The company will integrate MedImmune, which has operated as the biologics research arm of AstraZeneca, amid an R&D and commercial restructuring.

As the company's turnaround plan matures, 2019 will remain a year of cost-cutting and focus as it looks to pay down debt and stabilize its financials. "We'll be focused on optimizing our own business rather than adding new businesses," CEO Schultz said.

IPO market is expected to pick up in 2019 after a slow start, due in part to the government shutdown, and VC investment appears steady, but M&A outlook remains mixed.

Pharma is facing a big headwind in 2019 in the form of diminished drug pricing power. The pricing trend puts net drug prices squarely in the red for most large pharma manufacturers, but US lawmakers aren't likely to be reassured heading into an upcoming hearing on drug pricing.

GSK said its oncology pipeline has doubled in size since July to include 16 assets in the clinic and highlighted the newly in-licensed bifunctional immunotherapy M7824.

Isatuximab could be the next building block in Sanofi's ambitions to rebuild in oncology. The CD38-targeting antibody extended PFS in relapsed/refractory multiple myeloma in combination with Celgene's Pomalyst and dexamethasone.