The Next 25 Years of Pharma: Who Will Lead the Transformation?

The certainties that have defined the pharmaceutical industry for decades are changing. Long-standing assumptions around pricing, scale and supply chains are being reshaped by US pricing reforms, geopolitical fragmentation, rising Asian innovation hubs and escalating R&D costs. Yet this environment of uncertainty coincides with one of the greatest growth opportunities in the industry's history: the global pharmaceutical market is projected to grow from around USD 1.8 trillion in 2025 to USD 3.2 trillion by 2035, with global medicine use approaching 4 trillion daily treatment doses. Growth will be driven primarily by expanding access to healthcare and rising demand in oncology, immunology, diabetes and obesity.

Valtus Alliance's sector report of July 2026 distils this picture into a single, sharp question: which companies and which regions will capture this expansion? The findings, organised under eight themes, suggest that the answer lies not in strategy itself but in the ability to bring strategy to life. As E&E Group Interim, the Türkiye partner of Valtus Alliance, we have compiled the key highlights of this transformation, which we follow closely.

The Geography Is Shifting, Competition Is Being Redefined

The centre of gravity in pharma is moving. Europe remains a major force: in 2024, the research-based industry invested an estimated €55 billion in R&D across the continent and directly employed nearly 950,000 people. Yet North America accounts for 54.8% of global pharmaceutical sales, compared with just 22.7% for Europe. This gap reflects not only pricing differentials but also the fragmented nature of European market access pathways. Even more striking is the divergence in growth rates: between 2019 and 2024, the Brazilian market grew by 14.3% and India by 9.5%, while Europe's top five markets averaged 7.9%. This points to a structural migration of economic activity and research capacity towards faster-growing regions.

Over the same period, the performance gap between companies has also widened. According to Roland Berger's 2025 study covering 163 leading pharma and life sciences companies, top performers delivered 12% average annual revenue growth between 2021 and 2024, while the weakest declined by 3% annually. The difference stems from portfolio focus, R&D discipline and operational efficiency. In other words, what separates winners from laggards is not market conditions but the quality of management.

Within Europe, there is no single recipe for competitiveness either. Switzerland, Germany and Austria offer three distinct models demonstrating that competitive strength can be built through different combinations of scientific excellence, innovation ecosystems, advanced manufacturing and regulatory positioning. Switzerland, home to Novartis, Roche and a dense ecosystem of mid-sized innovators, represents perhaps the most concentrated expression of R&D-led value creation in the world. According to Simon Frei, CEO of FS Partners, whose views feature in the report, sustaining this position depends on five factors: maintaining innovation leadership, preserving access to global talent, accelerating speed to market, building supply chain resilience and safeguarding a stable, competitive business environment. As Frei emphasises, intellectual property protection and predictable regulation are strategic assets that compound over time.

Germany faces a related but distinct test. The country remains a global leader in pharmaceutical R&D, yet is experiencing growing tension between scientific excellence and commercial execution. According to Tobias Eitel, Partner at Valtus Germany, strengthening international competitiveness will depend on a balanced regulatory environment, predictable market access conditions and continued investment in innovation. Equally important is deeper collaboration between biotech companies, established pharma firms, academia and private capital to translate scientific breakthroughs into commercial success.

Austria's story, meanwhile, shows how strategic weight can extend far beyond geographic size. The country processes 20% of global blood plasma annually, and the Sandoz plant in Kundl the last penicillin production site in the Western world delivers 200 million drug packages per year. Vienna alone counts more than 750 life sciences organisations, 49,000 employees and €22.7 billion in annual sales. This density makes the country a natural platform for clinical, regulatory and commercial expansion towards Central and Eastern Europe. Alongside anchor names such as Takeda, Octapharma, Boehringer Ingelheim and Novartis, 191 active biotech companies generating €1.7 billion in turnover are competing globally in oncology, immunotherapy and specialty biologics.

From R&D Productivity to Acquisition Strategies: New Priorities

One of the industry's most fundamental dilemmas lies on the R&D front. R&D spending has risen to a record 17% of revenues, while average annual revenue growth between 2021 and 2024 reached only 3.9% below the long-standing 5% benchmark. The challenge is no longer to invest more in research, but to improve the productivity of that investment. As blockbuster patents expire, companies are shifting towards personalised therapies targeting smaller patient populations and more complex development pathways. In response, platform-based innovation built around technologies such as cell and gene therapy and RNA therapeutics is enabling companies to leverage a single scientific foundation across multiple disease areas.

The geography of innovation is expanding as well. India is taking its position as the world's largest supplier of generics and vaccines to the next level. As Sanjay Lakhotia, CEO of Noble House, notes, the world is waking up to the R&D capability of Indian talent, and Global Capability Centres are being established in the country to tap into it. New manufacturing units, compliant with global standards, are coming online as part of a strategy to de-risk global supply chains. India is also moving from simple generics to complex biologics, biosimilars and specialty drugs a transition that will contribute to the goal of providing cost-efficient healthcare worldwide.

China is undergoing a similar transition: from generic manufacturing to innovation-led growth. According to Thaddeus Mueller, Managing Partner at FES Partners, the defining bottleneck of this transition is the leadership gap between domestic capability and global ambition. Companies increasingly require leaders capable of navigating regulatory transitions from the domestic authority to FDA standards, redesigning commercial organisations around outcomes-based models and leading complex organisational change.

The pressure on R&D productivity is also transforming M&A strategies. According to EY, life sciences M&A reached USD 240 billion in 2025, up 81% year-on-year, driven primarily by larger transactions rather than a higher volume of deals. The momentum has continued into 2026, with dealmaking already reaching USD 106 billion by mid-year. Behind this activity lies a structural driver: more than USD 230 billion in biopharma revenues will face loss-of-exclusivity exposure by 2030, creating mounting pressure on leading companies to replenish their pipelines externally.

The strategic logic has shifted as well. Rather than pursuing scale, companies are prioritising precision in disease areas such as cardiometabolic disease, immunology, oncology and radiopharmaceuticals. Focused acquisitions in the USD 1–5 billion range are increasingly preferred, as they allow companies to add specific products, capabilities or technology platforms without the complexity of full-scale integration. The search for innovation is also expanding geographically: China now accounts for approximately one-third of global biotech pipeline assets and 34% of total global alliance investment in 2025. Japan, meanwhile, is following a different strategic route. As Hajime Baba, CEO of Clareza Partners, observes, Japanese pharmaceutical companies are pursuing global expansion through M&A and strategic alliances in major overseas markets, while simultaneously accelerating digital transformation to enable personalised medicine and more patient-centric healthcare. This dual-track approach reflects a broader repositioning that balances international expansion with internal capability building in data, digital infrastructure and patient-centric care models.

Developments on the pricing front, in turn, are redrawing the risk map. The Most-Favored-Nation prescription drug pricing executive order issued in May 2025 and the Medicare pricing provisions introduced under the Inflation Reduction Act are constraining companies' room for manoeuvre in what has historically been their most profitable market: the United States. The industry's response was swift: in 2025, approximately €350 billion in planned US manufacturing and R&D investments was announced, reflecting both tariff concerns and a broader push for supply-chain resilience. Europe faces a different picture: while the EU Pharmaceutical Legislation and the EU Biotech Act aim to strengthen competitiveness, 66.9% of sales from medicines launched between 2019 and 2023 occurred in the United States, compared with only 15.8% in Europe's five largest markets. Closing this gap will require not only regulatory reform but also stronger incentives for innovation and faster market access. More broadly, pharmaceutical supply security has become a strategic priority; shaped by the lessons of the pandemic, ageing populations and rising healthcare expenditure, governments now increasingly view medicines through the lens of economic resilience and national security.

Execution: The True Differentiator of the New Era

Perhaps the report's most critical finding is this: strategic foresight is no longer enough on its own. The ability to translate strategy into results across different regulatory environments, manufacturing networks and talent markets — in other words, execution — is becoming the primary source of competitive advantage. As Joe Poling, CEO of Think Consulting, emphasises, the US pharma industry is not facing a single challenge but the simultaneous convergence of pricing pressure, supply chain risk and declining R&D productivity. Companies that address these issues independently are expected to struggle compared with those that take an integrated approach. The companies that outperform over the next decade will be those that connect portfolio strategy, product development and commercial execution into a single operating model.

This dynamic is particularly visible in Europe, where reindustrialisation ambitions are being tested against operational realities. Across both the US and Europe, the increasing complexity of operating environments is making organisational flexibility and the ability to integrate internal capabilities with external expertise more valuable than ever. The experts featured in the report converge on precisely this point: companies that successfully combine internal capabilities with external expertise, while adapting rapidly to technological, regulatory and market shifts, will be best positioned to remain competitive in the future.

Interim management is taking on an increasingly strategic role in this equation. The items on pharma's transformation agenda translate directly into concrete needs for experienced leadership:

• Regulatory transitions: As the Chinese example shows, demand is rising for leaders who have navigated different regulatory regimes and can manage the transition from domestic authorities to FDA standards.

• Integration processes: The rise of focused acquisitions means every transaction requires swift, disciplined integration leadership.

• Commercial model transformation: Designing outcomes-based commercial organisations calls for both sector knowledge and change leadership experience.

• Supply chain restructuring: Diversifying manufacturing networks and investing in resilience gain pace under executives with operational transformation experience.

• Digital transformation: Investments in data and digital infrastructure that enable personalised medicine require leadership profiles combining technology with sector expertise.

What these needs share is that they concentrate within a defined transformation window rather than requiring a permanent addition to the leadership team. The integration of an acquisition, a regulatory transition or a supply chain restructuring are intense, critical periods with a clear beginning and end. Bringing in an interim executive with the right experience at precisely this window directly affects both the speed and the likelihood of success of the transformation. The recurring message across the report's expert perspectives from China to Japan, from Germany to the United States confirms it: the real bottleneck of the new era is not capital, but leadership.

The next 25 years of pharma will belong to companies capable of combining scientific precision with operational agility; able to move rapidly from discovery to commercialisation, manage their portfolios with discipline and adapt to regulatory and geopolitical shifts without losing strategic coherence. Across the industry's leading hubs, distinct strengths from advanced manufacturing and precision R&D to biotech innovation and digital transformation are redrawing the global map. The next wave of pharmaceutical leadership will be genuinely multipolar, and those that thrive will be the ones that understand this new map and build the organisational capabilities to lead within it.

As E&E Group Interim, in our capacity as the Valtus partner in Türkiye, we meet the interim management needs of organisations in Türkiye to global standards and with local expertise, bringing the right leadership to life at the right time. With the experience we have built since 1992, we stand by your side throughout your transformation journey.

Kaynak: Valtus Alliance, Sector Insights – Pharma, July 2026