Efruxifermin

After a surge of large transactions at the end of 2025, will the trend continue in 2026? Many industry watchers—based on what they witnessed in the fourth quarter—believe 2026 will follow suit and be a banner year for M&A. Johnson & Johnson’s $14.6 billion buyout of Intra-Cellular Therapies in the first month of 2025 suggested it would be a big year for high-priced transactions in the biopharma industry. But it was a false alarm.With unprecedented turnover at the FDA fueling concerns about the agency’s procedures and timelines, and amid President Donald Trump’s threats to impose tariffs and set most-favored-nation (MFN) prices for drugs, companies put their business development plans on hold as uncertainty reigned.But, later in the year, when drugmakers gained more clarity on the new regulatory and pricing landscape, the M&A market heated up. Of the 10 largest transactions executed in 2025, eight came in the second half of the year, with six of those deals in the fourth quarter. Will the trend continue in 2026? Many industry watchers—based on what they saw in the fourth quarter—believe the market is primed for a banner year for M&A.“As people got more comfortable with what the regulatory regimes looked like, they were able to build that into their model and how they were looking at targets,” Gabrielle Witt, an M&A Partner at law firm Hogan Lovells, said in an interview with Fierce. “We think that sort of momentum will continue in 2026.”Bart Van de Vyver, an M&A consultant with McKinsey, takes it a step further.“We’ve seen an acceleration of (major deals) in the second half of ’25 and we expect a further acceleration of that in 2026,” he said in an interview.Pierre Jacquet, of Boston-based L.E.K. Consulting, added that “pressure to rebuild pipelines is intensifying,” because companies are losing $300 billion in revenue through the loss of exclusivity of their products by 2030.“Supported by significant patent-cliff risk, strong balance sheets, and improving biotech sentiment, 2026 is likely to see a major acceleration in dealmaking, including 20-plus acquisitions over $1 billion,” Jacquet predicts. The rebound of valuations The biotech industry hit a bottom in the spring of 2025, according to the XBI, a stock index of U.S. biotechs. After Trump revealed his Liberation Day Tariffs in early April, the XBI tumbled to its lowest figure in 18 months. But, by December, the index had increased by 75%, to its highest price since 2021.The uptick in valuations has leveled the playing field between buyers and sellers in the M&A market, fueling more transactions, Arda Ural, EY Americas life sciences sector leader, said on Fierce Pharma’s "Top Line" podcast in December.“We are in the normalization phase of dealmaking, going back to historical normals,” Ural said.Given their firepower and the oncoming wave of patent expirations pharma companies are facing through the end of the decade, many are anxious to make deals, Van de Vyver explained, even at higher valuations. While there are still risks with biotech investments—especially considering the continued turbulence at the FDA—analysts at William Blair believe the uptick will continue in 2026 as the “worst-case scenarios are off the table” with respect to tariffs and MFN pricing.“As long as the sector continues to reward strong clinical results and companies are able to commercially launch drugs without significant government regulations around pricing, we believe specialist investment in biotech can continue to have strong performance,” the analysts concluded. Increased specificity of M&A targets Over the last decade, Sandy Donaldson, the co-founder and chief strategy officer of Impiricus, an artificial-intelligence-powered platform connecting healthcare professionals with pharma resources, has witnessed more selectivity with respect to what assets drugmakers are targeting.Donaldson pointed to Novo Nordisk’s $5.2 billion October acquisition of Akero and its promising candidate for metabolic dysfunction-associated steatohepatitis (MASH). Data from a phase 3 trial of the prospect, which were called “transformational” by analysts at Evercore ISI, triggered a doubling of the biotech’s share price.For Novo, the treatment efruxifermin isn’t just a random target of opportunity. It fits into the Danish company’s cardiometabolic wheelhouse. Its expertise in the treatment area produced revolutionary GLP-1 drug Ozempic. To fill gaps in their pipelines, “big players are taking very specific thematic bets,” Donaldson said in an interview.“I think you’re gonna see more of that in very specific therapeutic areas within rare disease, next-generation biologics, oncology,” Donaldson added. “The pipeline gaps, the need for innovation and the more innovation around de-risked models is really kind of driving this M&A growth that we’re seeing.”Jessica Bisignano, also an M&A Partner at Hogan Lovells, echoed the recent emphasis companies are placing on filling gaps in their pipelines.“There’s just continued demand for companies, for strategic acquirers, to be more disciplined with their capital,” she said. “I really think they are trying to buy into their pipelines as opposed to just making unrelated acquisitions.” Shifting treatment targets Another new industry trend emerging is the push for neurology assets, evidenced by the two largest transactions in 2025—J&J’s buyout of Intra-Cellular and Novartis’ $12 billion purchase of Avidity Biosciences.Close behind neurology and oncology as the top targets in 2025 were cardiometabolic assets, fueled by the “GLP-1 gold rush,” Ural noted.This was “an absolute diversion from past trends when oncology really dominated everything through and through,” Ural added.The “gold rush” was illustrated by Pfizer and Novo Nordisk’s pursuit of obesity drug developer Metsera. Pfizer ultimately won the race in November with its $10 billion acquisition. That came after Metsera initially agreed to a $4.9 billion up-front deal with Pfizer. Just over a month later, Novo dropped a bombshell offer of $6.5 billion up-front for the biotech, which is developing a longer-acting, monthly-dosed GLP-1. All of the public Metsera offers featured contingent payments based on potential future milestones.As for oncology, antibody-drug conjugates (ADCs) and bispecifics remain the top two targets.“That continues to be a very vibrant space,” said Van de Vyver, who added that many of the licensing deals for the oncology candidates are coming out of China, which has developed into a hub for innovation.“We’ve seen at least five deals this year with a headline value—admittedly a good chunk of that is biobucks, milestone-based, etc.—of more than $2 billion,” Van de Vyver said, speaking specifically of Chinese companies.  “The entrepreneurial energy in China is quite impressive. There’s 1.5 billion people, many of which have advanced degrees. There’s a high savings rate and a large availability of capital and a willingness and a desire to move fast and invest at scale and that has been built up over the past decade," Van de Vyver added. "As evidenced by some of these deals, we’re seeing innovation that’s viewed as valuable around the world.”Also worth watching in the oncology space in 2026 are tri-specifics and tetra-specifics, according to Cyriac Roeding, CEO and co-founder of Stanford spinout Earli, who notes that companies such as AbbVie, J&J, Merck, Gilead and Novartis are developing the next-generation therapies. Any slowdown in AI will be temporary There is widespread agreement that AI will play an increased role in the way that pharma companies conduct business and especially in their efforts to make R&D more efficient, according to Witt. But in the short term, there could be a slowdown in its adoption, Ural warns, as the industry figures out how to shift from generative AI to agentic AI.“How fast AI evolved from generative AI to agentic AI has been stunning for the industry,” Ural said. “But now there is a tremendous inflection point for how the industry will be able to use AI. The adoption curve will probably be stalled as the industry is figuring out: How do I do the change management with individuals who will be using it in my company. What are the use cases that make the most sense? How do I adjust my workflow in my company?”Donaldson added that AI is becoming a more significant deal catalyst as people are getting a better understanding of its tangible impact.“You see AI being a major element for the pharma companies as they look to accelerate drug discovery, improve their clinical outcomes and success predictions, and also get much better commercial models,” Donaldson said. “I think there’s going to be a lot more AI deals going forward.” Are major consolidations in the works? During Trump’s first term as president, there was a run of huge transactions, with large drugmakers acquiring other companies of significant size.These included Takeda’s $64 billion takeover of Shire, AbbVie’s $63 billion buyout of Allergan and Bristol Myers Squibb’s acquisition of Celgene for $74 billion, which remains the largest deal in industry history. Each of these transactions included companies where both the buyer and the seller generated revenue of at least $15 billion in the year before the deal.Since then, biopharma has not seen any mergers that fall into this category. With Trump back in office, is it time to expect these similar-sized consolidations?Bisignano and Witt don’t think so, saying that investors in the current environment are insisting that capital be used “judiciously.”Donaldson agrees, saying that while the regulatory environment would likely not be an impediment to these sorts of transactions, he believes that drugmakers are no longer looking to grow horizontally. “I do think we’ll see, if anything, more downsizing of a lot of these companies and more focus,” Donaldson said. “Companies are not saying they want to be active in 25 therapeutic areas, like Pfizer was 20 years ago. I think you’re going to see much more specialization and focus on very specific areas and, if anything, more vertical integration within the areas that they dominate.”Van de Vyver dismisses the idea that Trump’s regulatory approach had much to do with the splurge of major biopharma deals in his first term. But he does see the potential for larger M&A deals.“There is an appeal to having scale, so that you can have multiple (blockbusters),” Van de Vyver said. “The cost to keep replenishing the pipeline has gotten higher. If prices are under pressure and innovation doesn’t become cheaper, pharma companies will need to find more efficiencies elsewhere and consolidation would be one way of getting those.” 

iStock, RomoloTavani These deals radically reshaped the biopharma world, either by one vaccine rival absorbing another, a Big Pharma doubling down after another failed acquisition or, in the case of Pfizer and Novo, two heavyweights duking it out over a hot obesity biotech. 2025 proved to be a high-drama year for dealmaking as pharmas fought over companies, swallowed their rivals and found inspiration in other companies’ transactions. The biggest deal of the year—Johnson & Johnson’s $14.6 billion buy of Intra-Cellular all the way back in January—didn’t even make the list of what BioSpace editors consider the most influential M&A deals of the year. While the year won’t go down as the biggest in value by any means, some of these deals will have an indelible impact on the industry for years to come. Pharmas dealt in obesity, cancer, cell therapy, mental health and a slate of others, growing and expanding their businesses. These deals, such as Pfizer’s fight to get an up-and-coming obesity biotech, AbbVie doubling down on psychedelics for mental health conditions and the fall of gene therapy’s darling shook and reshaped the biopharma sector in 2025, setting up excitement for the year ahead. Read on for 2025’s seven most impactful biopharma M&A deals. 1. The Pfizer/Novo/Metsera Saga, Obviously There could only be one story in the top spot, and it was the epic bidding war between Pfizer and Novo Nordisk over obesity startup Metsera. To make a long story short: Pfizer tried and repeatedly failed to develop a competitive obesity pipeline in-house. After several flunks earlier in 2025, the company looked to its business development team. Pfizer made a $4.9 billion offer for Metsera in September, to gain access to a long-acting GLP-1 and a long-acting amylin analogue. The deal seemed to be on the way to closing, until Novo offered an unsolicited $8.5 billion bid for the company a month later. Facing a different set of problems as the obesity space’s early leader, Novo was looking to rebuild its pipeline as rival Eli Lilly seemingly scored one win after another. A series of counteroffers, legal threats and FTC scrutiny followed, with Pfizer finally winning out for a price of about $9.2 billion for Metsera. With the dust now settled, Pfizer is back in the obesity business. The size of the obesity market, according to a Reports and Data analysis, is set to hit $27 billion yearly by as soon as 2028 and $150 billion by the early 2030s. The fight over Metsera seemed to indicate that Big Pharmas are still willing to go big in the obesity market. On the other hand, analysts wondered: Was it worth it? Obesity Is Metsera Worth the Fuss? Pfizer and Novo Nordisk seem to want Metsera bad. Analysts are wondering, though: Is the obesity biotech really worth this much effort? November 5, 2025 · 4 min read · Annalee Armstrong 2. BMS Spends $1.5B for Orbital as Others Retreat From Cell Therapy Over the course of 2025, there was a massive pullback from cell therapy, with Takeda and Novo Nordisk abandoning billions in long-term investments. But Bristol Myers Squibb doubled down. The Big Pharma plunked down $1.5 billion to get Orbital Therapeutics, snagging OTX-201, a circular RNA therapy that induces a patient’s own cells to make anti-CD19 CAR type constructs. The therapy is being tested to treat B cell–driven autoimmune disorders. The Orbital deal deepens BMS’ roots in cell therapy, adding to its approved anti-BCMA therpay Abecma , for relapsed or refractory multiple myeloma, and the CD19-directed Breyanzi for blood cancers. But the buy also told the industry that there is still potential in cell therapy if you know where to look. 3. Novo Deepens MASH Stature With $5.2B Akero Buy Metabolic dysfunction–associated steatohepatitis—MASH—is suddenly one of the buzziest sectors in the pharma industry again. Novo Nordisk paid $5.2 billion to get Akero Therapeutics in October, adding efruxifermin, which reduced liver fibrosis by 24% in a Phase IIb study that read out earlier this year . It was such a good result that it pushed Roche to go hunting for an anti-MASH molecule, spurring that company’s purchase of 89bio for $3.5 billion in September. The Akero buy only deepened Novo Nordisk’s presence in the MASH space, as its multi-blockbuster GLP-1 Wegovy received approval for the liver condition in August . The Roche and Novo deals marked a turning point for the MASH space, which Big Pharma had largely abandoned years ago after numerous failures. The small biopharma Madrigal Pharmaceuticals finally broke through with the 2024 approval of Rezdiffra in MASH, reigniting interest in the space. Psychedelics Psychedelics Space Enters New Era as AbbVie Dives In With AbbVie’s $1.2 billion acquisition of Gilgamesh Pharmaceuticals’ lead depression drug, the psychedelic therapeutics space has soundly rebounded from Lykos’ rejection last year. There are now seven programs in Phase III trials across the sector, with multiple companies vying for that first approval. September 22, 2025 · 6 min read · Heather McKenzie 4. AbbVie Goes Back to the Mental Health Well With Gilgamesh Buy AbbVie paid $1.2 billion to get just one asset from neurotech biotech Gilgamesh Pharmaceuticals in August . That gave them an entree at a table that Big Pharma has nibble at for a while: psychedelics. AbbVie gained bretisilocin, a fast-acting analogue of dimethyltryptamine (DMT) for major depressive disorder (MDD). The rest of Gilgamesh’s pipeline spun out into a separate company, Gilgamesh Pharma Inc., which carries on an existing AbbVie partnership. The Gilgamesh buy suggested that AbbVie was undeterred after a $9 billion quagmire in the form of Cerevel . AbbVie paid the princely sum to get the company and its schizophrenia asset emraclidine in 2023, which went on to flunk Phase II trials one year later . The Gilgamesh deal helped galvanize interest in psychedelics. AbbVie’s investment came at a time when most neuropsych-focused pharmas “have kept a distance,” from psychedelics according to Aaron Bartlone, CEO of the Canadian mental health biotech Cybin. The only other Big Pharmas in the psychedelics space right now are Johnson & Johnson, with its ketamine derivative Spravato, and Japanese giant Otsuka. The latter paid $59 million in 2023 to absorb Mindset, a Canadian psychedelics biotech. 5. Bluebird—Ahem, Genetix—Goes Private Bluebird was the standard bearer of gene therapy, until it wasn’t. Private equity outfits The Carlyle Group and SK Capital bought the biotech, which at one time had been worth north of $10 billion, for a scant $50 million in February . It was a precipitous fall for bluebird, which had more than $1 billion in cash the first quarter of 2021. That number fell to just $118.7 million by the third quarter of 2023 . Gene therapy is facing a “ cold winter ,” as promising science has not translated to good business, with sky-high costs and infrastructure issues hobbling the sector. Still, Carlyle and SK have options for turning bluebird’s assets into profits—including just selling the three approved gene therapies off, as PitchBook Senior Biotech Analyst Kazi Helal suggested to BioSpace in July. Those assets are Lyfgenia for sickle cell disease, Skysona for cerebral adrenoleukodystrophy and Zynteglo for beta thalassemia. Bluebird’s sale was the biggest indicator of a growing trend: the entry of private equity into the biotechnology space. In the last few years, PE firms like BlackStone have launched life sciences–focused funds, put billions of dollars into backing new ventures and even funded individual professors’ research. Bluebird renamed itself to Genetix in September , shedding a unique biopharma name adopted in 2010 and returning to its original moniker. Deals Bluebird Go-Private Deal Signals the ‘PE-ization of Pharma’ Why did two private equity firms with more than $460 billion under management want a little old gene therapy biotech called bluebird bio? We wanted to know. July 2, 2025 · 7 min read · Annalee Armstrong 6. Once Hot Sage Fades Away in Supernus Buy In late November 2024, Sage’s lead asset dalzanemdor flunked a Phase II trial for Huntington’s disease, the third such fail for the drug. It was just the capstone of a series of setbacks for Sage over the last few years; another asset, SAGE-324, flunked a Phase II study for essential tremor and was discontinued, and its Biogen-partnered postpartum depression drug Zurzuvae failed to get FDA approval in major depressive disorder. Maryland-based Supernus stepped in and scooped up Sage for $795 million in June . It was a “good end” for the company, according to analysts, and represented a much larger buyout than one put forward by long-time partner Biogen in January. Biogen offered $469 million to fold in its partner in Zurzuvae in January 2025 . Sage declined the offer with extreme prejudice, going so far as to sue Biogen. Along with Zurzuvae, Supernus absorbed Sage’s other approved drugs: the ADHD medication Qelbree; Onapgo, a wearable device for treating motor fluctuations associated with Parkinson’s disease; and Gocovri, for treating dyskinesia in Parkinson’s. Stifel analysts, writing at the time of the Supernus buy, said that it “feels like an unremarkable outcome for a company that was once one of the hottest stories” in treating central nervous system disorders. 7. BioNTech Ends CureVac Rivalry With a Pot of Money In 2022, BioNTech said in a lawsuit that it faced “threats of a groundless patent infringement suit” from a company that was “unable to bring to market any product to help in the fight against COVID-19.” Three years later, BioNTech bought that company, CureVac, for $1.25 billion, ending a winding legal drama that was still ongoing at the time of the deal. That purchase gave BioNTech a new mRNA-based therapy for the tough brain cancer glioblastoma. Despite both companies gaining fame for working on vaccines, the deal was motivated mostly by interest in cancer. Getting access to CureVac’s pipeline of cancer immunotherapies “marks the next milestone in the execution of [BioNTech’s] oncology strategy,” the company said in announcing the deal. Despite regulatory headwinds prevailing against mRNA-based therapies and vaccines in the U.S.—like the federal government canceling hundreds of millions of dollars in research dollars aimed at projects using the technology—BioNTech’s bid to swallow up its rival is a signal that, even as the company diversifies into other modalities like bispecifics , mRNA-based therapies as a platform are here to stay. .responsive-container { display: flex; flex-wrap: wrap; border: 1px solid #ededed; font-family: Helvetica, Arial, Sans-Serif; padding: 20px 20px 10px 20px; } .column-left { flex: 1; max-width: 45%; padding: 20px 20px 10px 20px; } .column-right { flex: 2; padding: 20px 20px 10px 20px; } @media (max-width: 768px) { .column-left, .column-right { max-width: 100%; flex: 100%; padding: 10px 0; } } Subscribe to BioPharm Executive! 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