Survey finds C-suite sentiment improving, dealmaking rebounding, and hiring plans warming, even as the FDA clouds the outlook.
Biotech executives are not declaring a comeback. But compared with the despair that gripped the sector last spring, the mood in the C-suite has lifted.
The latest Endpoints 100 survey, drawing responses from 77 senior biotech executives, largely CEOs, suggests the industry may have passed its emotional and financial rock bottom. Years of falling valuations, frozen IPOs and capital flight have left deep scars. Yet renewed deal activity, a rebound in public biotech indices, and clearer signals from large pharma that it is willing to pay for innovation have softened the outlook.
Half of respondents say they feel “somewhat better” about the economics of drug development heading into 2026, with another 20% reporting they feel “much better.” Only a small minority expect conditions to worsen meaningfully. For an industry that recently watched dozens of companies trade below cash, that shift alone is notable.
As former Alnylam CEO John Maraganore put it: “After a long, bleak winter, I can finally see some green shoots… For God’s sake, innovation needs this break!”
The clearest source of improved sentiment is M&A. Nearly 90% of surveyed executives are optimistic about dealmaking in 2026, buoyed by a run of multibillion-dollar transactions and a visible willingness by big pharma to restock pipelines externally.
That enthusiasm stands in contrast to continued skepticism about IPOs. Public offerings remain scarce, and most executives still rate the IPO and follow-on market as poor to fair. However, even here the tone has improved: six months ago, near-universal pessimism prevailed. Now, guarded hope has replaced outright despair.
Investment flows remain uneven. Roughly one-third of respondents rate venture investment as “fair,” while about a quarter still call it “poor.” But that, too, marks progress from the spring, when 60% described funding conditions as poor – a record low.
Sentiment is also turning up in hiring plans, a closely watched indicator of executive confidence. About two-thirds of the respondents expect to add staff in 2026, while only 6% anticipate layoffs.
That reversal is striking, given that hiring intentions hit a decade low earlier this year. While many companies remain lean by necessity, CEOs increasingly appear willing to invest in people again, particularly if deal flow and access to financing continue to stabilize.
Despite unrelenting headlines about disruption at the FDA, most biotech executives report little direct regulatory fallout so far. Well over half say they have not experienced material delays or disruptions, with another 20% saying it is too early to tell.
Some executives even report faster review timelines, particularly for advanced modalities such as cell therapy. Others, however, describe deep dysfunction, warning that leadership instability could eventually erode regulatory credibility.
Views on FDA Commissioner Marty Makary have shifted sharply since the spring. Approval now sits at roughly one-third, while 40% disapprove, a steep drop from earlier “wait-and-see” attitudes.
Critics cite politicization and poor leadership choices; supporters argue the agency is still functioning and that Makary’s modernization goals remain promising if realized.
By contrast, sentiment toward HHS Secretary Robert F Kennedy Jr. is overwhelmingly negative. Fewer than 2% approve of his performance, with executives frequently citing concerns over anti-vaccine positions and the sidelining of scientific expertise.
Notably, most biotech leaders are no longer bracing for catastrophic fallout from drug-pricing policies such as MFN rules or the IRA expansion. Half expect only modest negative effects, while nearly a third see little impact at all. Many believe worst-case scenarios have been avoided, with pricing pressure potentially offset by higher volumes or global cost-sharing.
Meanwhile, interest in China as a clinical development venue continues to rise. Forty-two percent of respondents say they are planning, conducting or considering trials in China. While geopolitical concerns persist, executives increasingly view China trials as a pragmatic competitive tool rather than a red flag.
Biotech’s “fiesta days” remain far off. Valuations are mostly rated low to average, and capital remains selective. But the survey suggests the sector has moved off rock bottom.
For 2026, CEOs are planning not for a boom, but for something almost as valuable: a more predictable environment in which deals can close, teams can grow and innovation can once again attract capital…cautiously, deliberately and with realism.
