An Industry-Wide Reckoning Transforms America’s Healthcare Landscape
Executive Summary
- Mass Industry Contraction: Major pharmaceutical companies including Merck (6,000 layoffs), Moderna, Bristol Myers Squibb, and Novartis have implemented widespread workforce reductions in 2025, totaling thousands of job cuts as the industry faces declining revenues and patent expirations.
- Historic Trust Collapse: Public confidence in pharmaceutical companies has plummeted to record lows, with only 20% of Americans expressing positive views of the industry, while 59% believe business leaders deliberately mislead the public on health issues.
- Regulatory and Legal Pressures: The Trump administration has launched aggressive enforcement against pharmaceutical advertising, while lawsuits over products like Tylenol threaten billions in liability, culminating in major stock declines and investor uncertainty.
- Grassroots MAHA Movement: The “Make America Healthy Again” movement has gained significant political influence, successfully pushing policy changes that challenge pharmaceutical dominance and promote health sovereignty, with global ripple effects across international markets.
Industry on the Brink: Mass Layoffs and Shrinking Fortunes
The U.S. pharmaceutical industry is facing an unprecedented downturn. Once buoyed by blockbuster drugs and pandemic windfalls, Big Pharma is now slashing thousands of jobs amid an industry-wide retrenchment. In August 2025, Merck announced 6,000 global layoffs — about 8% of its workforce — in a bid to save $3 billion annually¹. This dramatic cut comes as Merck braces for the patent expiration of its top-selling cancer drug, Keytruda, and grapples with declining vaccine revenues.
Merck is not alone. Moderna, Bristol Myers Squibb (BMS), and Novartis have all unveiled major layoffs in 2025, citing “shifting market demands” and looming patent cliffs². Moderna, for example, is trimming 10% of its staff after its COVID-19 vaccine sales collapsed — Q1 2025 revenue plunged to just $108 million — forcing a “difficult but necessary” downsizing³. BMS has enacted four rounds of cuts in 2025 (over 1,300 jobs) to pare costs, and Novartis axed hundreds of U.S. jobs as its heart drug Entresto lost exclusivity.⁴
These mass layoffs underscore a broader decline in Big Pharma’s fortunes. After years of sky-high profits, the industry’s market dominance is shrinking. Companies are retrenching to survive a perfect storm: post-pandemic demand slumps, fewer new blockbusters, and the Inflation Reduction Act’s upcoming drug price controls. Even the stock market’s confidence in pharma has wavered; Pfizer and Moderna, once market darlings for their COVID vaccines, have seen their valuations slide as sales dry up. The result is a sector “navigating workforce reductions amid industry-wide cost-cutting” and bracing for leaner times⁵. In short, Big Pharma’s long-held growth narrative is cracking — and the cracks are widening by the day.
Pharma’s Army: Bigger than the World’s Militaries
This comparison is even more striking than it first appears.
Pharma’s Global Workforce
The global pharmaceutical industry employs over 5 million people across R&D, manufacturing, sales, regulatory, and distribution. In the U.S. alone, roughly 1.3–1.5 million people work directly in pharma and biotech, with several million more in health insurance, hospitals, and medical device companies — all parts of the wider medical-industrial complex. If you zoom out to include the entire healthcare industry (hospitals, nursing, insurance, pharma, devices, etc.), the number balloons to 22+ million U.S. workers (about 14% of the national workforce).
