21bnon

51%year-over-yeargrowth.ThestrengthofSkyriziandtheoralJAKinhibitorRinvoq(upadacitinib)arehelpingAbbVietobridgetheHumirasalesgap.

Merck&Co.movedupintheScrip100rankingstotake

thenumberthreespot,tradingplaceswithJohnson&

Johnsonwhichrankednumberfour,withbothcompaniesgeneratingsolidrevenuegrowthin2023.

Novartisgetssmaller

NovartisAGfelloutofthetopfiveontheScrip100

altogether,continuingasteadydeclineintheScrip100rankingssinceOutlook2022whenthecompanyheldthe

numberonespotwith$48.65in2020pharmaceuticalrevenue.

Thecompany’sSwissrival,Roche,moveduponespotintheScrip100rankingstotakeNovartis’snumberfive

spot,evenasitsowngrowthplateauedastheSwissfrancappreciated.

NovartishasplacedinthetopfiveintheScrip100foratleast10years,frequentlyrankingfirstorsecond,butthecompanyfelltonumbersixintherankingsinOutlook

2025.Novartisgeneratedpharmaceuticalrevenuesof

$45.44bnin2023,6.5%lowerrevenuethanwhatit

reportedexiting2020,threeyearsprior,thoughthe

declineismainlyduetothespinoutofitsgenericsdrugunitSandozlateintheyear.

Novartishasbeensteadilyshrinking.Thecompany

rankedfourthinOutlook2023andfifthinOutlook2024,with$48.27bnin2022pharmarevenues.Butin2023,

Novartismadethestrategicdecisiontospinoutits

genericdrugunit,Sandoz,intoastandalonecompany,strengtheningitspositionasapureplaypharmaceuticalcompany.

Sandozgenerated$9.2bnforNovartisin2022,sothe

completionofthespinoutinOctober2023resized

Novartis,though2023financialresultsstillincludedninemonthsofSandozrevenues.AmorenoticeableimpactwillbeseenintheScrip100nextyear.

InapositivedevelopmentforNovartis,thecompany’solderblockbustersandnewergrowthdrivershavebeenturninginsteadygrowththisyear.Forexample,inthe

thirdquarter,Novartis’sworkhorsebrands,Entresto

(sacubitril/valsartan)andCosentyx(secukinumab)grewby26%and28%,respectively,whileKisqali(ribociclib)

grew43%,Kesimpta(ofatumumab)grew28%,Pluvicto(lutetiumvipivotidetetraxetan)grew50%andLeqvio(inclisiran)grew119%.

ThestrongquarterledNovartistoraiseits2024revenueguidancefromhighsingledigitgrowthtolowdouble-

digitrevenuegrowth.

Sandoz,meanwhile,madeitsdebutontheScrip100as

anindependentcompany,rankingatnumber25,with

2023pharmaceuticalrevenuesof$9.65bn(ifthe

companywereoperatingthefullyear).Sandozentered

wellbehindtwoofitsgenericdrugrivals,Teva

PharmaceuticalsandViatris,whichrankednumber17and18,respectively,ontheScrip100.

TherollercoasterrideatP??zer

LikeNovartis,Pfizeralsosplito?itsestablishedproductsbusinessyearsagowiththegoalofbecomingaleaner

pureplaypharmaceuticalcompany.In2020,whenPfizerspuno?establishedproductstomergewithMylaninthecompanythatisnowknownasViatris,PfizerrelinquisheditsnumberonespotontheScrip100andrankednumberseveninOutlook2022.ButPfizer’sdropintheScrip100rankingsdidn’tlastlong.Oneyearlaterthecompanywassolidlybackontop,fueledbytheCOVID-19pandemic

andPfizer’ssuccessfullaunchofthevaccineComirnaty.

COVID-19productsaleshavehelpedPfizerretainthetopspotforthreeyears,thoughthetailwindhasrapidly

turnedintoaheadwindasCOVID-19vaccinationshave

taperedo?.Lastyear,PfizeracquiredtheantibodydrugconjugatedeveloperSeagenfor$43bntohelpdrive

portfolioandpipelinegrowth.Seagenranked72ndontheScrip100lastyearPfizer’sacquisitionclosedlatein2023sodidn’thaveasubstantialimpacton2023

pharmaceuticalsales,whichwere$58.5bn,agigantic

dropfromitspandemicpeakof$100.33bnin2022.

InvestorsaretryingtoabsorbPfizer’sriseandfalland

areworriedaboutbigLoEs—thatareexpectedto

amountto$17bninlostrevenues—cominginthesecond

halfofthedecadethatcouldchallengePfizer’sgrowthambitions.

ActivistinvestorStarboardValuerecentlyboughta$1bnstakeinthecompany,claimingPfizerhasoverpaidfor

assetsandfailedtodeliveronR&Dandwithastated

goaltoturnthecompany’smarketvaluearound,thoughhowitenvisionsdoingsohasnotbeenrevealed.

LillyandNovoontherise

EliLilly&CompanyandNovoNordiskaretwocompaniesadvancingquicklyuptheleaderboardonthestrengthoftheircompetingmetabolicfranchises.Withinvestor

expectationsforLilly’sGIP/GLP-1agonisttirzepatitdeandNovo’sGLP-1agonistsemaglutidesoaring,thetwocompaniescouldquicklyrisetothetopofthe

pharmaceuticalranks.

Inthemostrecentrankings,Lillymoveduponespotto

number11,as2023pharmaceuticalrevenuesgrew20%to$34.12bn,drivenbythesuccessfullaunchofMounjaro,theversionoftirzpetideapprovedbytheUSFoodandDrug

AdministrationinMay2023fortype2diabetes.The

additionalapprovaloftirzepatideforobesitylateintheyearasZepboundisfurtheracceleratingLilly’sgrowth

thisyear.

Thetwodrugstogethergenerated$4.37bninthethird

quarterof2024.Onthestre