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A Brave New World: Six Key Healthcare Industry Trends to Monitor in 2025 for Emerging Biopharma
Jul 09, 2025
For stakeholders throughout the healthcare industry, the current environment likely feels more dynamic, more volatile and, in many ways, more challenging than ever. Emerging biopharma companies (EBPs) are no exception. By nature, EBPs lack the heft to influence external forces of complexity and change. Much like the weather, while these dynamics cannot be controlled, it’s critical to stay informed of the environmental forecast.
With that in mind, think of this blog as a big-picture “weather report” for industry trends in 2025. It highlights some of the most critical policy, regulatory, and market shifts, and sets the stage for an upcoming IQVIA insight brief on how EBPs can adapt and thrive.
First: a $500 billion question
To understand why policy conversations are so relevant right now, consider these statistics from the IQVIA Institute’s most recent Understanding the Use of Medicines report: Pharmaceutical product sales at list price exceeded $1 trillion in the U.S. in 2024. The actual net sales to manufacturers? Less than half at $487 billion.
In other words, more than $500 billion disappeared in gross to net spread economics. At IQVIA, we have termed this the spread economy, and it is gigantic. If that $500 billion were a country’s gross domestic product, it would rank as the 30th-largest economy in the world, alongside Austria and Thailand. It’s a complex flow of dollars that moves through rebates to pharmacy benefit managers (PBMs) and employers (estimated at $315 billion), hospital 340B discounts (estimated at $80 billion), group purchasing organization fees to pharmacies (estimated at $50 billion), and various other industry-paid offsets throughout the healthcare system.
Key trend 1: Rapid-fire policy and regulatory change
In its first 120 days, the Trump administration issued more than 120 executive orders—an unprecedented pace that’s reshaping healthcare policy in real time. Many of the Trump administration’s healthcare policies target that $500 billion flow, whether through list-price reduction, PBM reform for transparency, or populist policies aimed at reducing U.S. costs while raising prices elsewhere.
Key trend 2: Benefit redesign changing the rules of the game
Another dramatic shift is underway due to Medicare Part D benefit redesign—changes that are fundamentally altering who pays for what.
As an example, consider a specialty product costing $22,000 per month (that is, a $264,000-a-year prescription for a perfectly adherent patient). Just two years ago, patients faced 5% coinsurance in the catastrophic phase. But by 2024, that dropped to zero, and by 2025, patients will be facing an out-of-pocket (OOP) maximum of just $2,000. As patient financial exposure virtually disappeared, payer responsibility tripled from $55,000 in 2024 to $160,000 in 2025.
The ripple effects are profound, as patient behavior changes due to lower out-of-pocket costs, payer behavior changes as utilization rises at the same time as their liabilities, and markets shift as economic tradeoffs become more complex across the spread economy.
Key trend 3: Lower OOP caps driving surge in utilization
To continue the weather metaphor, sometimes a gentle breeze becomes a tailwind. When the 5% catastrophic coinsurance was eliminated in January 2024, oncology prescription volume under Medicare Part D exploded by 53% virtually overnight.
What caused such a dramatic stair step in utilization? It was not that there was an influx in cancer diagnoses. Rather, many patients had been “warehoused” in patient assistance programs, charity care, and foundational assistance—sitting outside the insured market despite being on therapy. Many in the industry were blind to the impact of how important this change in out-of-pocket exposure impacted the industry.
Once OOP costs dropped to zero, patients flooded back into the visible market. This trend continues in 2025 with the $2,000 out-of-pocket cap affecting all products, not just oncology.
EBP organizations now need to be aware of what is happening across all drugs a patient utilizes, not just the one they market. Thinking BIGGER about Above Brand dynamics requires access to data that many simply do not possess.
Key trend 4: The “pill penalty” wild card
This potential policy change could be a game-changer for small-molecule development.
Currently, small molecules become eligible for Medicare Maximum Fair Price negotiations nine years after launch. By contrast, biologics enjoy 13 years before negotiations. That’s a significant advantage, as industry analysis shows that approximately half of a product’s lifetime value comes during years 9 through 13.
A proposal to close or reduce the “pill penalty” gap could double the lifetime value of small-molecule assets and fundamentally shift R&D investment incentives. For EBPs focused on small-molecule development, this represents a massive potential valuation change that could reshape entire business models.
Key trend 5: ‘Boom-or-bust’ launch environment
Alongside the complex policy and regulatory changes, the launch environment has become increasingly polarized between booms and busts.
Consider that just five drugs (GLP-1s and RSV vaccines) captured 80% of first-year sales in 2022 and 2023, while 84 other launches shared the remaining 20%. What’s more, from 2015 to 2019, one in five drugs successfully achieved $100 million in first-year sales. From 2020 to 2024, that dropped by half to just one in 10.
Of the 23 products that did achieve $100+ million in first-year sales since 2020, half came from emerging biopharma companies compared to 13 from large pharma. This suggests that while the overall environment has become more challenging, nimble EBPs may enjoy advantages over larger competitors.
When faced with an asymmetric launch strategy against larger players, knowledge is key to success. Precision sales targeting, tapping into early adopting physicians and practices, knowledge of promotional sensitivity, and understanding the impact of how generous patient and transition assistance programs at launch impact time to commercial breakeven are just a few of the insights needed to find success in the modern market.
Key trend 6: The hidden challenge of demand capture
Finally, the efficiency of demand capture has become a crucial yet often overlooked element of modern launch dynamics. It’s a challenge best illustrated via real-world example: a specialty brand that generated significant physician demand but lost 96% of it between the first prescription attempt and 12-month patient adherence.
Here’s how the brand’s demand erosion took shape:
- 44% lost to coverage rejections and prior authorizations
- 13% lost to distribution limitations and plan restrictions
- 15.5% lost to patient abandonment after approval
- 5% lost to one-and-done treatment discontinuation
With most companies measuring only filled prescriptions, they’re missing 80% of the patient journey and associated opportunities to intervene.
EBP: Ready to adjust your sails?
From policy to changing launch dynamics, industry trends create both headwinds and tailwinds for emerging biopharma companies. While EBPs can’t control market forces or heavily influence policy decisions, you can adapt your strategies to navigate them more effectively.
IQVIA is here to help navigate the Brave New World
Asymmetric launch strategies work but need deep analytics to support them. Getting an accurate “weather forecast” means going beyond traditional market strategies to maximize the return on effort. The industry is filled with examples of companies that spent hundreds of millions of dollars to launch a product only to return a fraction of that investment.
In an upcoming insight brief, we’ll highlight specific strategies you can employ to adjust your EBP’s sails in this changing environment. That includes rethinking everything from indication sequencing and pricing strategies to manufacturing partnerships. In the meantime, view the full-length IQVIA webinar, A Brave New World: 2025 Trends Reshaping Healthcare, and explore how IQVIA serves the EBP market.
A Brave New World: 2025 Trends Reshaping Healthcare
Attend this webinar to explore the transformative trends reshaping the U.S Healthcare landscape in 2025. Join us to discover insights and the implications for emerging biopharma organizations.