2024 was quite a year for significant strategic action among the pharmaceutical giants. Here are five key trends that will carry forward into 2025:

1. Greater strategic focus

The pharmaceutical leaders tightened their grip in specific areas where they see great potential. We recently considered Roche ROG moving toward obesity and shifting away from dementia and schizophrenia. Obesity and diabetes affect millions worldwide and the numbers are rising in many countries. This is a single example.

Johnson & Johnson JNJ purchasing Shockwave Medical for just over $13 billion ranks at the financial top of the acquisition board. Medical devices – the means of administering medication — ranks high on the list of strategic priorities.

Novo Nordisk’s NVO plan to acquire Catalent, a manufacturing company, for approximately $16.5 billion is another example of this trend. With a strong foothold at the outset, an effective acquisition improves the company’s outlook.

2. Pharmaceutical breakthroughs are precious

No surprise here, but recently the giants work to protect their good name when patents expire. In 2024, among those losing their patent exclusivity is Novo’s Victoza, a forerunner of Wegovy and Ozempic.

New breakthroughs are even more exciting. Investors know they are also expensive. Research and development expenses continue to rise. Merck MRK claims the financial trophy for spending about $30 billion a year on R&D.

Other breakthroughs are growing rapidly. Cardiac surgery is on the move. Valve replacements, once a rare, leading-edge procedure, haves grown wildly in the last few years, reaching 150,000 or more annually in the US.

Among the most monumental medical achievements of the year, pig transplants stand out. Massachusetts General Hospital was the scene of the first successful transplant of a pig kidney into a human. Even though the patient died several months later from other causes, the achievement is notable.

The success of a pig transplant, even though the kidney was modified, offers hope for greater future success with kidneys and other organ transplants. The curious similarity between human organs and pig organs is quite remarkable.

3. Method of delivery

A critical skill and rising in financial significance: People want easy-to-use, painless solutions to their problems.

Among the most successful current medications are those that a large portion of the population are able to take on their own. Self medication – actually injecting yourself — is building rapidly. Taking a pill or using over-the-counter medication is one form of self medication, but there is a massive growth of people injecting themselves with very serious medications that were once administered only by medical professionals.

According to Drug Development & Delivery, this part of the pharmaceutical industry adds up to more than $750 billion for 2024. Auto-injectors and sprays are growing rapidly. Among the most popular self-injection medications are adalimumab, penicillin and Ozempic.

4. More attention on ‘specialty’ illnesses

Specialty illnesses, which only a fraction of the population may suffer from, have risen to the top of the research agenda. For example, this year we covered various diseases that are finding new treatments and breakthroughs although the suffering population is small including Sjogrem’s disease, lupus and myelofibrosis. This shows that there is a great amount of money available to pursue cures.

5. ‘Pretty good’ not good enough with vaccines

Consider how the now-dated coronavirus played out. The big breakthrough creators began with “good” or “very good” results. Effectiveness in the 70% range stunned people at first. Coming from no vaccine to 70% effectiveness was a great accomplishment. Then the bar was raised to 96% or 98%. Everyone had to adjust to the higher number or would risk falling by the wayside. The vaccine giants – Moderna or Pfizer – were in a rush.

According to the National Library of Medicine, it is difficult to pin down how much was spent to create a superior Covid vaccine. The Biomedical Advanced Research and Development Authority indicated a cost of $40 Billion through 2021. Separately, the U.S. government invested $900 million or more in pre-clinical research for multiple candidate vaccines.

Consider that some vaccines are 50% effective. Even half effectiveness beats zero, but this got pushed aside when the 96% to 98% results appeared.

Investors might at least ask if the expenditure on research was really worth the extra 48% effectiveness. Does that sound heartless? There is a highly uneven track record on how countries fared in dealing with the corona virus.

According to Johns Hopkins University of Medicine Coronavirus Resource Center, the top Covid death countries include Peru, Mexico and Brazil. How did these three countries deal with the issue of vaccine? Latin America leaned toward Chinese and Russian vaccines. In Brazil, the government response was seen as slow, which turned into an ugly political issue.

Overall, 2024 ranked as a momentous year in the pharmaceutical area, featuring changes of personal behavior, medical breakthroughs and a great deal of money moving around. How much more is to come in 2025?

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