What does 2026 hold for the biotech industry? 

Biotech enters 2026 with scientific momentum, new modalities continue to mature, data readouts are accumulating across oncology, metabolic disease, and neurology, and the industry’s toolkit is broader than it has ever been. Yet, the environment is still disciplined, capital remains selective, and large pharmaceutical companies are prioritizing assets that can be scaled, commercialized, and integrated into existing portfolios rather than open-ended experimentation. 

With a major patent cliff approaching and investors still cautious after several difficult years for biotech markets, companies are funneling resources toward de-risked assets and platform strategies that promise repeatability  

So, let’s take a look at what 2026 holds for biotech. 

The 2026 dynamics: deal flow, capital markets, geopolitics, and business models 

It seems the biopharma market is showing a slightly better mood in early 2026, but still with a familiar structural problem. The structural problem is the patent cliff, a large slice of big pharma revenue is approaching loss of exclusivity. A recent Stifel biotech outlook report says that over 40% of big pharma revenue is at risk from patent expirations in the next six years. 

That helps explain why dealmaking regained momentum in the second half of 2025 and why many forecasters expect it to carry into 2026, especially for late-stage or marketed assets, where the probability of near-term revenue replacement is highest. PwC’s 2026 deals outlook explicitly describes a strong second half of 2025 and frames 2026 as a year where acquirers have capital and confidence to deploy it, with a focus on “precision-driven” moves rather than spray-and-pray buying. ING’s 2026 outlook similarly expects M&A to accelerate by 15% in 2026, explicitly tying it to the looming patent cliff. 

The Stifel report also explains that cash is still competing with other priorities, including rainy day resilience and maintaining credit ratings. That discipline is showing up in the kind of deals being done, more targeted, often with clearer clinical or commercial line-of-sight. As an early-2026 scene-setter, GSK’s $2.2 billion deal in immunology and allergy is a good example of big pharma shopping for pipeline reinforcement, with a differentiated long-acting profile. 

The capital markets backdrop is also improving, but selectively. Reuters reported that U.S. biotech IPOs fell to the lowest level in over a decade in 2025 but are set to pick up in 2026, and that investors are now most interested in companies with mature pipelines and positive clinical data. In practice, that selectivity reinforces the late-stage bias Tim Opler from Stifel described in his Beyond Biotech podcast appearance: if public markets are picky and private rounds are still price-sensitive, strategic buyers have even more leverage, and assets with late-stage data become scarce and expensive. 

While we still have to temper our optimism, there have been concrete signs of IPO resurgence in January already. The best example would be radiopharma developer Aktis Oncology’s $318 million IPO on January 12. 

Finally, geopolitics and global competition are increasingly shaping business development. China is no longer just a manufacturing base or a generics developer; it is increasingly a source of licensable innovation, noted the Stifel report. 

Biotech trend 1 in 2026: Obesity & metabolic disease enter a platform era 

The obesity story heading into 2026 is no longer just about GLP-1 hype, it’s becoming a platform business with multiple modalities, multiple routes of administration, and a growing share of competitive advantage shifting from molecule novelty to scale, supply, and positioning. 

Stifel’s report pegs obesity as a potential $200 billion market, driven less by niche, high-priced drugs and more by widespread use at prices that health systems are willing to support at scale. 

That platform logic is also visible in deal flow as large pharma is paying for next-gen obesity approaches that could improve tolerability and long-term use, including amylin-based strategies designed to complement or compete with GLP-1s. 

Late 2025 saw Pfizer close a roughly $10 billion acquisition of Metsera, followed by the rapid initiation of phase 3 trials on acquired assets. Rival bids from Novo Nordisk for the same target highlighted how competition for metabolic assets is intensifying. Beyond mega-deals, collaborations such as Novo’s $2.2 billion licensing pact with Septerna and Roche’s $5.3 billion obesity deal with Zealand Pharma show big pharma is broadening its metabolic pipelines, not just chasing single winners. Meanwhile, growth financings such as Corxel’s $287 million series D just yesterday signal that investors remain committed to differentiated oral approaches. 

The race to more convenient administration is also advancing on the clinical front. In a phase 3 trial, orforglipron, a once-daily oral small-molecule GLP-1 receptor agonist, produced statistically and clinically significant weight loss over 72 weeks in adults with obesity, with gastrointestinal (GI) side effects shaping tolerability discussions. Oral options could expand adoption, improve convenience, and reshape supply dynamics compared with injectable peptides. 

Reuters reported that investor interest has rotated toward weight-loss drugs as a faster path to returns, while gene therapy has cooled amid manufacturing complexity and slower commercialization. Meanwhile, scaling capacity has become a competitive weapon in its own right. Reuters has highlighted Lilly’s multi-year manufacturing buildout to meet global demand and support expansion into additional markets. 

What to watch in 2026 

• More oral incretin readouts and positioning. 
• The next wave of differentiation: combinations including amylin and “quality weight loss” strategies aimed at issues like muscle preservation. 
• Ongoing supply chain and manufacturing moves that determine how quickly demand can convert into durable revenue. 

Biotech trend 2 in 2026: AI shifts from discovery buzz to development decisions 

By 2026, the most interesting artificial intelligence (AI) story in biopharma is no longer whether companies are using AI – almost everyone is – but where it is starting to matter inside drug development. The shift is from AI as a discovery accelerator to AI as part of the machinery that shapes clinical programs: how trials are designed, how patients are stratified, how endpoints are read, and how evidence is generated and defended. 

In 2025, the U.S. Food and Drug Administration (FDA) published draft guidance on the use of AI to support regulatory decision-making, explicitly framing AI not as a black box but as a tool that must be justified for a specific context of use, with validation proportional to risk. That framing steers sponsors away from broad AI-powered claims and toward auditable, governed applications. 

In December 2025, the FDA qualified AIM-NASH, its first AI-based drug development tool, designed to standardize liver biopsy assessments in MASH trials. The tool does not replace pathologists, but it reduces variability and subjectivity in a notoriously noisy endpoint. Similar use cases are emerging around imaging, pathology, safety signal detection, and data quality, where consistency and speed matter more than novelty. 

At the same time, the field is hitting a necessary reality check on timelines. Google-backed Isomorphic Labs, often cited as a flagship of AI-first drug discovery, now expects its first clinical trials to begin by the end of 2026, later than initially anticipated. The delay is not a failure of AI, but a reminder that translating models into clinic-ready assets still requires chemistry, toxicology, manufacturing, and regulatory work that does not compress like software cycles. 

Importantly, pharma interest has not evaporated alongside this recalibration. Isomorphic’s newly announced research collaboration with Johnson & Johnson in January 2026 shows that large drugmakers still want optionality on AI-native capabilities, but increasingly with sober expectations about where AI can accelerate decisions. 

What to watch in 2026 

• Evidence that AI improves development outcomes, not just discovery optics: shorter cycle times, fewer protocol amendments, cleaner endpoints, or better decisions. 
• Protocol design, patient stratification, site selection, imaging reads, and safety monitoring. 

Biotech trend 3 in 2026: CGT industrialization meets a business-model squeeze  

Cell and gene therapies (CGT) enter 2026 with a growing gap between what works clinically and what works operationally. The science is no longer the main bottleneck; manufacturing throughput, reliability, site readiness, and reimbursement mechanics increasingly are. 

Analyses from Boston Consulting Group point to CAR-T and gene therapies struggling after approval, not because of weak efficacy but because complex production, delivery logistics, and access hurdles slow uptake and inflate costs. The implication is not that personalization is going away, but that the most artisanal versions of it are becoming harder to justify outside narrow settings. 

Reuters also reported investor enthusiasm for gene therapy cooling as commercial realities set in, especially compared with categories where scale and repeat prescribing are easier to model. High upfront prices, complicated manufacturing, and uneven payer acceptance have made CGT a tougher sell in a more selective funding environment. That pressure is forcing companies to rethink how these therapies are built and delivered. 

This week, Novo Nordisk amended its diabetes cell therapy collaboration with Aspect Biosystems in a way that reflects its retreat from hands-on CGT execution. Rather than continuing to build and run a cell therapy unit itself, Novo transferred rights to its stem cell-derived islet and hypoimmune cell technologies and is letting Aspect lead development, manufacturing, and commercialization, while reserving rights to participate later via equity, milestones, and royalties. 

What to watch in 2026 

• Partnerships where large pharma deliberately offloads operational burden instead of trying to internalize every step. 
• Signs that industrial choices (standardization, throughput, release testing) begin to differentiate programs as much as biology.   

Biotech trend 4 in 2026: Neuroregenerative medicine hits an inflection point

If we had to pick one place where regenerative medicine stops being an abstract promise and starts looking like a product category, Parkinson’s is a strong candidate. The field has a clean biological target, lost dopaminergic neurons, and the Unified Parkinson’s Disease Rating Scale (UPDRS) as a common measure to evaluate efficacy. Stifel’s report indicated that several cell therapy programs are posting UPDRS improvements that look unusually large compared to what today’s dopamine drugs and deep brain stimulation typically achieve. 

The credibility jump in 2025 came from data that looks more like real translational medicine. One early-stage study of an allogeneic iPS-cell–derived dopaminergic progenitor approach reported that transplanted cells survived, produced dopamine, and did not form tumors, with supportive imaging signals.  

Another Nature study using human embryonic stem cell-derived dopaminergic neuron progenitors reported early clinical data showing graft survival and tolerability in patients, reinforcing that the signals emerging in Parkinson’s cell therapy are not limited to a single cell source or platform. 

In 2025, Bayer’s subsidiary BlueRock Therapeutics advanced its dopaminergic cell therapy bemdaneprocel into a phase 3 trial. At that stage, the focus shifts from whether transplanted cells can survive in the brain to issues such as durability of benefit, variability across surgical sites, reproducibility of the procedure, and the design of an appropriate control arm. 

Parkinson’s cell therapy also surfaces the practical fork in the road the whole regenerative field is facing: autologous against allogeneic, immunosuppression requirements, dose control, and whether manufacturing can be made routine. The next hurdle is replication at scale and whether cell therapy can move into routine clinical use. 

What to watch in 2026 

• Whether early efficacy signals hold up with longer follow-up. 
• The first signs of true industrial thinking: reproducible surgery workflows, consistent product release, and manufacturing scale plans that look realistic. 

2026, a rebound year for biotech? 

The industry is walking into a patent-expiry driven replacement cycle that keeps pushing large pharma toward selective dealmaking. The center of gravity is still moving toward assets with clearer late-stage line of sight, whether that means marketed products, near-registrational programs, or technologies that de-risk development and manufacturing as much as they improve biology.  

On the financing side, the tone is less frozen than it was, but it’s not a return to the 2020-2021 levels. 2026 has already shown some encouraging signs in the IPO department, although it’s still early in the year to be too optimistic.  

At the same time, the four trends explored here do not exhaust what is moving in biotech. Radiopharmaceuticals and theranostics continue to gather momentum, with deal activity and early-2026 IPOs such as Aktis Oncology’s. Antibody-based approaches, including next-generation ADCs and bispecifics, remain a well-funded lane. RNA-based therapeutics, beyond mRNA vaccines, are also progressing more quietly, particularly in rare and liver-targeted diseases where delivery hurdles are clearer. And in immunology and inflammation, several players are revisiting large indications with more selective mechanisms and longer-acting profiles, reflecting a broader push toward durability and differentiation.