Six months ago, much of the industry set itself cautious targets for 2026, wary of the patent cliff and the pricing questions - the first half has turned out better than that. Now comes the part no forecast can manage for: the results themselves, starting this week.
Hold on to one question as they land: how much of January's caution was real, and how much was room left on the table?
Cautious For A Reason
By most measures, the first six months of 2026 treated drugmakers well. Deals have been booming, the DRG and XBI indexes have climbed, a few new launches are showing promise, and the two worries that hung over January, tariffs and drug pricing, have slid down the agenda. After a cautious start to the year, that counts as a good run.
The reason for the January caution has not gone away. A wave of patent expirations runs from now to the end of the decade, and it takes some of the industry's biggest earners with it: Eliquis, shared by Pfizer and Bristol Myers Squibb; Merck's Keytruda; and Bristol Myers's Opdivo. Add the pricing questions still circling, from most-favored-nation deals to the Inflation Reduction Act, and it made sense that several companies opened the year promising very little. Merck, Novartis, GSK and Amgen all gave forecasts of flat or low-single-digit growth. Modest guidance is the easy kind to beat, which is part of why a careful January can flatter a strong July.
Two went further and guided down outright. Pfizer, with its COVID products fading and Xeljanz losing ground to biosimilars, put 2026 somewhere between a 4.9% decline and flat. Bristol Myers, absorbing the loss of Revlimid, Pomalyst and Orencia, guided to a fall of 2.5% to 4.5%.
The Two Running A Different Race
Two names sat outside all of this. Eli Lilly opened the year forecasting 23% growth on its tirzepatide diabetes and obesity franchise, the outlier on the high side. Novo Nordisk sat at the other extreme, warning in its fourth-quarter report that revenue could drop by as much as 13%. Demand has since been kinder to both. Lilly delivered the year's biggest upgrade after the first quarter, raising its revenue target by $2 billion to a range of $82 billion to $85 billion on the strength of Mounjaro and Zepbound. Novo trimmed its expected decline, now no worse than 12%, helped by its GLP-1 line and a strong debut for the Wegovy pill.