Oncology remains the largest segment in global pharma, accounting for around $241bn in 2025 prescription drug revenues. But portfolio momentum is fragmenting, and the next growth cycle looks materially different from the last one. We address many of the big issues in the oncology space in the new Evaluate Spotlight episode which is available here.
The past five years were largely built on checkpoint inhibitors and established biologics, but that era is closing. A concentrated wave of patent expiries begins reshaping portfolio trajectories from 2026 onward, and only around half of the largest oncology companies are forecast to maintain positive sales growth through 2032. Keytruda alone faces a projected $25bn reduction in annual sales by 2032, with Opdivo, Xtandi, Ibrance, and Perjeta each adding further multi-billion-dollar losses over the same period. The industry has limited historical precedent for managing simultaneous losses of this scale within a single therapy area.
That pressure is reshaping how deals get done. The era of the mega-merger is giving way to something more targeted – or surgical. Companies are identifying specific pipeline gaps and going after single assets or focused platforms, with human efficacy data and clear differentiation against existing standards of care increasingly non-negotiable. Deal values for the highest-quality late-stage assets are clustering in the $5-15bn range.
A new modality mix
The modality mix is shifting too. ADCs and bi- and multispecific antibodies have grown from roughly 10 percent of initiated oncology trials at the start of the decade to around a third today, expanding at 25 percent and 21 percent CAGR respectively between 2020 and 2025. Traditional monoclonal antibodies have declined sharply. Small molecule trial initiation has stagnated, driven less by science than by the Inflation Reduction Act’s shorter pricing protection window relative to biologics.
Biotech funding has recovered selectively since its 2021-2022 peak. Clinical-stage companies with differentiated assets are finding receptive investors. Seed and early platform funding remain well below prior levels, and cuts to US scientific funding introduce a delayed risk that won’t show up in deal flow data for years, but will eventually affect the supply of licensable assets that large pharma increasingly depends on.
Find out more in Evaluate Spotlight: Oncology
You’ll find loads more detail on the topic in the Evaluate Spotlight webinar and report. Take a look for a fuller picture of where oncology growth is heading, how deal structures are evolving, and what the funding landscape means for pipeline sustainability.
If you’re looking for data and insight to support your oncology pipeline strategy, or if you need guidance on your best next steps, get in touch to chat to our team.
