This is a special edition of Value Report brought to you by RC Resolve, Real Chemistry’s corporate affairs advisory. Today, Megan Hickey and Leslie Isenegger review the policy trends within Q2 2026 earnings calls and share how companies can best prepare for discourse ahead of Q3 changes.

Across dozens of major biopharma and payer earnings calls, Q2 earnings marked a clear shift from watching policy risk to operating inside of it. Compared with Q1, healthcare companies spent far more time explaining how Washington, reimbursement, tariffs and global pricing dynamics are beginning to shape commercial strategy — not just investor sentiment.

What Changed

The biggest change was the breadth of policy discussion. Companies spent considerably more time addressing government actions, reimbursement pressures and market access dynamics than they did in Q1.

Tariffs, which generated significant uncertainty earlier this year, appeared to be less of a concern. Several companies, including Amgen and Johnson & Johnson, indicated they had adjusted guidance and manufacturing strategies in response to the latest developments.

Major pharmaceutical companies also doubled down on China as a growth and innovation story. AstraZeneca noted the country’s growing importance for industry partnership opportunities, while Sanofi commented, “China has revealed to be, over the past few years, an extraordinary source of innovation with the speed and the ecosystem associated to it being really interesting.”

Payers were not exempt from the policy turn. While reforms to the 340B Drug Pricing Program have long been a strategic priority for pharmaceutical companies, CVS Health called out the program as a current pressure point and future headwind — underscoring that drug-pricing policy is now landing across the healthcare value chain.

What Stayed the Same

Companies continue to grapple with the reality of MFN, with leaders describing how it could affect launch sequencing, ex-U.S. reimbursement negotiations and the value story for new medicines.

Novel federal programs, especially TrumpRx and the Medicare GLP-1 Bridge Program, continue to buoy Eli Lilly and Novo Nordisk as important drivers of obesity treatment uptake and expanded patient access.

Over the past year, tariffs, MFN and reimbursement pressure surfaced primarily in the earnings Q&A sessions with analysts. This quarter, several executives proactively raised these issues in prepared remarks, getting ahead of issues with details on how their business is evolving to operate in the current environment.

For example, Amgen and J&J described the adjustments each company has made relative to the policy environment, revising guidance and shifting manufacturing plans. Lilly and Novo did something similar with the Medicare GLP-1 Bridge Program, tying this federal access initiative directly to their obesity treatment numbers. 

Still, other companies continue to reference MFN and/or 340B as issues to monitor rather than variables they’ve modeled. Those characterizations are likely to be tested, as payers, competitors and regulators could potentially offer numbers on these same dynamics; once data is shared, the rest of the sector is likely to be measured against it.

Looking ahead, Q3 will have a variable that Q2 did not: the U.S. midterm elections. Many companies will schedule earnings calls immediately before and after election day (November 3). The midterm cycle continues to feature drug pricing and tariff policy as campaign topics, meaning Zoom room and conference calls may see investors rub shoulders with campaign staff, committee aides and political reporters.

For this reason, language that reads as a reasonable hedge in the summer might be read differently in an inherently political autumn. Companies should expect their Q2 policy positions to be interrogated with calls for more detail. It’s now imperative to build a clear, well-supported position on issues like MFN, 340B and tariffs well in advance of that call. It’s as much of a government affairs task as an investor relations one — and something internal teams should be working on in tandem.

– Megan Hickey, Managing Director, and Leslie Isenegger, Head, Policy, Public Affairs and Access, RC Resolve