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Tune in as Glenn Hunzinger, US Health Industries Leader, and Roel van den Akker, US Pharmaceutical & Life Sciences Deals Leader, share their outlook on pharmaceutical and life sciences dealmaking in 2026. They discuss how precision-led growth, therapeutic focus, and available capital are sustaining M&A momentum, as well as trends in deal sizes, loss of exclusivity pressures, and the growing role of global innovation.
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We’ve summarized the full discussion in a short Q&A format so you can get the highlights in minutes.
Why 2026 is shaping up as an active year for PLS dealmaking
Q. Glenn Hunzinger
Why is 2026 expected to be a strong year for pharma and life sciences M&A?
A. Roel van den Akker
The outlook for 2026 is optimistic, driven by strong innovation, available capital, and continued focus on precision-led growth. Buyers are prioritizing targeted, asset-centric transactions that strengthen pipelines and deliver meaningful patient impact.
Where investment and deal focus is intensifying
Q. Glenn Hunzinger
What areas are attracting the most investment attention?
A. Roel van den Akker
Therapeutic areas such as oncology, CNS, and immunology continue to see strong innovation and capital allocation. As losses of exclusivity accelerate between 2026 and 2029, companies are increasingly leaning into external innovation to fill pipeline gaps.
How deal size and structure may evolve
Q. Glenn Hunzinger
Are deal sizes expected to change in 2026?
A. Roel van den Akker
While mid-sized deals in the $5–15B range have dominated recently, there is potential for larger transactions in the $15–35B range as revenue gaps widen and market conditions become more predictable.
The role of global innovation
Q. Glenn Hunzinger
How is cross-border innovation influencing dealmaking?
A. Roel van den Akker
Global innovation—particularly from China—is becoming increasingly important due to rapid scientific progress and regulatory speed. At the same time, the US remains a strong innovation hub supported by capital markets and leading research institutions.
The key watchout for 2026
Q. Glenn Hunzinger
What’s the most important trend to watch going forward?
A. Roel van den Akker
A more stable policy and interest rate environment could support sustained M&A momentum, with innovation continuing to be the primary driver shaping deal activity in 2026.
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Episode transcript
Find episode transcript below.
00:00:03:24 Hello everybody. Welcome back to PwC’s Next in Health. I am Glenn Hunzinger, PwC’s U.S. Health Industries Leader. Today, we are looking at what's ahead for Pharma and Life science deal making in 2026.
00:00:17:08 As we look across everything, innovation continues to be strong. Balance sheets and capital markets exist for financing. And there are clear signals that we're kind of set for an active year. Joining me today is Roel van den Akker, PwC’s U.S. PLS Deals Leader.
00:00:35:05 Roel and his team have just released our latest view on what's ahead in 2026 as it relates to PLS and M&A. Roel, thanks for being here.
ROEL VAN DEN AKKER:
00:00:47:16 Glenn, thanks for having me. Always excited to be on the podcast and talk about what's ahead.
GLENN HUNZINGER:
00:00:52:17 So Roel, on top of this being my favorite time of year from a holiday perspective, I love it because it really sets the trend and the expectation for what we're going to see in the year ahead. So, you put out your thought leadership. You've explained you think it's going to be a very active and buoyant year. Can you just talk a little bit about what you expect to see and sort of why?
ROEL VAN DEN AKKER:
00:01:12:13 Yeah. Glenn, thanks for having me again. Great to be here. And I agree with you on the time of the year. It's great to sort of look ahead. Listen, we're very optimistic for 2026. You know me by now. I'm an optimistic individual. But we're very optimistic about where activity levels are going to sort of go in 2026.
00:01:29:12 Well, why do I believe that? We're going to continue to see precision-led growth to continue in 2026. We think that therapeutic focus will intensify and continue to drive capital allocation. And as you kind of previewed in your introductory remarks, the pace of innovation and the premiums for innovation will continue to accelerate. So that's effectively what we've laid out as our vision for 2026.
00:01:53:08 Why do we believe that? Right. Because I think it's important to kind of peel that back a little bit. Listen, I think if you look at the market in 2025, both for biopharma and pharma services, it's been very focused on targeted and asset-centric transactions that really filled gaps in the pipelines.
00:02:10:09 Buyers continue to look at innovation in the standard of care and therapies that really make a difference in patient lives and are directing their M&A capacity both from a cash flow as well as from a balance-sheet perspective to those areas where innovation arises.
00:02:27:11 I think on the therapeutic area front, we continue to see and you referred to it as well, innovation in the therapeutic areas. That's truly fantastic, right? Whether it's in CNS where we've seen strides, whether it's in oncology, whether it's immunology, that's where the pace has really been high.
00:02:44:30 And I think if you then take really a step back and think about, we sort of quoted this in the report, 2026 through 2029 are really going to be the years where the losses of exclusivity of currently banded global pharmaceutical revenues are going to pick up, right.
00:03:02:01 So the headwinds are going to be more profound over the next couple of years than they have been over the last 2 to 3 years. And I think if you combine all of that, you're sort of effectively having a set up where we expect that corporates are going to increasingly lean into external innovation and look where they can source those companies and those compounds that really can deliver for the enterprise.
GLENN HUNZINGER:
00:03:24:14 Now, I think that's great. I think your comments on this precision-led growth, with this TA focus and it has been clear. I think we've seen a lot of value-creating M&A over the past couple of years. I think a lot of the corporate development, the heads of strategy, and certainly leaders, I think have been very disciplined about how they invest, where they invest.
00:03:44:03 There's no doubt, as you sort of highlighted in your report, premiums continue to be high. But I think like anything else in the world of if you're betting on good science, it's a binary outcome and that outcome hits. It's sort of okay on the premium side because you're going to have those kinds of returns. So, I think a great point to highlight there. As you think about and you've touched on it with TA focus,
00:04:05:22 how do you think about types of investments there, right? Because we always see the 5 to 10 to $15 billion biotech singular product or within a product family TA investment. How do you think about bigger deals? What's going to be different this year in your mind?
ROEL VAN DEN AKKER:
00:04:21:15 Yeah, it's a great question, Glenn. I think we've seen a preference in the market for that 5 to 15 billion EV range recently. And I think the reason for that was it was easier to string together transformation through smaller deals, more specialized, more focused, more precision. And it's also kind of coupled with sort of the regulatory regime that we've had for a long time that was kind of acting as a bit of a break on kind of larger scale M&A, right?
00:04:47:11 Like we've seen the industry over the arc of a long period. And episodes lean into larger scale M&A. We haven't really seen that. I think what's perhaps a bit more in store for ‘26 is that we could perhaps see companies leaning into more, I wouldn't call them mega deals,
00:05:04:01 but larger transactions than what we've seen over the last two years or so and perhaps kind of go up from the 5 to 15 to perhaps more into that 15 to 25 or 15 to 35 range. And why do I believe that? I do think per my prior remark that we're now really starting to see these LV gaps be more pronounced for certain acquirers,
00:05:24:00 and they require augmentation beyond internal innovation to complement the external innovation. Right. So, I really think that that's perhaps leading the market to somewhat larger transactions. The other factor there is, I think we're going to wade into an environment in ‘26 that I think is now a little more predictable from a policy perspective.
00:05:47:05 We've seen elections in ‘24, some changes in the regulatory domain and the pricing domain and the health agencies in ‘25 that certainly have acted as a bit of a brake on M&A because the uncertainty existed. And we now also are going to have a marginally more constructive stance in the interest rate environment with balance sheets in that capacity that's still very good across the sector.
00:06:10:12 So if you combine all that, put that in the blender, I do think there is certainly an opportunity that we could see a little bit more larger transactions going into ‘26, which I think is kind of what you're speculating around in your question as well.
GLENN HUNZINGER:
00:06:23:15 I think it's interesting too, because you're right, capital exists. People want to deploy it in the most efficient way. And I think certainly in 2025 and previous, we've seen that 5 to $15 billion deal. I think the interesting thing is probably on the supply side, because science has evolved, we're actually seeing companies with a lot more value or valuation.
00:06:44:18 And so, combine that with the need and hopefully it's a match to be made there. As you think about the world ahead, right. Like bunch of years back, we were flying all over the world, looking at assets everywhere. That became a little bit US-centric for a bit. How do you think about cross-border? You kind of mentioned, we may be back to a little bit of science is everywhere. Can you just talk a little bit about that?
ROEL VAN DEN AKKER:
00:07:06:04 Yeah, I think you're right. The pendulum always swings. And that's what makes this industry so fascinating. When we talk about global innovation, I think the talk of the town really is China. And I think, it's sort of phenomenal in terms of the progress in the strides that have been made there over the last couple of years. Right.
00:07:22:02 We're seeing cutting-edge science to speed through the regulatory pathways in cycles is significantly in excess of what we're able to do domestically. And I think we see a lot of US MNCs and global MNCs, for that matter, really leaning into effectively the innovation that's coming out of China.
00:07:40:05 And I do think that that's a trend that's here to stay. And will continue. Glenn, you've been in the industry for a long time, too. I think the debate is raging at the moment. What does it mean for innovation in the US and biotech and science in the US going forward? There are a lot of fantastic things happening in China.
00:07:56:06 I'd be cautious to bet against the US. I still think that the US capital markets, the universities that we have continue to be second to none. But I think corporates will continue and have sort of been leading into this increasingly look into the innovation that's popping up there. Right.
00:08:12:30 So, I think there's been conferences that have spoken about how fast clinical trials can get run, how fast a regulatory pathway is, how to set up base from a capital-markets perspective in Hong Kong and other places. That trend warrants continued monitoring and I think necessitates a deliberate strategy in the C-suite here in the United States.
00:08:34:02 But again, I continue to be bullish on what we're able to do here domestically as well. I think it creates better outcomes for patients. Global offshore innovation I think generally on the margin is a good thing. So, I continue to watch for that and where it will go in ‘26. But the direction of travel is very clear to go ahead. And I think, you kind of alluded to it in your question.
GLENN HUNZINGER:
00:08:53:00 Yeah. No, I mean, listen, I think the innovation coming out of China, it's clear. It's pretty consistent as far as the themes. I'm super encouraged that the FDA is looking at processes to figure out how we can continue to balance risk with speed and make sure we can be competitive. So, I think that's an interesting one. But certainly, no doubt for 2026, I think there's going to be a lot of activity outside the US.
00:09:15:23 So, thank you for sharing that. And Roel, as we close this out and we leave our listeners with a last thought, maybe the question is what's the watch out? What's the thing that maybe you sort of have in a back pocket that you’d say, wow, that would be interesting if that plays out, to leave people with an interesting note, if you will.
ROEL VAN DEN AKKER:
00:09:35:06 Yeah. I mean, I am an optimistic individual. I'm very optimistic for ‘26. I think we've talked a lot about the backdrop on the regulatory front, the elections, the interest rates for the last two years. In a way, it might be a predictable and kind of stable year for all those factors going into ‘26. And I think generally speaking, that is a good thing.
00:09:56:18 So, Glenn, I see M&A continue to evolve at the pace that it's been over Q3 and Q4 here exiting ‘25. And I'm just very excited to see where innovation will take us and M&A will follow from there. That would be my spin on kind of where I see ‘26 spin out.
GLENN HUNZINGER:
00:10:13:03 Roel, thanks so much for your insight here. I think it's great to kick everybody off with the optimistic view of what's going to look ahead in 2026. So, thank you for being here, happy holidays. Everybody else, thank you for tuning in to PwC’s Next in Health. For more on these topics and other insights across health industries, please subscribe to our podcast at PwC.com/US/Next in Health podcast. Until next time, this has been Next in Health.
FEMALE VOICEOVER:
00:10:48:21 This podcast is brought to you by PwC. All rights reserved. PwC refers to the US member firm or one of its subsidiaries or affiliates, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. This podcast is for general information purposes only and should not be used as a substitute for consultation with professional advisors.
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