GSK has long been Big Pharma's underachiever. Under new chief executive Luke Miels, the company is attempting an intense game of catch-up after years of lagging behind rivals on breakthrough science and growth prospects. First quarter results under Miels show the company beat analyst expectations with revenue up 5% and core operating profit growing 10% year-over-year, though much of that growth still comes from older drugs like HIV medicine Dovato and oncology therapy Jemperli.

The challenge is significant. Since 2006, GSK has increased revenue at just 1.7% annually, while UK rival AstraZeneca grew from a similar base at nearly 2.5 times that rate. The root cause is chronic under-investment in R&D—a decade ago, GSK dedicated roughly 13% of revenue to research compared to AstraZeneca's 25%. Miels is now prioritizing R&D investment, with spending projected to outpace sales growth this year. But time is short: drugs using its best-selling ingredient dolutegravir go off-patent from 2028, putting about a fifth of its revenue at risk.

GSK's strategy is twofold: accelerate its pipeline of 57 drugs and buy time through acquisitions. It added RAPT Therapeutics for $2.2bn and 35Pharma for $950mn in the past three months to strengthen its respiratory and immunology portfolio. The credibility gap is closing—analysts now forecast GSK will fall short of its 2031 revenue target of over £40bn by only about 5%, compared to the 20% shortfall they predicted in February. The stock trades at 11 times forward earnings, roughly a third below AstraZeneca.