The latest insights on M&A activity in life sciences commercial vendors
As part of our quarterly pharmaceutical industry review, we’re pleased to share an update on merger and acquisition activity to help our clients understand the market dynamics impacting pharmaceutical manufacturers, service providers, and their supplier relationships.
Key M&A highlights in Q4 2025
✓ Q4 2025 marked the strongest quarter for pharmaceutical M&A activity in recent years, with six of the ten largest transactions of 2025 announced in the fourth quarter. Total deal value surged to approximately $67.5 billion in Q4 alone, bringing total 2025 M&A value to over $179 billion—a 31% increase year-over-year.
✓ The obesity therapeutics bidding war between Pfizer and Novo Nordisk for Metsera captivated the industry, culminating in Pfizer’s approximately $10 billion victory. The dramatic competition—involving legal battles, FTC intervention, and escalating offers—underscored the strategic importance of next-generation GLP-1 assets as companies position for the weight-loss market projected to reach $150 billion annually by decade’s end.
✓ RNA therapeutics emerged as a major investment theme, highlighted by Novartis’s $12 billion acquisition of Avidity Biosciences—the largest pharma deal of Q4 and Novartis’s biggest acquisition in over a decade. The deal brings first-in-class antibody oligonucleotide conjugates for neuromuscular diseases, signaling confidence in precision RNA delivery platforms.
✓ MASH (metabolic dysfunction-associated steatohepatitis) became the hottest therapeutic space of 2025, with three major FGF21 analog acquisitions totaling over $10 billion: Novo Nordisk’s $5.2 billion acquisition of Akero Therapeutics and Roche’s $3.5 billion purchase of 89bio, both completing in Q4, plus GSK’s earlier purchase of Boston Pharmaceuticals’ asset.
✓ Merck continued its aggressive pipeline diversification with the $9.2 billion Cidara Therapeutics acquisition for a first-in-class long-acting flu prevention drug—aimed at offsetting Keytruda’s looming patent cliff beginning in 2028.
✓ Biotech-on-biotech acquisitions demonstrated the evolving dealmaking landscape, with Genmab’s $8 billion purchase of Merus representing a significant move by a mid-cap company into the top tier of acquirers. The deal, centered on breakthrough bispecific antibody petosemtamab for head and neck cancer, closed in late December.
✓ Rare disease consolidation accelerated, with BioMarin’s $4.8 billion acquisition of Amicus Therapeutics combining two pioneering companies in lysosomal storage disorders. The deal adds approved Fabry and Pompe disease treatments with $600 million in combined annual revenue.
✓ Contingent value rights (CVRs) became the defining deal structure of 2025, appearing in nearly all major transactions as buyers seek to de-risk acquisitions while sellers capture upside potential. Average milestone payments increased 255% in Q4 compared to Q3, reflecting continued caution amid optimism.
✓ Bidding wars returned to pharma M&A after years of relative quiet, with the Pfizer-Novo contest for Metsera and the Alkermes-Lundbeck competition for Avadel demonstrating renewed urgency among acquirers facing patent cliffs and pipeline gaps.
2025 Q4 Activity Highlights
In the fourth quarter of 2025, pharmaceutical industry M&A activity reached exceptionally robust levels, with Q4 surpassing Q3’s already strong $43.2 billion total. The following significant deals were announced or completed:
1. Novartis acquires Avidity Biosciences for $12 billion (October 2025)
Novartis announced on October 26, 2025 a definitive agreement to acquire Avidity Biosciences, Inc., a San Diego-based biopharmaceutical company pioneering Antibody Oligonucleotide Conjugates (AOCs) for serious neuromuscular diseases, for $72 per share in cash, representing an approximately $12 billion total value.
The acquisition brings three late-stage clinical programs to Novartis: delpacibart zotadirsen for Duchenne muscular dystrophy (DMD), delpacibart etedesiran for myotonic dystrophy type 1 (DM1), and delpacibart braxlosiran for facioscapulohumeral muscular dystrophy (FSHD). Avidity’s AOC platform enables targeted RNA delivery to muscle tissue—a breakthrough capability previously considered difficult to achieve.
This represents Novartis’s largest acquisition in over a decade and extends its established position in spinal muscular atrophy into broader neuromuscular therapeutics. Novartis has raised its 2024-2029 sales growth forecast from 5% to 6% as a result and anticipates multiple product launches before 2030. Prior to closing, Avidity will spin off its early-stage precision cardiology programs into a separate publicly traded company. The transaction is expected to close in H1 2026.
2. Pfizer wins bidding war for Metsera at approximately $10 billion (November 2025)
Pfizer completed on November 13, 2025 its acquisition of Metsera, Inc., a clinical-stage biopharmaceutical company developing next-generation obesity and cardiometabolic medicines, following a dramatic bidding war with Novo Nordisk. The final deal valued Metsera at approximately $10 billion, consisting of $65.60 per share in cash plus contingent value rights worth up to $20.65 per share tied to clinical and regulatory milestones.
The acquisition saga escalated dramatically from Pfizer’s initial $4.9 billion offer announced in Q3. Novo Nordisk made an unsolicited $6.5 billion offer in late October, subsequently raised to approximately $7.6 billion. After Pfizer filed lawsuits alleging antitrust violations and the FTC warned of “potential risks” with Novo’s deal structure, Metsera’s board determined Novo’s proposal presented “unacceptably high legal and regulatory risks” and accepted Pfizer’s sweetened offer.
The deal brings Pfizer a pipeline including MET-097i, a once-monthly GLP-1 receptor agonist, and MET-233i, a long-acting amylin analog. CEO Albert Bourla indicated therapies could reach market as early as 2028, helping Pfizer enter the obesity market after internal development setbacks with discontinued candidates lotiglipron and danuglipron.
3. Merck acquires Cidara Therapeutics for $9.2 billion (November 2025)
Merck announced on November 14, 2025 a definitive agreement to acquire Cidara Therapeutics, Inc., a biotechnology company developing drug-Fc conjugate therapeutics, for $221.50 per share in cash—a 109% premium to the prior closing price—for a total transaction value of approximately $9.2 billion.
The acquisition centers on CD388, a potentially first-in-class, long-acting antiviral designed to prevent influenza in individuals at higher risk of complications. Unlike vaccines, CD388 aims to provide season-long protection regardless of immune status, with a single dose showing up to 76% protection from symptomatic influenza over 24 weeks in Phase 2 trials. The drug received FDA Breakthrough Therapy Designation in October 2025 and is currently in Phase 3 trials.
This acquisition continues Merck’s science-led business development strategy to diversify revenue sources ahead of Keytruda’s patent expirations beginning in 2028. The deal is expected to close in Q1 2026.
4. Genmab acquires Merus for $8 billion (September-December 2025)
Genmab A/S announced on September 29, 2025 a definitive agreement to acquire Merus N.V., a Netherlands-based clinical-stage biotechnology company, for $97 per share in an all-cash transaction valued at approximately $8 billion. The tender offer was completed on December 12, 2025, with approximately 94% of shares tendered, and the acquisition was finalized on December 30, 2025.
The deal adds petosemtamab, a potentially first- and best-in-class EGFRxLGR5 bispecific antibody for head and neck cancer, to Genmab’s portfolio. Petosemtamab has received two FDA Breakthrough Therapy Designations and demonstrated compelling Phase 2 results showing a 79% 12-month survival rate. Two Phase 3 trials are ongoing with topline readouts anticipated in 2026.
This acquisition marks Genmab’s evolution from a royalty-focused company to a global biotechnology leader with wholly owned commercial assets. Genmab anticipates petosemtamab launch in 2027 with at least $1 billion in annual sales potential by 2029. The deal was funded through cash on hand and approximately $5.5 billion in debt financing.
5. Novo Nordisk acquires Akero Therapeutics for up to $5.2 billion (October-December 2025)
Novo Nordisk announced on October 9, 2025 a definitive agreement to acquire Akero Therapeutics, Inc., a clinical-stage company focused on metabolic diseases, for $54 per share in cash ($4.7 billion) plus a contingent value right worth up to $6 per share ($0.5 billion), for a total potential value of $5.2 billion. The transaction closed on December 9, 2025.
The acquisition brings efruxifermin (EFX), a potentially best-in-class FGF21 analog for treating metabolic dysfunction-associated steatohepatitis (MASH). EFX is the only FGF21 analog to demonstrate significant fibrosis regression in Phase 2 trials for patients with compensated cirrhosis (F4)—the most advanced stage of liver fibrosis. Three Phase 3 trials are ongoing.
This represents the first major acquisition by Novo Nordisk’s new CEO Mike Doustdar, who took the helm in July 2025, and signals the company’s strategy to address obesity-related comorbidities. The deal positions Novo to address the full MASH disease spectrum, pairing GLP-1s like Wegovy (approved for MASH in August 2025) for early-stage patients with efruxifermin for those with advanced liver damage.
6. BioMarin acquires Amicus Therapeutics for $4.8 billion (December 2025)
BioMarin Pharmaceutical Inc. announced on December 19, 2025 a definitive agreement to acquire Amicus Therapeutics for $14.50 per share in an all-cash transaction valued at approximately $4.8 billion—a 33% premium to Amicus’s prior closing price. This represents BioMarin’s largest acquisition in its 28-year history.
The acquisition adds two marketed products: Galafold (migalastat), the first oral treatment for Fabry disease with $458 million in 2024 sales, and the Pombiliti plus Opfolda combination therapy for Pompe disease. Combined, these products generated approximately $600 million in revenue over the past four quarters. BioMarin also gains U.S. rights to DMX-200, a potential first-in-class treatment for focal segmental glomerulosclerosis (FSGS) in Phase 3.
The deal unites two pioneering rare disease companies, expanding BioMarin’s portfolio to 10 marketed therapies. The transaction is expected to close in Q2 2026.
7. Roche acquires 89bio for up to $3.5 billion (September-October 2025)
Roche announced on September 18, 2025 a definitive agreement to acquire 89bio, Inc. for $14.50 per share in cash at closing ($2.4 billion) plus a non-tradeable CVR worth up to $6 per share ($1.1 billion), for a total potential value of approximately $3.5 billion. The tender offer closed on October 29, 2025, with approximately 60% of shares tendered, and the second-step merger completed the same day.
The acquisition brings pegozafermin, a FGF21 analog currently in late-stage development for MASH in moderate to severe fibrotic patients (F2, F3, and F4 stages). This marked Roche’s entry into the MASH therapeutic space and underscores its dedication to advancing cardiovascular, renal, and metabolic disease (CVRM) therapies.
Together with Novo Nordisk’s Akero acquisition, the 89bio deal demonstrates the strategic value pharmaceutical companies are placing on FGF21 analogs as a distinct and potentially complementary approach to treating MASH alongside GLP-1 therapies.
8. Alkermes acquires Avadel Pharmaceuticals for up to $2.4 billion (October-November 2025)
Alkermes plc announced on October 22, 2025 a definitive agreement to acquire Avadel Pharmaceuticals plc for up to $20 per share, valuing the company at approximately $2.1 billion. Following an unsolicited competing bid from Lundbeck in November, Alkermes increased its offer to up to $22.50 per share—$21 in cash plus a $1.50 CVR—valuing Avadel at up to approximately $2.4 billion.
The acquisition adds LUMRYZ (sodium oxybate), the first and only once-at-bedtime oxybate approved by the FDA for treating cataplexy or excessive daytime sleepiness in patients with narcolepsy, to Alkermes’s commercial portfolio. LUMRYZ is projected to generate $265-275 million in 2025 revenue.
This strategic move accelerates Alkermes’s entry into sleep medicine ahead of its orexin receptor agonist alixorexton advancing toward Phase 3 trials. The deal is expected to close in Q1 2026.
9. Sanofi acquires Dynavax Technologies for $2.2 billion (December 2025)
Sanofi announced on December 24, 2025 a definitive agreement to acquire Dynavax Technologies Corporation for $15.50 per share in cash, representing a total equity value of approximately $2.2 billion and a 39% premium over the prior closing price.
The acquisition brings HEPLISAV-B, an adult hepatitis B vaccine differentiated by its two-dose regimen over one month (versus three doses over six months for competitors), which generated $268 million in 2024 sales and holds approximately 46% U.S. market share. The deal also includes Z-1018, a shingles vaccine candidate in Phase 1/2 development that demonstrated immune response comparable to GSK’s market-leading Shingrix with a better safety profile.
This represents Sanofi’s second billion-dollar vaccines acquisition of 2025, augmenting its adult immunization presence. The deal is expected to close in Q1 2026.