More Insights from JP Morgan 2026 with Jeff Berkowitz, JD

Where was the drama at JP Morgan this year? Host Burt Zweigenhaft, PhD, and seasoned healthcare executive Jeff Berkowitz, JD, debate why the 2026 meeting seemed to be missing its normal electricity. They also share their thoughts around challenges with direct-to-patient models, most-favored-nation and its impact on product launch and pricing both in the US and Europe, and how AI may or may not be the key to finally achieving value-based outcomes. 

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Transcript

Value‑Based Voices 

Guest: Jeff Berkowitz, JD
Host: Burt Zweigenhaft, PhD

Burt (00:00)
Welcome to Value-Based Voices, a podcast from the Association for Value-Based Cancer Care. Each episode dives into the shifting terrain of cancer care in the United States, exploring what value means today from a clinical policy and a patient-centered perspective. Our mission is to spark informed conversations, dialogues, and promote transparency with every stakeholder, from providers to payers to patients.

With the insights that we all need to navigate cancer care with clarity, confidence, and purpose.

So let's get into it. My name is Bert Zweigenhaft. I'm the founder and executive director of the Association for Value-Based Cancer Care. I'm your host today, so you're stuck with me. But today, more importantly, we have a great guest, Jeff Berkowitz, CEO of Real Endpoints, an industry advisory and analytics firm delivering solutions to enhance appropriate access and innovation. And today we're discussing healthcare 2026 and kind of a look at what we saw because Jeff and I were both at JP Morgan last week. And it's kind of the linchpin of the start of the health year for most of us in this sector. So welcome, Jeff, and thanks for joining us this morning.

Jeff (01:27)
Thanks, Burt. Always a pleasure to be with you. Looking forward to the discussion.

Burt (01:33)
So Jeff, how many years have you been doing JP Morgan?

Jeff (01:39)
20.

Burt (01:41)
Yeah, I think so. I think you and I might even go back to the H \&Q days, right? When Dennis Purcell had started before JP Morgan bought it. And every year it changes, but what was the most dramatic thing that you felt, heard, or observed at JP Morgan this year?

Jeff (02:10)
Well, that's a good question. Most dramatic. You know, I would almost say—this will sound funny—but I'd say maybe the most dramatic thing was a lack of drama overall. It was a fairly muted meeting in my mind. If you ask me, there weren't any major announcements. There weren't any major skirmishes. There was a little bit of not so much business as usual.

But not all of the concern that we've seen in some of the past meetings where there was a lot more angst around the biotech winter or things that the administration was doing in pricing or what did AI mean. To me, it was actually the opposite of dramatic. It was a fairly pragmatic meeting where people were really not worried so much about some macro things that people felt comfortable that they knew what things were going to look like foundationally for 2026, like pricing issues and issues related to AI. AI, for example—everybody was talking about it—but this was the first time that I think more practical solutions and business cases were being discussed rather than nebulous concepts.

Burt (03:25)
That's interesting. When I also say dramatic, I think—yeah, there wasn't a lot of drama—but this meeting, there seemed to be a lack of M&A activity and a lack of capital deployment over the last two years, maybe on the back end of COVID and uncertainty in the markets. And I would have expected, Jeff, that given MFN and IRA and the government programs and all the announcements with the administration and everything, that that might have created more of a whirlwind of what is going to happen, what is going on here, and maybe more drama. But you didn't see that. So if you had to take that apart…

Jeff (04:10)
Yeah, it's interesting. Actually the one big deal that was announced—with Merck and Revolution—ends up not moving forward. So there really wasn't anything major that happened. In my mind, in answering your question, there were also haves and have-nots. The organizations doing really well, or the large well-funded organizations, were still able to have productive conversations.

There were tons of people having licensing and BD conversations. But if you didn’t have something differentiated or in a class with a lot of excitement, it's getting harder and harder to fundraise—creating these haves and have-nots. People with a good story are getting attention. People with a less compelling story, it's getting much harder.

I use Zeeland Pharma as an example. I'm on the board of Zeeland—it's a company focused on obesity. Obviously this year, tremendous amount of discussion around obesity. That's a little bit of that Lemmings effect or Gardner's-playing-soccer effect we always see—cell and gene therapy, then ADCs and radioligand therapy. Last year and this year, it's all obesity all the time, particularly on the heels of Pfizer and GLPs and what they mean.

Burt (05:43)
Mm-hmm. So there's plenty of cash in the marketplace, but there's still not any really good places to place it. That seemed to be the buzz. If you went around the venture capital rooms, the private equity rooms, and even the corporate rooms around the hotel—30,000 people show up there every year. Only about 5,000 at the conference and 25,000 in alternate sites. So is that kind of right? No?

Jeff (06:15)
Yeah, I think to your original question on the drama, one of the things—30,000 people being there—and one of the key misses were the people not there.

JP Morgan’s healthcare gatherings have always been cross-functional. Coming from pharma, retail, pharmacy, and payer, I believe deeply in having everyone across the ecosystem in the room together to discuss bigger, thornier problems.

The silence was a bit deafening with the absence of the rest of the supply chain—especially payers. We're still recovering from the UnitedHealth Group safety issues, but it’s remarkable how absent those players were. It’s creating an echo chamber—biotech and pharma talking to themselves rather than broader healthcare.

Burt (07:23)
So why were the typical insurers, the health plans—the ones that have been there for years—absent? I understand last year with the precautionary activity given the unfortunate incident with the UnitedHealthcare CEO. But why this year? I thought that was over. And I didn't even see a ton of security around the building this year.

Even before the United situation, there were always protesters, always a lot of security. This year was lax. And you're right—they weren't there. You're a great observer of this since you've been in corporate America, wholesale, distribution, payer side, Walgreens experience. So why weren't they there, Jeff? What do you think?

Jeff (08:16)
I wish I knew the answer. I think they should have been there. I don't think it was safety anymore. One of the problems is polarization.

As I've said, I've been in pharma, Walgreens, specialty pharmacy, UnitedHealth Group. I'm scarred by the disconnects in the healthcare system.

To have productive conversations—especially in an era of GLP-1s where we think that can solve a lot of healthcare problems—you need payers, PBMs, wholesalers in the room to have a broader dialogue around where these therapies fit into broader healthcare savings that make the system more affordable so you can continue to invest in new solutions and R\&D.

Burt (09:28)
So I'm going to challenge you on this. I have an opinion, like everyone. One is affordability—big word out there. You see it on the news daily. Healthcare, PBM investigations, middlemen, gross-to-net, health plans and PBMs—many of them vertically integrated. They're under fire. I think they were told to stand down and not be out there because they're having a hard time defending their position with legislation possibly going against them.

Jeff (10:20)
Yeah. I don't think they're cowards. Having been an executive at UnitedHealth Group, these guys feel good about where they are. My view—maybe cynical—is that there's limited incentive for disruption in the current healthcare delivery model. You made the point—vertically integrated entities, horizontally massive organizations. Payers own PBMs, have relationships with wholesalers and retailers; three to five players deliver care to 85% of the US population.

We've been talking about disruption in PBMs for 25 years. And yet they're bigger, stronger, more integrated.

Jeff (11:31)
I saw one of my mentors, Fred Hasson, the other night. I remember dragging him to payers to discuss antihistamines with Caremark. He’d say, “Why are you bringing me to PBMs? They add no value.” But here we are 25 years later—they’re even more powerful.

Everyone always asks about disruptors—Mark Cuban, Amazon. Even Amazon, Berkshire Hathaway, and JPMorgan couldn’t disrupt. Amazon has been trying to disrupt PBMs since 2017.

Burt (12:28)
On that acquisition.

Jeff (12:29)
So I'm a contrarian. Limited incentive to disrupt the status quo. That's why these players need to be at JP Morgan. We need cross-functional discussions—not wishful thinking.

Burt (12:55)
Look, I agree. Lawyers and PR teams probably told them not to show up. They're avoiding attention. But we needed their voices. That vacuum created a room full of people basically all agreeing.

Jeff (13:36)
Direct-to-patient was a huge theme. GLP-1s and obesity have pharma thinking about new models. But without payers and PBMs, we don’t know how it works. Direct-to-patient alone doesn’t solve affordability. We don’t know if these opportunities are unique to GLP-1s or broader.

Burt (14:56)
But the biggest payer is Medicare/Medicaid—the government. And who was there this year? Dr. Oz, Chris Klopp, Abe Sutton. Big presence. Very unusual.

Jeff (15:50)
Yes. And not only were they there—they were welcomed. Our industry showed willingness to talk. That's why I say last year was full of angst; this year felt more comfortable. People felt they knew what they were dealing with.

Burt (17:03)
Oz said just because companies negotiated lower prices doesn’t mean they’re off the hook. So giving Trump a win doesn’t protect them. Did you read it that way?

Jeff (17:59)
Yes. Pharma CEOs believe if they cooperate, they'll avoid harm. But Oz suggested otherwise. Even after concessions, there may be curveballs. And leadership shifts in trade associations might impact this.

Burt (19:12)
Let’s talk about global pricing. MFN might force alignment. Is that noise? Reality?

Jeff (20:15)
Yes. And generics—we pay highest. Europe is anxious. I serve on two Danish boards—they're concerned. Europe doesn’t have a strategy. Toothpaste can’t be pushed back into the tube. Launch strategy is the big issue—US companies may avoid launching in Europe to avoid pricing impacts.

Burt (22:43)
So strategy teams have a lot of thinking to do. Consultants will be busy.

Jeff (23:21)
Exactly. Market access, pricing, reimbursement—now just as important as science. Investors realize this.

Burt (24:32)
AI. Dot‑com déjà vu. Hundreds pitching AI. Shakeout coming. Winners? Losers?

Jeff (25:47)
AI won’t fall apart. Wish I could pick winners. In boardrooms, AI is everywhere—R\&D efficiency, target finding, faster decisions. But early days. Hard to keep up.

Burt (28:18)
AI will change everything—contracts, salesforces, protocols. Maybe outcome-based agreements become real.

Jeff (29:22)
You and I have been advocates for value-based arrangements. Surprised it hasn’t taken off. Payers missing is a big reason. AI could finally help measure outcomes reliably.

Burt (30:11)
Yes—AI could solve data and measurement problems. Could shrink pipelines. How many PD‑1s do we need?

Jeff (31:13)
Exactly. Many companies chase big categories but the payer element blocks access. We need to solve bigger problems like cardiometabolic disease.

Burt (32:33)
Will payers return next year?

Jeff (32:39)
Hard to know. Stocks reacted dramatically to Medicare reimbursement news. Cost-shifting hurts outcomes.

Burt (33:29)
Lots of uncertainty ahead. Interesting year.

Jeff (33:50)
Yes. Despite everything, the science is incredible. China innovation was also a theme. Tremendous opportunity.

Burt (34:41)
Will change accelerate?

Jeff (35:16)
Science will accelerate—AI will drive it. But system disruption? Still limited. Obesity could be an inflection point. Workforce shortages will worsen.

Burt (37:00)
Thank you, Jeff. Always insightful.

Jeff (37:27)
Thanks, Burt. This work feels like my life’s purpose.

Burt (37:52)
We're privileged to be in healthcare. Helping navigate the system matters.

This wraps up today's episode of Value-Based Voices, brought to you by the Association for Value-Based Cancer Care. Thank you to Jeff Berkowitz for sharing insights, and to our listeners for joining. Subscribe for more episodes spotlighting voices shaping the future of oncology.