Introduction
I just got back from the annual J.P. Morgan (JPM) Healthcare Conference, which got me thinking about the tension between optimism and pessimism in our industry. That reminded me of a surprising insight from Andrew Ross Sorkin’s 1929: Inside the Greatest Crash in Wall Street History: even days before the market collapsed, strong optimists (bulls) and pessimists (bears) were making their case for the U.S. economy. Today, biopharma faces a similar dynamic, raising an important question: what are the bull vs. bear arguments for 2026? And what events could tip the balance?
In my view, there are four areas of U.S. biopharma to watch in 2026: scientific innovation, capital markets, China, and policy. For each, it’s a fascinating race between bull and bear arguments. Given my perch, I will spend this blog digging into the first three categories, as I am not a policy expert! But first, let’s discuss the overarching bull and bear cases in 2026.
What are the bull and bear arguments for U.S. biopharma in 2026?
I read Sorkin’s book at the end of 2025, while visiting my family for the holidays, which is why it was top of mind going into JPM. In the midst of reading the book, I reached out to colleagues and friends in biopharma for their perspective on bull vs.…
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Early in my career, I was often asked, “Do you want to work in academia or industry?” The emphasis was always on “or,” a clear line drawn between the supposed ivory tower of academia and the commercially driven environment of industry. The way the question was framed made it clear: there were discrete tracks of scientific pursuit, and at some point, scientists needed to choose one track or another.
Moreover, the connection between these tracks was always portrayed as being very linear. Foundational research happened in academia. Smaller companies would advance those findings in drug discovery and development programs. Ultimately, large pharmaceutical companies would usher new treatments through FDA approval and commercialization. It was like a 400-meter relay, where each player ran a segment of the race and then handed off the baton to the next in line.
That model worked for a time, but science has outgrown the simplicity of a relay race. Today, the reality looks very different. The life sciences field is now highly interconnected, collaborative, and far more complex. It’s less like a relay and more like a forest – vibrant, diverse and interdependent.
Given this evolution, rather than “or,” I believe we should be talking about “and” – academia and industry (link here), biotech and Big Pharma, venture capital and public funding…and, And, AND!…
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