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Future Readiness Indicator
From an industry of products to an industry of solutions
The Future Readiness Indicator 2025 reveals a pharmaceutical industry undergoing rapid transformation. The competitive edge now belongs to companies that control a diverse portfolio of therapeutic platforms, from obesity drugs (GLP-1s) and Antibody-Drug Conjugates (ADCs) to cell and gene therapies. The most future-ready companies are pairing therapies with devices, apps, and data services to improve outcomes and deepen engagement. Meanwhile, legacy giants, clinging to the old pill-only model and weighed down by patent expirations, struggle to keep up.
- Johnson & Johnson (100.0), Roche (97.2), and AstraZeneca (95.4) are pharma’s most future-ready companies, according to the 2025 Future Readiness Indicator. Their edge lies in broad diversification, spanning traditional drugs, biologics, and medical devices, combined with massive R&D spending and early AI adoption. By integrating digital health and data analytics across their value chains, these companies continue to outpace peers in both innovation and growth.
- A wide middle band (ranks 4–16) includes major players like Novartis, Eli Lilly, Merck & Co., Pfizer, Sanofi, and GSK. These companies excel in select domains or because of their blockbuster pipelines. However, they lag the elite group in innovation velocity, portfolio breadth, or ecosystem reach. Many are actively restructuring or pursuing biotech acquisitions and spin-offs to accelerate transformation and close the gap.
- Novo Nordisk, one of Europe’s most valuable companies, drops to 12th place in this year’s indicator, signaling risk. It remains highly concentrated, deriving most of its revenue from diabetes and obesity care. This single-track model offers huge upside, but also vulnerability to competitors (like Eli Lilly) catching up and supply chain constraints.
- Generic-drug manufacturers, old-line conglomerates, and smaller niche specialists are being left behind due to patent expirations eroding pricing power, cost pressures squeezing margins, and limited investment in data, digital, or next-generation science.
Future-ready companies and those falling behind
The 2025 Future Readiness Indicator shows a widening gap between pharma’s platform pioneers and legacy laggards. The best performers combine diversified therapeutic portfolios, AI-enabled R&D, and digital ecosystem integration. The traditional pharmaceutical business model, characterized by broad therapeutic area coverage, blockbuster-focused commercialization, and incremental technological adoption, is increasingly vulnerable. Those at the bottom remain trapped in outdated cost structures and suffer from an overreliance on a few revenue sources, leaving them more exposed to external pressures.
1. The elite tier: R&D titans (Scores > 90)
American and European giants still dominate the top ranks, led by Johnson & Johnson (100), Roche (97.1), and AstraZeneca (95.44). These three epitomize what “future readiness” looks like: robust financials, relentless innovation, and ecosystem control, and it shows in their scores, which are all above 90. Each has outpaced the industry’s single-digit revenue growth and sustains deep pipelines that secure long-term success. Collectively, they invested tens of billions in R&D last year; AstraZeneca alone spent more than 25% of sales on R&D, fueling a steady stream of new medicines. Their edge lies in mastering the full pharma value chain and their success in building next-generation therapeutic platforms.
Johnson & Johnson, the world’s largest healthcare company, leverages its broad diversification, from drugs to medical devices, to cross-pollinate innovation and buffer risk. It has sharpened its focus on high-growth segments, spinning off its consumer-health arm in 2023 and planning to separate its $9.2bn orthopedics unit to double down on oncology, immunology, and novel therapeutics. Despite a major patent loss (Stelara), J&J’s pharmaceuticals arm still grew about 7% in Q3 2025, powered by blockbusters like Darzalex, a cancer treatment drug, and what analysts call “steady growth across the core portfolio,” making it “one of the cleaner stories” in an industry often full of complexity and volatility.
Roche, long an innovation leader, remains formidable, thanks to its biotech legacy (Genentech) and dual strengths in pharma and diagnostics. The company has faced ongoing revenue pressures over the last couple of years because many of its blockbuster drugs, including Avastin, Herceptin, and Rituxan, are facing growing competition from biosimilars, and because of declining COVID-19 test sales, but the company is retooling fast. In early 2024, it cut eight underperforming projects and redeployed capital toward high-growth bets: next-gen eye therapy Vabysmo ($4bn in 2024 sales), and a $2.7bn deal with Carmot Therapeutics to enter the GLP-1 obesity race. Roche’s pipeline still counts nearly 150 new molecular entities, and it sealed three acquisitions in the first half of 2024 alone. In short, Roche excels at what defines future readiness: knowing where to bet and when to cut. By channeling resources into immunology, neuroscience, and novel oncology modalities while pruning low-potential programs, it stays firmly in the top echelon.
AstraZeneca, now the UK’s most valuable company by market cap, has evolved into a genuine science powerhouse. Under CEO Pascal Soriot, it pivoted decisively toward biologics, gene therapy, and ADCs. This has paid off. Oncology sales were up 19% year-on-year, mid-teens growth guidance for 2024, and a bold target of $80bn in revenue by 2030 from 20 new medicines in development. AstraZeneca is a textbook case of innovation that pays for itself, with disciplined R&D yielding explosive returns.
2. The middle tier: Playing catch-up (Scores ~50–90)
Ranks 4–16 make up pharma’s middle tier. This diverse group includes multinationals, high-profile biotechs, and strong regional players. Each has notable strengths, but also areas of vulnerability, which is why their scores sit below the elite tier. These companies are typically high-stakes specialists that are betting everything on a single blockbuster or bracing for a patent cliff.
Leading this middle pack are Novartis (88.9), ranked fourth in this year’s indicator, and Eli Lilly (85.8), ranked fifth. Both are on upward trajectories: Novartis completed its transformation into a “focused innovative medicines company” in 2023. It executed the spin-off of Sandoz, its generic drugs division, in October 2023, freeing up management attention and capital to concentrate on high-value novel therapies.
Eli Lilly, meanwhile, is the breakout story of the group. Long a steady player in diabetes and oncology, its fortunes have exploded with a breakthrough in metabolic medicine. Its dual-branded tirzepatide (sold as Mounjaro for diabetes and Zepbound for obesity) delivers unprecedented weight-loss efficacy, unlocking a vast new market. Analysts project the franchise to exceed $30bn in annual revenue by 2025–26, potentially overtaking Novo Nordisk in the GLP-1 race. Eli Lilly’s market cap and share price have surged to record highs in recent times, briefly making it the world’s most valuable pharma company. Crucially, it’s not a one-drug story: the 2024 FDA approval of donanemab (Kisunla) for early Alzheimer’s, shown to slow cognitive decline by approximately 29–35% (or 4.5 to 7.5 months over 18 months), opens another enormous market. In the first half of 2025, Eli Lilly’s revenues jumped so sharply that investors raised their valuation targets yet again.
Novo Nordisk (Rank 12, 64.4) has been the other headline-grabber globally. Its GLP-1 drugs Ozempic (diabetes) and Wegovy (obesity) turned obesity treatment into a cultural phenomenon and made Novo Nordisk Europe’s most valuable company for a time. In 2023, the company’s market value climbed so high (around $570bn at peak) that it exceeded the GDP of Denmark. In June 2025, it overtook SAP to become the most valuable company in Europe. However, our Index underlines a caution: future readiness rewards breadth as well as brilliance. Its extreme specialization (nearly all its revenue comes from diabetes and obesity care) poses a concentration risk. Competition from Eli Lilly’s rival GLP-1 drugs, supply bottlenecks, and the need to expand beyond metabolic diseases temper its long-term outlook.
Each player in this mid-tier excels in at least one area, be it therapeutic dominance, financial muscle, or pipeline depth, but few check every box. That’s why nearly all have been restructuring or deal-making in the past two years: divesting non-core units, striking R&D partnerships, or acquiring biotech pipelines to reset their trajectory.
3. The bottom tier: Struggling to transform (Scores < 50)
The lower third of the rankings, roughly ranks 17 through 27, is made of companies that have been slow to adapt in a sector racing toward an AI-driven, biotech-centric future. These are the companies still anchored to legacy products or outdated business models, struggling to reinvent themselves as the industry’s innovation frontier accelerates.
This cohort is dominated by generic-drug manufacturers, old-line conglomerates, and smaller niche specialists. Their challenges differ in detail but share the same root cause: structural inertia. Patent expirations have eroded pricing power, cost pressures have squeezed margins, and limited investment in data, digital, or next-generation science has left them behind.
Forces transforming pharma in 2025
Three powerful dynamics have continued to accelerate in 2024–2025, impacting the global pharmaceutical landscape.
1. AI-powered drug discoveries
The pharmaceutical industry faces an existential R&D productivity crisis. Drug development keeps getting slower and more expensive, straining even the biggest budgets. Artificial intelligence is emerging as the most promising answer. What started as a niche research tool has become the central engine of discovery, with AI expected to power 30% of new drug discoveries by 2025.
AI rewrites the R&D equation by automating workflows, which can cut the time to preclinical candidates by up to 40% and reduce costs by 30%. This is discovery by design, not by chance, which can shorten multi-year processes into months. Insilico Medicine, for instance, designed a novel compound and brought it to Phase 1 clinical trials in under 30 months, a journey that normally takes a decade.
The real breakthrough that AI has brought is that it raises the odds of success, which have historically been stuck at around 10%. By scanning vast datasets, AI can pinpoint new therapeutic targets, predict toxicity early, and optimize trial design and patient recruitment, reducing costly late-stage failures.
This shift has unleashed a wave of pharma-tech partnerships. Big drugmakers know they can’t build these capabilities alone, so they’re teaming up with AI-first startups to tackle declining R&D efficiency. The FDA is now actively engaged, hosting public workshops in 2025 to define how AI integrates into drug and biologic development. In today’s world, a company’s AI strategy is its R&D strategy.
2. US regulation and global geopolitics
The pharmaceutical industry is being shaped by two powerful, intertwined forces: geopolitics (which impacts supply chains) and regulation (which impacts drug pricing).
The US Inflation Reduction Act (IRA) is the most disruptive policy change in decades. Under the IRA, Medicare, a US government health insurance program that primarily covers people age 65 or older, can negotiate a Maximum Fair Price (MFP) for high-cost drugs, fundamentally changing the economics of the world’s largest pharmaceutical market. The IRA, together with inflation rebates and a new $2,000 annual out-of-pocket cap for seniors, is compressing the commercial lifespan of every branded therapy. Companies now must launch faster, scale quicker, and reach peak sales sooner to sustain returns. Simply put to deliver on expectations, manufacturers must drive faster uptake at launch. The pressure on R&D productivity (to refill pipelines before revenues dwindle) has never been greater.
Meanwhile, trade tensions and post-pandemic supply shocks have triggered a global wave of manufacturing reshoring. Dependence on Active Pharmaceutical Ingredients (APIs) from China and India, once seen as an efficient cost play, is now viewed as a strategic vulnerability. Today, supply chain security has become as vital as scientific innovation.
3. Integrated health platforms
Pharma’s business model is shifting from selling standalone drugs to delivering integrated health platforms. The most future-ready firms are pairing therapies with devices, apps, and data services (for example, a smart sensor linked to an asthma inhaler to improve outcomes and deepen engagement. Those clinging to the old pill-only model risk fading relevance as healthcare converges into a connected, patient-centric ecosystem.
Advantage in the platform era lies in owning systems that can repeatedly generate new assets.
Already, new modalities – spanning antibodies, cell and gene therapies, RNA-based treatments, and other novel platforms – account for roughly 60% of the global pharma pipeline’s projected value. As biology, chemistry, and data converge, the spoils will go to two types of players:
• Platform orchestrators – the elite few mastering end-to-end development and manufacturing of complex modalities.
• Best-integrated participants – agile, mid-tier firms that can plug into these platforms to keep their pipelines full.
Everyone else risks being left behind.
In 2025, we’re witnessing a deeper convergence across the entire healthcare landscape. The traditional walls between pharma, medtech, and care delivery are collapsing into integrated ecosystems. This is transforming not only how treatments are developed, but how patients experience care, pushing pharma beyond the pill. In the old world, roles were neatly divided: pharma made drugs, device makers built hardware, software firms handled health IT, and providers delivered care. Collaboration was episodic. The new world turns that model inside out. The winners will be those who can orchestrate the full patient journey – from diagnosis to treatment to continuous monitoring.
Pharma firms are responding by bundling therapies with digital and service layers. For example, Novo Nordisk and Eli Lilly pair their obesity drugs with coaching apps that help patients manage diet and side effects. Through its AMAZE program, AstraZeneca links inhalers to smart sensors and an asthma-management platform for real-time symptom tracking, while Roche, through mySugr, connects glucose monitors with insulin-dosing advice to complement its diabetes drugs.
These are early glimpses of a future where the real value proposition is not just the drug, but the drug + device + data + service. Those that fail to evolve risk finding their medicines out of the loop, prescribed less often simply because they don’t fit into the new, integrated model of data-driven care. Convergence is no longer optional; it is redefining pharma from an industry of products into an industry of solutions.
How is future readiness measured?
Our Future Readiness Indicator is designed to measure a company’s readiness for deep, long-term, secular trends. We use a rule-based methodology to arrive at a composite score for each company, enabling us to identify industry leaders. We can then investigate the behaviors and attitudes of specific companies.
The Future Readiness Indicator assesses a company’s preparedness for the future through a comprehensive methodology. This includes evaluating key factors: Financial Fundamentals, Investor’s Expectations of Future Growth, Business Diversity, Employee Diversity/ESG, Research & Development, Early Results of Innovation, and Cash & Debt. The methodology uses publicly available data, including company websites, annual metric reports, business models, press releases, and third-party sources like CrunchBase, Espacenet, and Sustainalytics. The ranking is based on these factors and aims to provide a holistic roadmap of a company’s position and potential for future success. For more details on how we develop the Future Readiness Indicator, please visit our Research Methodology page.
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