Swiss Pharma at a Crossroads: US Pressure and China's Rise Reshape Competitive Landscape
核心洞察
Switzerland's pharmaceutical industry accounts for 6% of the economy, employs over 56,000 people directly, and generated more than CHF100 billion in exports in 2025.
Roche and Novartis remain global top-ten players with combined turnover of approximately $57 billion, but have slipped in rankings due to Eli Lilly's meteoric rise driven by GLP-1 receptor (搜索) agonists.
China's share of innovative pharmaceutical firms has surged from 5% in 2017 to nearly 20% in 2026, while the US still hosts over 40% of R&D headquarters despite a declining share.
Switzerland's pharmaceutical industry, long a cornerstone of the nation's economic prosperity, faces mounting headwinds as intensifying global competition and geopolitical pressures threaten to erode its hard-won position. With exports surpassing CHF100 billion in 2025 and nearly 350 companies active in the sector, the industry remains formidable — yet the shifting dynamics of US trade policy and China's rapid R&D ascent are compelling a strategic rethink.
An Economic Pillar Under Strain
The pharmaceutical sector's importance to Switzerland is difficult to overstate. According to the Federal Statistical Office, nearly 350 companies were active in the pharmaceutical industry in 2023, including global heavyweights Novartis, Roche, and Sandoz, alongside Swiss subsidiaries of foreign competitors such as Pfizer, Takeda, and AstraZeneca. More than 56,000 people work directly in the industry, with a further 250,000 employed indirectly, according to a 2024 study by the BAK economic research institute commissioned by Interpharma.
In 2023, the industry's gross value added accounted for 6% of the Swiss economy, making it the fourth-largest economic sector. Including indirect added value estimated at CHF30 billion ($38 billion), BAK calculates that the pharmaceutical industry's entire value chain accounts for nearly one in every ten francs generated in the country. The sector also leads private R&D investment, spending nearly CHF5.5 billion in 2023 — almost a third of the approximately CHF18 billion spent by the private sector overall. Among OECD member countries, Switzerland remains where pharmaceutical companies invest by far the most in R&D.
Yet after a quarter-century of continuous growth, the industry's share of gross value added to the economy dipped slightly in both 2022 and 2023, the latest years for which data are available.
Roche and Novartis: Giants Facing New Realities
The two Basel-based multinationals have seen combined turnover rise from approximately $49 billion in 2020 to roughly $57 billion in 2025, keeping both firmly in the global top ten, according to rankings compiled by Drug Discovery & Development. However, their positions have slipped — not due to declining performance, but because of the extraordinary ascent of Eli Lilly. The US manufacturer climbed from ninth to first place in a single year, with turnover soaring from $45 billion in 2024 to $65 billion in 2025, powered by its anti-obesity blockbusters.
On the innovation front, Citeline's annual report on pharma R&D shows Roche rising from second to first place between 2025 and 2026, while Novartis dropped two places, overtaken by AstraZeneca and Sanofi, though it remains among the world's leading companies.
Six Swiss drugs — four from Novartis and two from Roche — featured among the world's 50 best-selling medicines in 2025. Roche's Ocrevus led Swiss products with $8.4 billion in sales, while Novartis's cardiovascular treatment Entresto maintained sales at nearly $7.8 billion. Two Novartis therapies, Kisqali and Kesimpta, entered the global top 50, while four Roche medicines — Hemlibra, Tecentriq, Perjeta, and Xolair — dropped out.
The broader landscape highlights the revolution brought about by GLP-1 receptor (搜索) agonists. Novo Nordisk's Ozempic and Wegovy, along with Eli Lilly's Mounjaro, ranked among the top performers in 2025. Zepbound, also from Eli Lilly, posted the strongest growth despite not featuring in the ranking in 2024.
The Trump Factor and US Production Pressure
Pressure from US President Donald Trump to repatriate pharmaceutical manufacturing is forcing both Swiss giants to review their American strategy. Novartis and Roche are planning to invest billions to boost production capacity across the Atlantic. Some experts fear this strategic redeployment could lead to a decline in jobs, turnover, and innovation in Switzerland, particularly in the Basel region, the historic heart of the country's pharma industry.
China's Meteoric Rise in Pharma R&D
The most dramatic shift in the competitive landscape comes from China. According to Citeline data, nearly 20% of all innovative pharmaceutical firms are now based in China, compared with just 5% in 2017. Meanwhile, the share held by European countries, including Switzerland, has fallen to 7% in 2026 from 13% just a year earlier.
When measured by where medicines are actually developed, the trend is equally striking. The proportion of medicines under development in China has risen from 18% in 2021 to over 30% in 2026. The US still accounts for the largest share at over 50%, though this has declined from 56% in 2021. Switzerland's share remains stable at just under 7%.
Annette Luther, president of scienceindustries, the national association of chemical and pharmaceutical industries, warned in a January 2026 interview that the US and China are adopting "very aggressive strategies to attract research, production and investment." She added that compared to other nations reacting quickly to global changes, "Switzerland seems less hungry for competition."
Competitiveness: Still Strong, But Relative Decline
Switzerland ranks third in the 2025 Global Industry Competitiveness Index calculated by BAK Economics, behind the United States and Ireland. The report notes that Switzerland performs well across all four dimensions assessed — performance, market position and operational capability, innovation and technological leadership, and location quality — and has no major weaknesses. The country boasts the best location quality in the world, very high productivity, and solid growth.
However, it is Switzerland's relative standing that has deteriorated, particularly in innovation. Countries such as Denmark — tied for third place — the Netherlands, and the United Kingdom have made significant strides. Luther emphasized that Switzerland's fundamentals remain solid, but "a new strategic impetus will be needed to maintain the country's competitiveness."
Swiss pharmaceutical exports to the United States carry particular weight: looking at global pharma export flows in isolation, Swiss shipments to the US surpassed all others, with a total value exceeding $35 billion. This deep trade relationship underscores both the opportunity and the vulnerability facing the Swiss industry as geopolitical currents shift.