Healthcare is no longer just a market. It is becoming strategic infrastructure, and the forces reshaping it go far beyond tariffs.

A shift in the underlying model

Recent United States measures have returned the pharmaceutical sector to the centre of trade policy. For decades, global healthcare and life sciences companies optimised for efficiency. Manufacturing was concentrated, supply chains were streamlined, and cross-border flows were taken as a given. That model is now being fundamentally reconfigured.

This is not simply a shift from globalisation to fragmentation. It reflects a deeper change: from efficiency-driven optimisation to politically conditioned operating and deal structures. The key question is no longer just whether a strategy is commercially or legally sound, but whether it is structurally feasible in a fragmented geopolitical landscape.

Converging pressures

Several forces are driving this shift. Geopolitical fragmentation is reshaping market access and driving divergence in regulatory regimes. Industrial policy is influencing where assets are located through subsidies, onshoring requirements and domestic content rules. Investment screening and enforcement tools are also being applied more frequently to transactions involving sensitive data, advanced technology or critical supply chains.

At the same time, the operating environment is becoming more complex. Cyber risk has moved firmly onto the board agenda given its implications for patient safety, regulatory liability and reputation. AI is moving into core clinical and commercial activities, bringing a layered compliance framework. Together, these pressures make assets and transactions more politically visible and more constrained.

Deal structure as a strategic lever

The impact is particularly clear in the deal market. Big pharma is returning to M&A with greater confidence, but political and regulatory considerations are shaping how transactions are designed from the outset.

Structuring has become central to execution. Companies are increasingly adopting staged or modular approaches to manage regulatory risk.

For example, transactions may involve an initial minority investment with option rights exercisable once regulatory clarity is achieved, or the ring-fencing of sensitive assets through licensing arrangements to reduce regulatory friction.

In this environment, deal design is not simply a question of efficiency, but of feasibility. The way a transaction is structured can determine whether it proceeds at all.

Healthcare may be an early indicator of broader geopolitical pressures affecting global industries. Boards and general counsel are increasingly asking not only “Is this structure legally compliant?” but “Will it remain viable as conditions continue to diverge?”

Next steps

These are some of the questions we will be examining in our upcoming Perspectives session: The forces reshaping the global healthcare and life sciences sector, on Thursday 18 June (8am EDT / 1pm BST / 2pm CEST / 8pm HKT).

If you'd like to take part in the webinar you can register your interest here, or access our Global M&A Trends 2026 analysis for a deeper view of how these dynamics are already shaping the deal market.