9 Pharma Trends To Watch In 2026

By Katie Anderson, Chief Editor, Pharmaceutical Online

There was no shortage of momentum in the pharmaceutical industry in 2026—streamlined regulatory pathways, continued advances in GLP-1 agonists, deeper integration of AI and robotics, and a steady drumbeat of greenfield and brownfield expansion announcements. The pace of change has been relentless. So, what does 2026 ultimately hold for the industry?

To explore that question, Lawrence Blatt, CEO of Aligos Therapeutics, sat down with me to share his perspective on the trends shaping the year ahead. From lessons learned in first-generation failures to the rise of small-molecule long-acting injectables, the key themes from his 2026 outlook are highlighted below, with the full discussion available in the accompanying video.

1. Pharma Deals on the Rise

Lawrence Blatt (LB): I think you saw a lot of deals being made in the second half of the year, and I think you saw investors starting to get back into investing early this year. We'll see if that continues. I think big pharma is waking up to doing deals. I think it's inevitable because in our ecosystem, the innovations are still coming from small biotech companies, and big pharma knows that and they're very good at taking on assets that have been de-risked and marketing them or doing the last stages of development. But in terms of the risk taking, discovery, innovation, that's still happening in the small biotech companies.

I think we are going to see more pharma partnering. It's inevitable that they have to invest in new drugs when their pipeline is mature. There's competition, there's things that go off patent, so they're going to need to replenish their pipelines with late stage or even approved drugs.

2. Out-Licensing from China

You used to see US biotechs or pharma doing deals with Chinese pharma with our drugs getting licensed, but we saw licensing of Chinese drugs from Chinese biotech into multinational pharmaceutical companies, and that was a direct result of the kind of funding that was available.

Certainly in the area of obesity, you saw a lot of China, small molecule GLP-1 agonist being out-licensed, and that's a new trend. And as a US biotech entrepreneur, that's a concerning trend for me because the access to capital for the US biotech companies has not been on the scale that it had been with the Chinese government funding a lot of these companies. So, that's something that I think the biotech industry needs to take note of as well as the US government.

3. Manufacturing Move

I think there is a trend to more manufacturing out of China. Will it return to the US? That is hard to predict. I do see it going to other places like India and perhaps other Asian countries. I think all of us would love to see manufacturing of the US, but the cost prohibition of that is probably a gatekeeper to competitiveness and ability to get that done.

4. Regulatory Fast-tracking

I think another interesting thing that's happening is a move towards the FDA becoming more flexible. The voucher program was just added last year. It's an experimental program. It's like a two to three month review, and that will certainly speed things up. I do commend the FDA that in my experience, in spite of the downsizing and the government shutdowns that we've seen, they have been very responsive and even worked through the shutdown.

5. First Generation Fail Leading To Late Stage Success

There’s always trends in these different marketplaces when there is sort of new inroads into a field. There's a lot of exuberance on the investor behalf. Then, in sort of a natural evolution, a lot of first generation drugs don't end up becoming drugs. There becomes investor fatigue. And then as second and third generation drugs prove their merit, there becomes exuberance again.

My favorite example of this is the MASH market. I would say 15 years ago there was exuberance. There were a lot of drugs that were being studied, mechanisms that were hypothetical, and there was a whole slew of failures because the target was wrong. But then there were some breakthroughs. So then in spite of all that, there were breakthroughs around the beta thyroid agonism mechanism with resmetiron. It was like a flip of a switch. And then everybody wanted to look at MASH, and there was a lot of excitement for good reason. And you saw some nice deals done with FGF 21 in MASH towards the end of last year. That's a cytokine that blocks fibrosis. In fact, every FGF 21 company that I’m aware of was either partnered or acquired.

Just like in MASH, the initial targets [of HBV] failed. But there was data that were glimmers of hope. But now we are cycling in the last half of that investor fatigue of HBV, as drugs are now finally starting to show efficacy. I think we're in that awakening period. I don't think it's completely awakened, but people are starting to take notice in HBV.

6. Incorrect Targets

What we always have to struggle with in drug development, among many things, is target validation. In the case of viruses, you would think it's easier because in the case of cancer, you don't know if an activation of a gene is the cause of the cancer or the consequence of the cancer. And that's what happened early in MASH. People were going after targets, but they weren't disease modifying because they were the result of the disease.

7. Drug Cycle Maturation

Well, I think it's like you can apply this cyclic nature to investors and enthusiasm to any technology, drug, or drug category. By and large, any novel technology takes 20 to 30 years to perfect to where you're going to reliably be able to make drugs.

For example, the idea of using antisense oligonucleotides and even siRNAs, is more than 20 years old. It's only now coming to fruition because there were lots of technological hurdles to overcome. I think that's true of gene therapy approaches. I think the idea of gene therapy has been around for a very long time.

8. Always Evergreen: Small Mol

Small molecules have been around hundreds of years. Medications were extractions of natural products. Some of those were small molecules. Each indication will have its own idiosyncratic things that you have to tackle. I think the practicality of a small molecule is sort of unbeatable. Small molecules are largely room temperature storage. You take a pill, you swallow it, and if it's designed right, it works.

9. Small Mol Long-Acting Injectables

I will say there's another trend occurring, especially in virology that's quite interesting, and that's taking existing small molecules and making them into long-acting injectables. You've probably seen 1,000 commercials on TV for PrEP (fHIV), which is in some cases pills, but in other cases an injection. And what people have done is taken small molecules and actually used undesirable properties of those small molecules to turn them into long-acting injectables.

Quick Adaptation

If 2026 proves anything, it’s that pharma’s evolution is accelerating. Science, regulation, and technology are converging faster than ever, reshaping how therapies move from concept to clinic. As Blatt underscores, success will favor those who adapt quickly, learn from early missteps, and invest with conviction. The pace isn’t slowing — and neither is the opportunity.