By Sabrina Valle
NEW YORK, Jan 9 (Reuters) - Healthcare dealmakers are heading to San Francisco this weekend betting on a new wave of mega-mergers in 2026 that could eclipse the industry’s standout years
of 2019 and 2021 when such tie-ups approached half a trillion dollars, according to more than a dozen top bankers and lawyers.
Ahead of the week-long 43rd annual J.P. Morgan Healthcare Conference, dealmakers said more forgiving antitrust scrutiny under U.S. President Donald Trump has given large pharmaceutical companies confidence to consider acquisitions worth $30 billion or even merging with equally big companies.
Fresh industry agreements with the White House on tariffs and drug prices are also helping, they said.
"Across a number of different industries, we have seen deals get approved in the last year that could have had more regulatory risk in the past," said Jeremy Meilman, global co-head of healthcare investment banking at JPMorgan. "So that has made people dust off the playbook on the art of the possible."
That is a sharp contrast in sentiment to 2024 when there wasn't a single biopharma deal worth more than $5 billion, and marks a rise in activity from last year, when several transactions exceeded $10 billion, according to LSEG.
SETTING THE TONE FOR DEALMAKING
The run-up to the annual gathering, which pulls thousands of investors, bankers, lawyers and companies into San Francisco, often sets the tone for healthcare dealmaking for the year with deals getting announced at and around the meetings.
Eli Lilly announced plans Wednesday to buy Ventyx Biosciences for $1.2 billion.
Speculation that AbbVie was close to buying Revolution Medicines ahead of the conference and that Merck was also interested, lifted the cancer‑drug developer’s market value by 34% to about $20 billion — even though AbbVie denied the talks and the company remains six months away from clinical trial results that are key for its valuation.
CEOs are running models to test how their portfolios would look under transformational deals, anticipating a potential window to win regulatory approval through 2026, before the U.S. midterm elections could reshape Washington.
Several transformational deals are being considered and should be discussed in side meetings, and even some merger-of-equals scenarios are being explored—if only to conclude they are not the best move and let discussions drop, people said.
The administration's "interventionist tendencies may provide an incentive for speed in M&A," PwC said in its 2026 outlook, with the first companies to reach agreements having an edge to get deals approved.
“We are seeing the need for change-fueling deals,” said PwC’s U.S. deals leader Kevin Desai, who focuses on healthcare.
THE CONFERENCE
The conference gives companies, such as $55 billion Alnylam Pharmaceuticals and $37 billion Insmed Inc, quoted in analyst reports as potential targets, the chance to pitch their businesses to investors and potential partners.
Big pharma companies are likely to address how they will replenish revenue losses, as patents for blockbuster drugs from companies like Bristol Myers Squibb and Merck expire in coming years.
Investors will be looking to the new CEOs of GSK and Novo Nordisk for any indication of their M&A plans.
Novo CEO Mike Doustdar already faced one of the fiercest competitive battlegrounds — and a likely driver of 2026 activity — in the race for next-generation obesity drugs. Pfizer and Novo spent late 2025 locked in an aggressive bidding war with a series of escalating offers for biotech Metsera. Metsera ultimately accepted Pfizer’s revised proposal, valued at up to $10 billion.
Presentations by obesity and metabolic drug developers Madrigal, Kailera, Viking and Structure Therapeutics will be closely watched for clues on deals.
EASED UNCERTAINTIES
Uncertainties around tariffs and drug-pricing policies that froze dealmaking in the second quarter last year have eased, and now a JPMorgan survey shows 60% of respondents expect biotech M&A to pick up in 2026.
The antitrust regulator under the Joe Biden administration opposed mega mergers in pharma, arguing it correlated to price increases for consumers. Trump in August repealed Biden's executive order against dealmaking, saying that it would promote lower drug prices through other methods.
Oncology, rare diseases, neuroscience and cardiometabolic health, including drugs to treat obesity, are among the heated areas for M&A.
Healthcare deal volume rose 56% year-over-year to an estimated $403 billion in 2025, even as the number of transactions fell 8% to around 4,159, according to LSEG data.
(Reporting by Sabrina Valle in New York, Editing by Dawn Kopecki and Nick Zieminski)
