The largest deal in recent months and indeed for a while, was the acquisition of Alexion Pharmaceuticals by AstraZeneca for a sizable $39 billion. Many companies in the past had been tipped to buy rare disease specialist Alexion but it is AstraZeneca who will now take over the company and its immunology and rare disease pipeline. Through the deal AstraZeneca will gain the rare blood disorder drug Soliris (eculizumab) and Ultomiris (ravulizumab) which is a monoclonal antibody developed for paroxysmal nocturnal haemoglobinuria.

In early November, Novo Nordisk announced that it would acquire drug delivery company Emisphere in a deal worth $1.8 billion, and it completed the acquisition on 8 December. The deal includes the Eligen SNAC technology, which can be used to enable oral delivery of biologics such as Novo Nordisk’s semaglutide, a peptide drug that is approved for the treatment of type 2 diabetes.

In another billion dollar deal, Novartis signed a licensing deal with Mesoblast for the development and commercialization of remestemcel-L, a cell therapy-based therapeutic developed for acute respiratory distress syndrome (ARDS), and being investigated for COVID-19-associated ARDS. Novartis will pay Mesoblast an upfront payment of $25 million, and will invest $25 million in Mesoblast equity. The deal will also include pre- and post- commercialization milestone payments that may total more than $1 billion.

During November and December Merck invested billions of dollars in oncology. First it acquired clinical-stage biopharmaceutical company VeLos Bio for $2.75 billion, which is developing a pipeline of oncology candidates focused on the receptor tyrosine kinase-like orphan receptor 1 (ROR1). The acquisition includes lead candidate VLS-101, an antibody-drug conjugate in clinical development for hematological malignancies and solid tumors.

Merck then signed a $1 billion deal with Janux Therapeutics for two of its T cell engager therapy programs that are being developed using Janux’ Tumor Activated T Cell Engager (TRACTr) platform. The program targets will be selected by Merck, which will then have exclusive rights to any successfully developed products in the future, leaving Janux eligible for a number of milestone payments on each program.

Finally Eli Lilly announced its purchase of gene therapy company Prevail Therapeutics for up to $1 billion in mid-December. Prevail brings with it a line of adeno-associated virus vector (AAV)-based development candidates for neurodegenerative disorders including programs for Parkinson’s disease, Gaucher disease and dementia amongst others.