Drug pricing is playing an outsized role in the dynamics of the November U.S. election, creating turbulence for drug companies and for patients that will extend years after the votes are counted. During a Feb. 27 morning session on drug pricing trends during an election year at the BIO CEO & Investor Conference in New York, key opinion leaders spoke about their concerns, including the need to explain drug-pricing rationale to voters and patients in plain terms.

Companies and investors, well aware of the natural up and down fluctuations of the market, keep expecting the current downturn to end. They’ve been expecting it to begin an upturn for the past two years. During a Feb. 26 session on venture capital trends at the BIO CEO & Investor Conference in New York, investors said the tough times might well extend further into 2024 than they would like.

The Biotechnology Innovation Organization (BIO) found in a new study that 77% of clinical programs focused on pain therapeutics five years ago are no longer active and that financings of companies working in the space are lackluster at best. Meanwhile, oncology companies, targeting an overall smaller market, have raised huge sums of venture capital money, $9.7 billion in 2021 vs. pain and addiction companies’ $228 million.

With the passage of the Inflation Reduction Act in the U.S. in August 2022, biopharma company leaders have re-evaluated pipelines, sought legal advice, and discussed ways to mitigate the potential impacts the legislation will have on pricing therapies and extending their reach to new indications.

The market downturn has left many biopharma companies searching for new ways to raise funds, with some eyeing the strong venture capital market as a potential resource. But having a disruptive technology and solid data may be the best way to stand out in a sea of companies, say financial executives that participated Feb. 6 in a panel discussion during the first full day of the BIO CEO 2023 conference in New York.

After two years of record venture capital financing, which peaked during the first quarter of 2021 with a whopping $38.27 billion raised, investments in biopharma have started to drop off, and industry watchers are expecting a slower deal pace ahead. The same is expected for the IPO market, which saw a record 134 companies go public in 2021. Those trends, combined with big pharma’s hefty cash balances, could mean an M&A surge in 2022, though the availability of special purpose acquisition companies could continue to offer private firms an attractive alternative to a buyout.

Despite big wins in precision oncology – such as last year’s accelerated FDA nod for Amgen Inc.’s Lumakras (sotorasib) in KRAS G12C-mutated locally advanced or metastatic non-small-cell lung cancer – industry has barely scratched the surface of the field’s potential. Part of the problem is on the scientific front. Only about a third of patients are currently eligible for targeted therapy, since the majority of patients “do not have a known therapeutic vulnerability for which we have a drug match,” Keith Flaherty, director of clinical research at Massachusetts General Hospital, said during a Feb. 14 session at the BIO CEO & Investor Conference. “And that’s a big problem.”