This earnings season, Europe’s largest pharmaceutical companies have reported results ranging from 7% better to 3% worse – but no one really cares.

Instead, drugmakers are looking ahead, with 2026 shaping up to be a decisive year after a dramatic 2025, with the impact of last year’s developments set to crystallize.

“2025 is about understanding the rules of the game going forward… What remains to be seen (in 2026) is how these companies actually execute on what they agreed to, particularly in the deals you’re seeing with the Trump administration,” McKinsey senior partner Greg Graves told CNBC.

In addition to political dealings, companies also face so-called “Patent Cliff” Over the next few years, some of the world’s best-selling drugs will lose exclusivity in key markets, exposing them to competition from cheaper generics.

Although drug manufacturers always to some extent Promote their channelsthey’re showing them off more now as they try to reassure investors that their pipelines have enough promise to offset the impact of upcoming patent expirations.

“As the scale of patent losses continues to grow over the next few years, you may hear more focus on optimism about the future rather than near-term delivery,” Graves said.

Novartis For example, CEO Vas Narasimhan As told to CNBC’s “Squawk Box Europe” Last week, his company was set to lose $4 billion in sales and nearly as much profit in the first half of the year, marking “the largest exclusivity loss in Novartis’ history.”

At the same time, he emphasized that they are still able to grow due to “huge growth momentum” and “strong pipeline.”

AstraZeneca Seemingly equally confident in its product pipeline, the company claims it may launch 25 new blockbuster drugs by 2030 and hopes to hit $80 billion in revenue by then, up from $59 billion in 2025.

Many companies are also emphasizing the importance of their business development strategies as they increasingly look to mergers and acquisitions to help them find the next blockbuster drug.

“Strategic fit” and “complementary deals” have become common phrases among CEOs.

While some companies are targeting smaller acquisitions and early-stage assets, others are open to larger later-stage deals to bridge the gap, Camilla Oxhamre, portfolio manager at Rhenman & Partners, told CNBC.

While companies can fill revenue gaps by developing drugs in-house, a buying spree often yields faster results.

Sanofi’s Chief Executive Paul Hudson has endured a rocky run as his tenure as chief executive came to an abrupt end on Thursday, ending a six-year reign at the French company in which his emphasis on research and development failed to yield quick results. Sanofi has not yet responded to CNBC’s request for comment on Hudson’s departure.

Belén Garijo, current CEO Merckwill replace Hudson and be responsible for “strengthening the productivity, governance and innovation capabilities of R&D”, Sanofi said in a statement.

Sanofi has been keenly aware of the need to offset the impact of patent expirations on its blockbuster asthma drug Dupixent, which now accounts for more than a third of sales and is set to lose key patents in the early 2030s.

As mergers and acquisitions become an increasing focus for companies looking to supplement product lines, China has undoubtedly become the most interesting place to be. It has become an important source of innovation, with several companies recently announcing Transactions with Chinese companies Secure access to assets being developed in the world’s second largest economy.

Oxhamre noted that a decade ago, deals with Chinese companies were extremely rare, but now they happen all the time.

“It has a lot to do with the end market – which today is primarily the U.S. and to a lesser extent Europe,” she said. “Many people believe that the final markets in ten years’ time may be the United States and China.”

Over the past year, Graves said, the discussion has shifted from talking about China as a market to talking about a source of innovation.

“What you’re hearing, especially since the beginning of this year (and) the end of last year, is that China is really making a concerted effort to get innovation out of there and get a presence in the market.”

He said companies are starting to see it as a way to potentially de-risk their assets, using China as “a platform to quickly understand how a drug works, knowing that their clinical development or discovery development life cycle is much faster than what we have in Europe or the U.S.”

Despite alleged direct threats from President Donald Trump Most Favored Nation Drug Pricingor most-favored-nation status, is not as popular as last year but is still a big topic.

Now the market wants to know how the company will actually play this role.

Will the company delay product launches in Europe to avoid being tied to European prices in the larger U.S. market? Or will they adopt a single-price model, even if it means less access to certain markets?

“These are questions we don’t know how to answer, but I think I can tell you that every company I’ve worked with has put a lot of thought into (these choices),” Graves said.

“The real key is what is the right pricing strategy as we launch a lot of new medicines and we have to think about that,” AstraZeneca Chief Financial Officer Aradhana Sarin said. told CNBC last week.

Another big unknown, especially for fat players, is how price-sensitive customers will be in the direct-to-consumer market.

Rothschild & Co Redburn analyst Simon Baker told CNBC that no one fully knows what will happen to sales if drug prices are lowered. “This doesn’t usually happen in the pharmaceutical industry, (if) you lower the price of a lung cancer drug, you don’t increase sales, you just decrease sales.”

it has become more like a consumer market The market is more important than the drug market, Oxhamre said, adding that other drug companies’ direct-to-consumer exposure has so far remained very limited.

This may change to Novo Nordisk and Eli Lilly and CompanyThe two dominant players are likely to face increasing competition as other companies develop competing drugs.

AstraZeneca is moving its GLP-1 pill elecoglipron into late-stage trials while Roche aims to be The top three obese athletesthere are several treatments in development.

In the United States, Pfizer take part in competition Acquisition of Maitra last year, and Amgen Monthly injection MariTide is being developed in hopes of helping Entering the weight maintenance market.

As the field becomes increasingly crowded, companies are working to differentiate their drugs.

Weight maintenance is a big topic, and research shows most people eventually stop taking diet pills regain weight.

Convenience is another differentiator driving the industry to target drugs such as Novo’s new Wegovy pills, The opposite of injection. Oral options are said to be popular with consumers and could also help companies with distribution because they don’t require refrigeration. More long-acting molecules may also play a role.

GLP-1 is often associated with side effects, most commonly gastrointestinal, and improved tolerability is another key differentiator that companies consider when targeting amylin therapy against another intestinal hormone, as well as treating related conditions.