About $300 billion in revenue generated by rated pharmaceutical companies is expected to face generic and biosimilar competition through 2031 — a shift with direct implications for how hospitals and health systems manage their drug budgets over the next several years, according to a June 1 Moody’s report.
Moody’s estimates the revenue at risk represents roughly 40% of rated pharmaceutical companies’ 2025 revenue. For health systems, that figure signals a window: As blockbuster drugs lose exclusivity, lower-cost generics and biosimilars typically enter the market, giving hospital pharmacy teams more leverage on acquisition costs for some of their most expensive product lines.
The ratings agency said major patent expirations will remain manageable through 2027 before accelerating between 2028 and 2031 — a timeline that gives pharmacy leaders a narrow window to build biosimilar-ready formulary and contracting infrastructure before the wave hits.
Among the blockbuster products facing loss of exclusivity later in the decade are Merck’s Keytruda, Johnson & Johnson’s Darzalex, Novo Nordisk’s semaglutide products in Europe and Bristol Myers Squibb’s Opdivo. Moody’s estimates Keytruda alone accounts for $31.6 billion in sales exposure.
For oncology programs that rely heavily on checkpoint inhibitors, biosimilar entry for drugs such as Keytruda and Opdivo could meaningfully reduce per-patient drug costs, though the extent of savings will depend on how aggressively payers and GPOs structure biosimilar contracting. Biosimilar semaglutide availability could also reshape hospital formulary decisions around GLP-1s, a category already generating significant prior authorization volume.
Some health systems are not waiting. Danville, Pa.-based Geisinger moved to a biosimilar-first model across all lines of business — Medicare, Medicaid, commercial and ACA plans — with its chief pharmacy officer citing the coming wave of biologic patent expirations as a central rationale.
The Moody’s report also highlighted accelerating biosimilar adoption. The FDA has approved 83 biosimilars since 2015, including 18 approvals in 2024 and 18 in 2025. Moody’s said upcoming patent expirations will provide a robust pipeline of opportunities for biosimilar manufacturers — expanding the menu of alternatives available to hospital formulary committees in the years ahead.
While pharmaceutical companies are expected to offset some revenue losses through new product launches and acquisitions, Moody’s said the wave of patent expirations is poised to reshape competition across the drug industry over the next several years.
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