Pharma M&A Activity Picks Up Pace: What Does It Signal for 2026?

After a muted start to 2025, Big Pharma is back on the M&A trail. In just a month, three major players — Pfizer PFE, Novo Nordisk NVO and Roche RHHBY — announced multi-billion-dollar deals targeting the fast-growing, lucrative metabolic and obesity-related disease space.

Pfizer Takes Another Shot at Obesity

Last month, this U.S.-based pharma giant announced a definitive agreement to acquire obesity drug developer Metsera for $47.50 per share in cash, representing a total enterprise value of $4.9 billion. The deal also includes a non-transferable contingent value right (CVR) of up to $22.50 per share, contingent upon the achievement of certain clinical and regulatory milestones.

This deal is significant since it marks Pfizer’s attempt to re-enter the lucrative obesity space after it scrapped the development of its oral GLP-1 drug, danuglipron, earlier this year. The transaction — expected to be completed before this year’s end — will add four novel clinical-stage incretin and amylin programs to Pfizer’s pipeline. This portfolio also includes Metsera’s lead candidate MET-097i, an injectable GLP-1 RA drug which is being evaluated in mid-stage studies for both weekly and monthly dosing schedules.

Roche to Expand Into Metabolic Liver Disease

The Swiss-based drugmaker announced that it is buying the clinical-stage biotech 89bio to augment its portfolio in cardiovascular, renal and metabolic diseases (CVRM). If the deal goes through, Roche will add 89bio’s key pipeline candidate, pegozafermin, a novel FGF21 analog, which is currently being developed in a late-stage program for metabolic dysfunction-associated steatohepatitis (MASH) — a fatty liver disease closely tied to obesity and diabetes. The total deal value is approximately $3.5 billion, including an upfront payment of $2.4 billion and $1 billion in non-tradeable CVRs, contingent on achievement of certain clinical and regulatory milestones.

MASH is one of the most prevalent comorbidities of obesity. The successful development of pegozafermin will therefore provide a good revenue opportunity for RHHBY, as obesity is currently one of the most lucrative spaces.

Novo Nordisk Deepens Its MASH Pipeline

The Denmark-based pharma giant announced plans to acquire Akero Therapeutics for $4.7 billion, plus $0.5 billion in non-tradeable CVR contingent payment tied to FDA approval of efruxifermin (EFX), Akero’s lead pipeline candidate. EFX is an FGF21 analog being evaluated across several late-stage studies for MASH.

The deal comes just a couple of months after Novo’s blockbuster obesity drug Wegovy received the FDA’s label expansion for MASH. Already one of the two leaders in the obesity market, Novo is now broadening its reach into adjacent areas like fatty liver — therapeutic fields that closely align with its existing diabetes and obesity portfolio.

M&A to Pick Up in 2026?

The recent acquisition deals suggest that Big Pharma is pursuing selective, innovation-driven biotech acquisitions rather than large-scale consolidation. Another noticeable trend is the shift in therapeutic focus — with M&A momentum moving away from oncology toward metabolic and cardio-metabolic diseases, where long-term growth potential now appears stronger.

At the same time, the current political climate is reshaping industry priorities. Recent drug pricing agreements between the Trump administration and major players like AstraZeneca and Pfizer have marked a turning point in U.S. healthcare policy. By trading price concessions for tariff exemptions and domestic investment incentives, these deals are prompting Big Pharma to redirect capital toward manufacturing and R&D expansion in the United States.

As companies allocate more funds toward building domestic infrastructure and production capacity, they are likely to have less capital available for large-scale acquisitions. Consequently, M&A activity is unlikely to accelerate significantly in 2026. To manage costs and reduce risk, industry players may increasingly favor collaboration and licensing agreements over outright takeovers.

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