Healthcare companies enter 2025 amid clinical breakthroughs and operational pressure

The start of 2025 has been anything but uniform for major healthcare companies in the United States. While some have managed to sustain their growth with clear commitments to innovation, others have begun the year facing headwinds that are forcing them to adjust their strategies and expectations for the rest of the year.

One of the companies that showed the greatest strength was Johnson & Johnson, which managed to increase its revenue in the first quarter of the year to just over $21.9 billion, with year-over-year growth of 2.4 percent. Innovative drugs, particularly Darzalex—focused on the treatment of multiple myeloma—and Tremfya, used for inflammatory diseases, contributed double-digit growth.

However, the pharmaceutical company also faced challenges. One of its flagship products, Stelara, lost patent exclusivity, resulting in a 32% drop in operating sales. Added to this was the tariff pressure, which could represent a hit of up to $400 million, which is why the company announced an ambitious investment plan to relocate part of its production to the United States.

Merck, for its part, also had a positive start to sales, reaching revenues of $15.78 billion in the quarter, a 10% growth in operating terms. The main driver was once again Keytruda, its flagship immuno-oncology treatment, which contributed more than $6.9 billion, followed by its antiviral Lagevrio, which regained traction in some countries due to Covid-19 outbreaks; however, the outlook was not entirely favorable. The company's net income fell 35%, due to higher operating costs, legal expenses, and a decline in its gross margin, which fell from 74.4 to 69.8 percent.

Management reaffirmed its confidence in the portfolio under development and the stability of the business, but acknowledged that the current operating environment demands greater financial discipline and adaptability.

In contrast to the pharmaceutical companies' performance, the most surprising case came from UnitedHealth Group, the health insurance giant. While its total revenue exceeded $109 billion (an increase of almost 10% compared to the same period last year), the company significantly lowered its earnings forecast for the rest of the year. The reason: an unexpected increase in the use of medical services by older adults enrolled in its Medicare Advantage program.

This rise in operating costs also impacted Optum Health, one of its most profitable divisions, which saw its revenue fall 5% year-over-year. Despite the blow, management has shown determination to regain profitability through adjustments to its care model and a review of its cost structures.

Beyond the figures, the first quarter confirms that large healthcare companies operate in an increasingly challenging environment. Adding to the effects of inflation are trade tensions, regulatory changes, and, in some cases, complex litigation that directly impact their medium-term outlook. Even so, innovation remains a key differentiator. Companies that focus on research and development, technological platforms, and new specialized therapies continue to capture market interest.

It's also clear that investors are paying close attention not only to quarterly results, but also to how companies respond to a changing environment. The reconfiguration of supply chains, moves to relocate production, and the ability to contain costs are becoming as important as sales growth.

Looking ahead to the rest of the year, the healthcare sector will need to maintain a delicate balance between innovation, efficiency, and responsiveness to external shocks. This performance shows that, while challenges abound, there is also room for companies with a strategic vision to maintain a steady pace in a relentless global market.