Business
Drug pricing, patent losses and deals: Here’s what pharma execs see ahead in the industry
President Donald Trump arrives for an announcement in the Roosevelt Room of the White House in Washington, Dec. 19, 2025.
Will Oliver | Bloomberg | Getty Images
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.
Drug pricing
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.
Sanofi CEO Paul Hudson speaks during an event held by President Donald Trump to make an announcement about lowering drug prices, at the Roosevelt Room of the White House in Washington, Dec. 19, 2025.
Evelyn Hockstein | Reuters
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 U.K. 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.”
Patent losses, dealmaking
Pharmaceutical companies were confident they will be able to 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.
Vaccine rhetoric
Health and Human Services Secretary Robert F. Kennedy Jr. announces new nutrition policies during a press conference at the Department of Health and Human Services in Washington, Jan. 8, 2026.
Jonathan Ernst | Reuters
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.
Business
Trump administration in advanced talks for a rescue package for Spirit Airlines, source says
A Spirit commercial airliner prepares to land at San Diego International Airport in San Diego, California, U.S., January 18, 2024.
Mike Blake | Reuters
The Trump administration is in advanced talks for a financing package for Spirit Airlines as the carrier is facing the risk of a liquidation, according to a person familiar with the matter.
Spirit had been facing a potentially imminent liquidation, people familiar with the matter told CNBC last week, speaking on the condition of anonymity to discuss matters that had not yet been made public. The Dania Beach, Florida-based carrier in August filed for its second Chapter 11 bankruptcy in less than a year, after it struggled to increase revenue to cover rising costs.
President Donald Trump hinted at potential government aid on Tuesday, telling CNBC’s “Squawk Box“, “Spirit’s in trouble, and I’d love somebody to buy Spirit. It’s 14,000 jobs, and maybe the federal government should help that one out.”
The White House didn’t immediately comment.
“We are hopeful that the government will recognize the needs for emergency funds especially in the current economic environment,” a spokesperson for the Associated of Flight Attendants-CWA, which represents Spirit’s cabin crews, said in a statement. “The last thing our economy needs is tens of thousands more people out of work and the last thing the travelling public needs is fewer choices in air travel.”
The terms of the financing deal weren’t immediately known. The Wall Street Journal earlier reported that the talks were in an advanced stage.
The U.S. airline industry accepted more than $50 billion in taxpayer aid to weather the Covid-19 pandemic, which is still its biggest-ever crisis, but those funds weren’t handed to one specific airline. Some of the aid gave the U.S. government stock warrants for airlines.
Airlines also received a government bailout following the Sept. 11, 2001, terrorist attacks, but that money was also for more than one company. The U.S. in 2008-2009 also bailed out the auto industry during the financial crisis and took stakes in manufacturers.
The Trump administration has taken equity stakes in some companies it deemed critical to national security like Intel and USA RareEarth, though Spirit stands out as it is in bankruptcy.
In February, Spirit said it expected to exit bankruptcy in late spring or early summer, telling a U.S. court that it would shrink and focus its planes on high-demand routes and travel periods. Pilot and flight attendant unions had also made concessions, including going on furlough in recent months, in a bid to help Spirit survive.
But jet fuel prices have nearly doubled in some parts of the U.S. since then, further adding to challenges for Spirit and the rest of the airline industry.
As a low-fare airline that also faces competition from larger carriers with their own no-frills, basic economy offerings, it has grown harder for Spirit to cover expenses. Spirit had introduced extra-legroom seats and other premium options to try to cater to higher-spending customers.
Business
Iran war: Trump sanctions waiver or not – why India continues to buy Russian oil – The Times of India
In early March, India was staring at a possible crude oil supply problem – the US-Iran war caused the Strait of Hormuz through which 20% of global crude transits to be effectively closed. To rescue came Russian crude oil! In fact, Russian crude has become a crucial support for India’s oil imports both in April and March. The import volumes are actually touching highs seen when India was bagging Russian crude at a huge discount.US President Donald Trump sanctioned two Russian oil majors towards the end of last year. This made it financially unviable for Indian refiners to continue to buy Russian crude at the same level as before, though flows of unsanctioned oil continued.However, in March, with the US sanctions waiver in effect, India has aggressively procured Russian crude, picking up millions of barrels. After the Russia-Ukraine war, Russian crude has maintained its position as the largest supplier of crude oil to India. Through Western sanctions, US President Donald Trump’s pressure and sanctions on Russian oil majors, crude from Russia has continued to flow to India, though the levels have varied.
However, experts believe that once the situation in the Middle East normalizes, India will go back to buying crude from Gulf countries, and Russia’s percentage in India’s oil imports will come down.
US sanctions waiver & India’s aggressive buying
India has never officially said that it will stop buying Russian crude, and even when levels dropped after sanctions, Russia was still the biggest contributor. However, the Donald Trump administration’s decision to waive sanctions on Russian crude, and extend that waiver to May has allowed Indian refiners to step up procurement without any worries.According to the latest report from Centre for Research on Energy and Clean Air (CREA)’s analysis, while India’s total crude imports recorded a 4% reduction in March, Russian imports doubled.
“The biggest shift was in state-owned refineries’ imports from Russia, which saw a massive 148% month-on-month increase. Their imports were in fact 72% higher than March 2025, presumably due to Russian barrels being more available in the spot market, which serves as the primary source of imports for them,” says CREA.Russia’s share of India’s crude oil imports in March 2026 placed the month at the upper end of historical highs, closely mirroring peak levels seen in 2023, when Western sanctions redirected Russian oil flows toward Asia and made Moscow India’s single largest supplier.Sourav Mitra, Partner – Oil and Gas, Grant Thornton Bharat explains the emergence of Russia as a dominant supplier of crude for India.Russia’s share surged sharply in the months following the Ukraine war, peaking during several months in mid‑2023, particularly around May–June, when imports rose to about 1.9-2.0 million barrels per day and accounted for nearly 42-45% of India’s crude basket, displacing Iraq and Saudi Arabia. That dominance persisted through much of 2023, with average shares close to 40% between April and September, before easing in 2024 and early 2025 as price discounts narrowed, compliance costs increased and refiners partially rebalanced toward Middle Eastern grades.“Against this backdrop, the rebound seen in March 2026 effectively matches the 2023 peak, although the underlying drivers differed, with the latest spike largely reflecting supply disruptions in West Asia that curtailed Gulf inflows and compelled refiners to rely more heavily on available Russian cargoes. We expect that while March marks a return to near‑record dependence on Russian crude, such elevated levels are unlikely to persist once Middle Eastern supply chains stabilize,” Mitra tells TOI.
No more discounts! India paying a premium for Russian crude
What stands out is the fact that when India stepped up its procurement of Russian crude after the Ukraine war began, the oil was available at very steep discounts. This was due to European sanctions that made Russian crude available at a much lower rate than Brent. Come 2026, with oil supplies via Hormuz disrupted and global crude oil prices rising, Russia is now selling at a premium!According to Sourav Mitra of Grant Thornton Bharat, Indian refiners are currently paying a premium of about $4-6 per barrel over the Brent benchmark for Russian crude. These are some of the highest delivered premiums on Russian crude since Russia began diverting large volumes of crude to Asia after the Ukraine war, he tells TOI. “This shift is attributed to intense competition for prompt Russian cargoes as disruptions to Middle Eastern supply routes pushed refiners to prioritise assured deliveries over price. The premium contrasts starkly with February 2026, when Indian buyers were still securing Russian crude at discounts of roughly $12–$15 per barrel, shortly before conditions deteriorated in the Strait of Hormuz,” he elaborates.In fact, the turnaround is even more pronounced compared with 2022-23, when Russian crude frequently traded $20-$30 below Brent. The price inversion was reinforced by the US sanctions waiver issued in early March 2026 and effectively released millions of barrels into the market, strengthening sellers’ leverage. “As a result, India has shifted from discount‑driven buying to security‑led procurement, paying a premium to ensure supply continuity while Gulf flows remain disrupted,” he adds.
Why India continues to buy Russian crude
Russian oil is not going out of India’s crude imports anytime soon, experts say.However, Ivan Mathews, Head of APAC Analysis at Vortexa expects Russian crude imports to decline month-on-month in April. “Discounts on Russian crude were less competitive due to increased demand during the sanctions waiver period, which has since been extended to 16 May. This will lead to lower marginal imports for economics-driven refineries in India. Additionally, reduced crude loadings from Russia will decrease the availability of Russian barrels for imports in the coming weeks,” Mathews tells TOI.
Mitra of Grant Thornton Bharat says that Russian crude is now well integrated into India’s refining system and serves as a reliable fallback when alternative supplies tighten. Russia is likely to remain an important supplier through 2026 even as its share moderates from March’s highs and Middle Eastern flows stabilize.Sumit Ritolia, Manager Modelling and Refining at Kpler believes that Russian oil will continue to be a major part of India’s crude oil imports in the coming months as well. Currently, India’s Russian crude imports are tracking at around 1.6mbd, which is approximately 375 kbd lower than March levels.However, as Ritolia points out, this dip needs context as Nayara (≈400 kbd, fully reliant on Russian crude) has been under maintenance since the second week of April. Adjusting for this, the underlying demand signal for Russian barrels remains intact.“The flows are expected to range between 1.5-2 mbd with a slight dip possible due to ongoing infrastructure issues in Russia due to the conflict with Ukraine,” Ritolia tells TOI.Interestingly, Kpler data shows that even after US sanctions on Russian majors Lukoil and Rosneft came into effect late last year, Russia continued to be the largest supplier of crude oil to India. However, admittedly the volumes saw a sharp drop, with February levels being much lower. While the Donald Trump administration claimed finalising a trade deal contingent on India stopping crude imports from Russia, New Delhi has never said it will not buy oil from Moscow.The US first waived the sanctions in early March and then extended the waiver recently. Experts are of the view that even when the sanctions waiver lapses, Russian oil will continue to be imported, though the quantities may dip.“A key point that is often missed is that Russian oil itself is not sanctioned but certain entities, vessels, and financial channels are,” says Sumit Ritolia.According to Ritolia, Russia continues to be a core supplier for India, but in the absence of sanctions waiver procurement must strictly ensure:• No involvement of sanctioned sellers or intermediaries• Use of non-sanctioned vessels• Fully compliant financial, insurance, and trading channelsIndia is unlikely to move away from Russian crude in the near term. Instead, we should expect more documentation, tighter screening rather than a structural shift in sourcing as and when sanctions lapse, Ritolia added.
India’s Diversified Crude Supplies
But even as Russia is expected to continue being an important player in India’s crude imports, it is equally important to note that New Delhi has diversified its basket to include over 40 countries.As Sushil Mishra, Director, Crisil Intelligence points out: Historically, Russia’s share in India’s crude imports peaked at over 40%, however, it has varied in the last few years amid diversification efforts and evolving geopolitical dynamics. Improved refinery flexibilities have enabled Indian refiners to process a wider range of crude grades including those from the American, Russian, and Middle Eastern.“India continues to strengthen its energy resilience by diversifying crude sourcing and maintaining a pragmatic sourcing strategy driven by price, availability, and energy security considerations. This approach allows flexibility to adjust sourcing patterns in response to changing global market conditions and geopolitical developments,” he tells TOI.
A United Airlines plane approaches the runway at Denver International Airport on March 23, 2026.
Al Drago | Getty Images
United Airlines slashed its 2026 earnings outlook Tuesday as it grapples with a surge in jet fuel prices due to the Iran war, but CEO Scott Kirby said demand remains strong.
United said it could earn between $7 and $11 a share on an adjusted basis this year, down from its previous forecast of between $12 and $14 a share that it released in January, more than a month before the U.S. and Israel attacked Iran.
Wall Street had already been adjusting its expectations for the year because of higher fuel. Analysts polled by LSEG had forecast that United’s adjusted, full-year earnings would be $9.58 a share.
The carrier, like others, is trimming some of its planned flying this year to reduce costs. Lower capacity can drive up airfare, with fewer seats on the market.
For the second quarter, United forecast adjusted earnings of between $1 and $2 a share. Analysts had expected $2.08 a share for the quarter. United estimated its fuel price would average $4.30 a gallon in the second quarter.
The carrier said it expects its revenue to cover between 40% to 50% of the fuel price increase in the second quarter, as much as 80% in the third and between 85% and 100% by the end of the year.
United reiterated that it is tweaking its schedules to adjust to higher fuel, with capacity in the second half of the year expected to be flat to up about 2% on the year. It grew 3.4% in the first quarter.
Here is what United Airlines reported for the quarter that ended March 31 compared with what Wall Street was expecting, based on estimates compiled by LSEG:
- Earnings per share: $1.19 adjusted vs. $1.07 expected
- Revenue: $14.61 billion vs. $14.37 billion expected
Revenue, profit climb
Revenue overall rose more than 10%, to $14.61 billion, up from the $13.21 billion from a year before.
For the first quarter, United’s net income rose 80% to $699 million, or $2.14 cents a share, compared with net income of $387 million, or $1.16 cents a share, a year earlier. Adjusted for one-time items, United posted earnings per share of $1.19 a share.
Unit revenue was up in every reported segment, including for domestic U.S. flights, where it rose 7.9% to $7.9 billion from a year earlier, signaling strong pricing power in the quarter.
Jet fuel in the U.S. was going for $3.51 a gallon on Monday, down from the high on April 2 of $4.78, but far above the $2.39 on Feb. 27, the day before the first attacks on Iran, according to prices assessed by Platts.
Airline executives have said demand has remained robust even while they have increased fares and checked bag fees as they pass along higher fuel prices to customers.
“Bookings are strong,” Kirby told CNBC’s “Squawk Box” on Wednesday.
United and the rest of the industry have become more reliant on travelers who are willing to shell out more for flights and bigger seats, and who are less affected by price increases.
Alaska Airlines pulled its 2026 forecast on Monday because of higher fuel prices. It has raised fares about $25, CEO Ben Minicucci told analysts Tuesday.
Merger ambitions?
Kirby is likely to face questions on the company’s 10:30 a.m. ET earnings call on Wednesday about his ambitions for a merger with another airline.
Kirby floated a potential merger with American Airlines to a Trump administration official earlier this year, according to a person familiar with the matter, but President Donald Trump said he was against the idea.
“I don’t like having them merge,” he told CNBC’s “Squawk Box” on Tuesday morning. He said he would like someone to buy struggling discount carrier Spirit but he also suggested that the federal government could “help that one out.”
American also rejected the idea of a merger with United last week.
When asked about floating the merger, Kirby declined to confirm the meeting to CNBC’s “Squawk Box” on Wednesday but said: “We want to create a truly global airline.”
Kirby reiterated his view that the U.S. is at a deficit in international air travel as customers fly on international competitors, some of which are state owned.
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