Biopharma Evolves to Find Value Beyond Mega-Blockbusters
Biotechs are self-commercializing as Big Pharma hold fire.
Yet despite having no idea when biotech markets will recover, how drug-friendly (or not) the FDA may prove to be, or which (if any) US drug pricing policies will stick, the biopharma sector is evolving. As Big Pharma dealmakers hold fire, smaller biotechs are taking on commercialisation single-handed – not just in ultra-niche segments, but in corners of highly prevalent diseases and in less-rare rare diseases. Many appear to be doing well. See Evaluate report: Going Solo – Biotech Commercialization.
Verona Pharma recently launched Ohtuvayre (ensifentrine), an inhaled PDE3/4 inhibitor, into the Big Pharma-dominated COPD market. The drug is projected to reach $1.4 billion by the end of the decade, even with new entrants Dupixent and GSK’s Nucala (mepolizumab), biologics used for eosinophilic forms of the condition.
Madrigal Pharmaceuticals is marketing newly approved Rezdiffra (resmetirom), the first treatment for metabolic disease-associated steatohepatitis (MASH), a fatty liver condition associated with obesity. BridgeBio’s new entrant Attruby (acoramidis) for transthyretin-associated amyloidosis with cardiomyopathy (ATTR-CM) could reach $1.6 billion in peak sales, according to Evaluate consensus forecasts.
There is more to come. Insmed anticipates US approval in August 2025 for brensocatib, an oral dipeptidyl peptidase 1 (DPP1) inhibitor for the inflammatory lung condition bronchiectasis. Brensocatib features in the top ten most valuable pipeline assets with projected 2030 revenues of over $3bn; it is also in development for chronic rhinosinusitis and hidradenitis suppurativa, an inflammatory skin condition.
These examples show that biotechs can, increasingly, play at Big Pharma’s marketing game. They also reveal other value hot spots. Respiratory diseases rarely top the therapy area charts, yet corners of COPD, and rarer conditions like bronchiectasis, are proving lucrative springboards for smaller firms.
Cardiovascular disease drugs – a category that includes Attruby – are also forecast to grow strongly through 2030 (CAGR close to 8%). BMS/J&J’s Factor XIa inhibitor milvexian, an anti-clotting drug, makes the top ten most valuable pipeline drugs ranked by net present value. The $925 million that Novartis paid up-front in February 2025 for Anthos Therapeutics and its Factor XI-targeted antibody belacimab, in Phase 3 for stroke prevention, underscores dealmakers’ interest in this space.
There is caution, too, though: Novartis held back up to $2.15 billion in potential regulatory and sales milestones. It likely recalled the Phase 3 failure in late 2023 of Bayer’s clot-buster hopeful asundexian, once hailed as a $5 billion prospect.
Overall prescription drug sales forecasts and top ten rankings provide useful pointers for the next decade. Yet they capture only part of a fast-evolving biopharmaceutical landscape; one where uncertainty may endure. On top of Trump-related volatility and cautious investors, biopharma firms face rampant competition from China and, as a result, growing pressure to effectively harness AI and other efficiency-boosting R&D tools.
Markets and M&A will return, but few dare predict when. Similarly, second-guessing the next hot therapy area appears unwise; few anticipated the explosion of obesity assets.
In these turbulent times, as biotechs stretch the rules around who markets pharmaceuticals, and as “venture” investors retreat toward safer, pharma-friendly assets, the best advice is to focus on fixing real unmet medical needs as fast and cost-efficiently as possible. There is value to be found in any therapy area, using the most suitable modality. Don’t try to time a trend.
