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Key takeaways from the Bank of America London Healthcare Conference

At this week’s Bank of America London Healthcare Conference, we engaged with healthcare leaders at the highest level. Here are the key themes and takeaways that stood out from our C-level meetings:
26.09.2025 - Terence McManus
#Healthcare Global
  • Given the timing of the conference, it was natural that a lot of the discussion was focused on US healthcare reform. We came away expecting the noise to continue, but hopeful of clearing events ahead. We met multiple pharmaceutical CEOs and other executives, along with industry consultants. There remains significant uncertainty on the response to President Trump’s Executive Order (deadline Monday, September 29). There is clearly significant activity at a PhRMA (lobby group), but also at the individual CEO level. However, we heard a consistent message that there is unlikely to be a direct response from any company answering all of President Trump’s demands. The demand for most-favoured-nation (MFN) drug pricing in Medicaid and for new drugs is very challenging for the industry on multiple levels, and we got the impression that no ground can be conceded on this. 
     
  • There is some common ground, and a belief that the President wants a visible win to take to the mid-terms. There was the suggestion that a press conference has been planned in which the President will highlight the progress that has been made. The industry is very receptive to direct-to-consumer routes to market, satisfying one of the administration’s demands. USD 800 bn in direct investments have been pledged by the industry, which some executives highlighted as providing leverage. Several executives highlighted that the IRA Medicare negotiations are underway, and may provide the opportunity for some headline wins for the administration. Select price cuts through this channel, and voluntary cuts (e.g. BMY this week), could provide the headlines needed for the administration to claim a win. What became clear to us is that different pharma companies are taking different strategies, with some engaging a lot more than others. This raises the potential for narrower deals or company-specific announcements next week. The consultants present pointed to obesity drugs as providing the kind of visible win the President is looking for.  
     
  • There remains the possibility for a pilot program around MFN, but it was highlighted that for this to be legal, it would need to have a very narrow scope. Along with jeopardizing the capex investment promised by the industry to date, executives were also keen to point out that damaging the drug development process in the West could be a national security risk given the rise of China biotech. Executives we spoke to were not certain whether all of the above concessions would be enough to satisfy President Trump. While the rhetoric creates concern, current valuations are discounting significant negative hits to near-term earnings, something we think is unlikely. We expect slowly increasing certainty in the coming weeks and months.
     
  • Despite the anti-vax rhetoric, the vaccine players we spoke to were constructive on the new ACIP guidance for COVID given last week, highlighting that it is in line with the stance of other developed countries (i.e. focus on high-risk patients).
     
  • The major generic manufacturers that we met were keen to highlight that they are immune from the current healthcare reform discussion or tariffs. Indeed, the recent dropping of the need for Phase III studies (albeit on a case-by-case basis) by the FDA and EMA has been a real advantage to biosimilar players. It could halve the cost of development and make some smaller biosimilar opportunities financially viable, hence broadening the opportunity.
     
  • In terms of innovation, we were impressed by the ambition of AstraZeneca with the new blood pressure drug baxdrostat (greater than USD 5 bn peak sales), with multiple combination therapies planned. The Novartis CEO was bullish on the recent ianalumab clinical trial data in Sjögren’s disease, highlighting that this is the second largest Rheumatology indication with a patient population with a high unmet need. The Roche CEO was keen to point out that the development haemophilia drug NXT007 could have a higher peak sales potential than current market leader Hemlibra, with better efficacy expected to expand the market. In terms of obesity, both AstraZeneca and Roche point to combination therapies as a way of both creating differentiation from the current incumbents, and potentially helping preserve pricing. Within biotech, we continue to view favourable BioNTech's bispecific antibody program, and got further insights into the rationale behind the recent deal with Bristol Myers to co-develop in this area.
     
  • Within the more consumer-exposed segments of healthcare, company management described consumer sentiment in the US as still weak and weighing on hearing aids, dental, and ophthalmology. In the near term, management pointed to the lowering of interest rates as a positive, especially for dental treatments in the US. In these spaces, tariffs have been mostly mitigated by now via price increases. The Chinese market remains soft in ophthalmology, and companies are preparing for the expected second round of price cuts related to Value-Based-Procurement (VBP) in the next few quarters, which will also impact dental implants. In terms of innovation, the hearing aids market is preparing for a number of product launches in the coming months, which could generate single-stock optionality.

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