Biostrategenix

Oncology & Rare Diseases Dominate the Deals in 2024-25

Global biopharma M&A has been muted post‑2023 but remains strategically critical. Deal values and volumes fell in 2024, with 2024 activity dominated by mid‑cap transactions rather than mega‑deals[1][2]. Many large‐cap companies are pursuing a “string‑of‑pearls” approach – acquiring smaller firms or assets to refill aging pipelines and hedge patent cliffs[3][2]. For example, according to Bain, historically active acquirers like Gilead, Merck and AbbVie continue to do deals despite the downturn[4]. Notably, deals in the $1–10 billion range have been most common, rather than blockbuster $20–40 billion mergers[3][1]. As one analyst observed, “not a single deal announcement outside of GLP‑1 manufacturing plays has surpassed $5 billion” in 2024[5].

Therapeutic Areas: Oncology, Immunology, and Rare Diseases

Oncology remains a top priority. Cancer therapies – especially targeted and precision modalities – have driven the largest transactions. In 2024–2025, more deals above $1 billion were in cancer than any other area[6][7]. Big pharma is snapping up antibody‑drug conjugates (ADCs), radiopharmaceuticals and precision oncology assets. For instance, AbbVie paid $10.1 billion for ImmunoGen (ovarian cancer ADC Elahere)[7], and J&J acquired Ambrx for ~$2 billion to access its portfolio of cancer ADC programs[8]. Radioligand targets have also been hot – BMS’s $4.1 billion purchase of RayzeBio gives it actinium‑based radioimmunotherapies for neuroendocrine and solid tumors[9], and AstraZeneca’s $2.4 billion Fusion deal added a PSMA‑targeted radioconjugate for prostate cancer[10]. Novartis made two oncology plays: Morphosys (for antibody drugs incl. pelabresib in myelofibrosis) and Mariana Oncology (radiopharma), underscoring this focus[6][11]. Even smaller deals reinforced oncology emphasis (e.g. Ono’s $2.4B buy of Deciphera, adding GIST and rare solid‑tumor drugs[12]).

Immunology and inflammation. With blockbusters like Humira/Stelara losing patent protection, companies have sought new biologics for autoimmune and inflammatory diseases[13]. Examples include Vertex’s $4.9 billion acquisition of Alpine Immune Sciences for its IgA nephropathy (autoimmune kidney) drug[14] and Sanofi’s ~$3.2 billion purchase of Morphic’s oral therapies for IBD (ulcerative colitis/Crohn’s)[13]. Lilly paid $3.2 billion for Morphic (late‑stage IBD drugs)[13]. These deals highlight that rare/immunologic niches (e.g. IgA nephropathy, alpha‑1 antitrypsin deficiency) are attracting big‑pharma interest as potential future blockbusters. (Notably, Vertex called Alpine’s lead IgA drug a “pipeline in a product”[15].)

Rare diseases. Acquisitions in rare or orphan indications surged. By definition, rare diseases have small patient populations, but “large unmet need, scientific advances and orphan incentives” have driven huge M&A value in this sector[16]. For example, Gilead’s $4.3 billion deal for CymaBay (with seladelpar for primary biliary cholangitis, a rare liver disease) closed ahead of FDA approval[17]. AstraZeneca spent $1.0 billion on Amolyt Pharma for a late‑stage peptide treating hypoparathyroidism (very rare hormonal disorder)[18]. Vertex’s Alpine (IgA nephropathy) and Ono’s Deciphera (rare sarcomas, GIST) are similar examples[14][12]. Analysts note that over 95% of rare diseases lack approved therapies[16], creating lucrative opportunities (enhanced by orphan‑drug exclusivities and pricing). Biogen and J&J also made targeted buys in rare diseases (e.g. Biogen’s IgA nephropathy candidate via HI‑Bio, J&J’s AATD therapy from Yellow Jersey)[13].

Other areas of interest include neuroscience (e.g. BMS’s acquisition of Karuna Therapeutics for schizophrenia[19] and AbbVie’s $8.7 billion buy of Cerevel (Parkinson’s, Alzheimer’s psychosis)[20]) and metabolic/obesity: unprecedented GLP-1 (diabetes/weight‑loss) demand spurred capacity moves (see Drivers below).

Notable Recent Deals (2024–2025)

Noteworthy M&A transactions (completed or announced) illustrate these trends:

• Novo Holdings (Novo Nordisk) → Catalent ($16.5B announced, pending) – acquisition of CDMO Catalent to secure injectable manufacturing capacity for GLP‑1 drugs (Ozempic/Wegovy)[21].
• Bristol-Myers Squibb → Karuna Therapeutics ($14B, closed Mar 2024) – neuroscience play for schizophrenia therapy KarXT[19].
• AbbVie → ImmunoGen ($10.1B, closed Jun 2024) – acquired ovarian cancer ADC Elahere and ADC pipeline[7].
• AbbVie → Cerevel Therapeutics ($8.7B, closed Aug 2024) – expanded CNS pipeline (schizophrenia, Parkinson’s, depression)[20].
• Bristol-Myers Squibb → Mirati Therapeutics ($5.8B, closed Jan 2024) – gained lung cancer drug Krazati and oncology pipeline[22].
• Vertex Pharmaceuticals → Alpine Immune ($4.9B, closed May 2024) – lead drug for IgA nephropathy (kidney disease)[14].
• Gilead Sciences → CymaBay ($4.3B, closed Mar 2024) – PBC (rare liver disease) drug seladelpar (with pending FDA review)[17].
• Bristol-Myers Squibb → RayzeBio ($4.1B, closed Feb 2024) – actinium radiopharma pipeline targeting NETs, lung, liver cancers[9].
• Roche → Carmot Therapeutics ($3.1B, closed Jan 2024) – three clinical GLP-1/obesity/diabetes assets (including a weekly obesity injectable and daily T1D peptide)[23].
• Novartis → MorphoSys (€2.7B/$2.9B, closed Jun 2024) – antibody therapeutics including pelabresib (myelofibrosis)[11].
• AstraZeneca → Fusion Pharmaceuticals ($2.4B, closed Jun 2024) – PSMA-directed actinium radioconjugate for metastatic prostate cancer[10].
• AstraZeneca → Amolyt Pharma ($1.0B, closed Jul 2024) – eneboparatide for hypoparathyroidism (rare endocrine)[18].
• Johnson & Johnson → Ambrx Biopharma (~$2B, closed Mar 2024) – ADC pipeline in multiple cancers (prostate, breast, renal)[8].
• Ono Pharmaceutical → Deciphera ($2.4B, closed Jun 2024) – adds Qinlock (GIST cancer) and an experimental drug for tenosynovial giant cell tumors[12].
• Sanofi → Morphic (~$3.2B, closed Sep 2024) – oral therapies for ulcerative colitis and Crohn’s disease[13].
• Eli Lilly → Scorpion Therapeutics (program) (~$2.5B, announced Jan 2025) – acquired STX‑478, an experimental PI3Kα inhibitor for breast/solid tumors[24].

This non‑exhaustive list spans large-cap deals (e.g. Novo/Catalent, BMS/Karuna) and mid‑cap transactions, covering oncology, CNS, immunology, rare and metabolic areas. Notably, nearly all involve pharma or biotech firms acquiring drug pipelines or platforms.

Drivers of Deal Activity

Several factors drive this M&A wave beyond any change in patient numbers:

• Pipeline renewal and patent cliffs. As blockbuster drugs (e.g. AbbVie’s Humira, J&J’s Stelara) face generic erosion, companies must replenish future revenues. Executives repeatedly cite “refilling mature pipelines” as the reason for deals[2]. Acquirers embrace a “string-of-pearls” strategy – buying early/mid-stage assets to hedge risk[3]. Deals like Novartis/Anthos ($3.1B, cardio) and Sanofi/Blueprint ($9.1B, immunology) are explicitly to shore up pipelines[25].
• High-value niches and innovation. Rare diseases and novel modalities command premium prices. Governments incentivize orphan drugs (priority review, market exclusivity, tax credits)[16], making even small markets lucrative. For example, IgA nephropathy and PBC have tiny patient pools but breakthrough-designated drugs (Alpine’s and CymaBay’s) sparked multi-billion buyouts. Big pharmas are also chasing cutting-edge tech: antibody‑drug conjugates, bispecifics, radioligands, cell/gene therapies, etc. Pfizer’s $43B Seagen (2023) and BMS’s $3.8B BioNTech license (2025) highlight such interest[7][26]. Unproven platforms get big valuations partly on future promise.
• Market opportunity. In fields like oncology and immunology, underlying demand (aging population, obesity, lifestyle diseases) remains strong. Moreover, rising obesity/diabetes prevalence has propelled a GLP-1 “gold rush.” Notably, pharma’s M&A report flags diabetes/weight‑loss as a future mega‑market[27]. Novo’s Catalent deal and Roche’s Carmot buy were directly about capturing GLP‑1 supply and pipeline. As Bain notes, “pharma companies are acquiring GLP-1 players” amid this boom[1].
• Financial and strategic factors. Many large pharmas have amassed cash from COVID-era revenues and low interest rates. At the same time, biotech valuations slid in 2024, making targets relatively cheaper. Deal activity follows the trend that frequent acquirers outperform: companies doing ≥1 deal/yr saw 12.2% annual TSR vs 0.3% for inactive peers[1]. In other words, Wall Street rewards smart M&A. Lower interest rates (expected) and modest rebound in 2025 could further fuel deals. Finally, regulatory changes are a spur: looming US drug import tariffs and pricing reforms are causing companies to reorient supply chains and portfolios, sometimes prompting divestitures and bolt-on acquisitions[28].
• Alternative deal structures. Because biotech risk is high, many recent agreements use contingent payments (milestones, earn-outs, royalties) rather than all cash upfront[29]. For example, Novartis’s Anthos deal is $3.1B with $925M up front[26]. This lets acquirers share risk with founders and align payments with clinical success.

In sum, the deals are driven largely by strategic and financial considerations – not by a sudden explosion in disease incidence. The appetite for rare and oncology assets reflects long-term market potential and unmet need[16], more than sheer patient numbers.

US vs Global Trends

Both U.S. and non-U.S. players have been active in similar areas, though some regional patterns emerge. U.S. companies (AbbVie, BMS, Lilly, Gilead, Johnson & Johnson, Vertex, etc.) have mainly acquired U.S. or global biotech assets to bolster pipelines in oncology, immunology and CNS[7][4]. For example, AbbVie’s ImmunoGen (MA) and Lilly’s Morphic (MA) deals were U.S. targets.

European/Japanese firms (Novartis/Switzerland, AstraZeneca/UK, Roche/Switzerland, Ono/Japan, etc.) have likewise pursued oncology and rare‑disease deals worldwide. Notable cross-border moves include Novartis’s buys of German (MorphoSys) and U.S. firms (Anthos), AstraZeneca’s acquisitions in Canada (Fusion) and the U.S. (Amolyt via U.S. subsidiary), and Ono (Japan) taking over Massachusetts‑based Deciphera.

Overall, there is no stark difference in therapeutic focus: oncology, rare diseases and immunology dominate on both sides of the Atlantic[6][16]. If anything, U.S. regulatory/policy headwinds may make deal valuations trickier: proposed import tariffs and US drug pricing reforms have added uncertainty. PwC notes that “cross-border M&A is facing higher scrutiny” and companies are modeling tariffs and pricing effects into deal valuations[28]. This may slightly dampen outbound deals, but not enough to alter the central strategy: acquiring innovation wherever it is.

Impact and Beneficiaries

Big Pharma: The acquiring companies stand to gain most from successful deals. They absorb new products/pipelines, prolong revenue growth, and gain market share in hot categories. Historically, companies that actively do deals outgrow peers – one analysis found acquirers achieved 12.2% annual TSR vs 0.3% for non‑acquirers[1]. In practice, an AbbVie or Novartis that buys a rising star biotech can replace lost blockbusters and justify premium valuations.

Biotech Shareholders/Founders: Owners of target companies also benefit, typically receiving rich upfront payments and upside in milestone deals. Especially for venture‑backed firms, an M&A exit in 2024‑25 has been one of the few paths to liquidity given the IPO drought. For example, Alpine Immune’s investors got a ~4x return when Vertex agreed to buy them[14].

Patients & Healthcare: In the longer term, successful M&A can accelerate development of new therapies. Consolidation can provide smaller firms with the resources to run large trials or scale manufacturing. However, payers and public health advocates watch such deals warily, worried about pricing and competition. From a commercial perspective, orphan and oncology drugs typically command high prices, so payers may face higher costs. Still, industry sources note that M&A is often “a critical cog in the biopharma machine” to bring new treatments to market[2].

Investors & Market: The overall effect is a reallocation of capital toward innovation in cancer, immunology and rare diseases. M&A activity indicates where companies see future profit pools. As one commentary put it, “pharma’s high-growth areas include immunology and oncology”[30] – meaning investors will follow the deals. Conversely, smaller or generic‑oriented firms see less M&A, reflecting a strategic shift into life‑cycle management and specialty drugs.

In summary, 2024–2025 pharma/biotech M&A has been strategic and targeted. Despite a general downturn in dealmaking, the largest transactions have clustered in oncology, immunology and rare diseases[6][16]. These are driven by unmet medical need, patent expiries and the pursuit of cutting-edge platforms rather than a sudden demographic shift. Large and mid‑cap companies alike are retooling their portfolios via acquisitions: the winners will be those securing tomorrow’s blockbusters, while smaller players cashing out or gaining resources to survive in a capital‑tight environment.

Sources: Analysis is based on industry reports and databases[2][3][21][7][11][24][16], including FiercePharma, PharmaVoice, DCAT, PwC, Bain and Reuters. Each cited source provides details on specific deals and market analysis as referenced above.

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[1] [4] [27] [30] M&A in Healthcare and Life Sciences | Bain & Company: https://www.bain.com/insights/healthcare-and-life-sciences-m-and-a-report-2025

[2] [5] [6] [13] [15] Among 2024’s modest M&A action, cancer, immunology and neuroscience deals trickle in | PharmaVoice: https://www.pharmavoice.com/news/pharma-acquisitions-mergers-immunology-cancer-neuroscience-vertex-novartis-lilly/732206

[3] [25] [26] [28] [29] Global M&A trends in health industries: 2025 mid-year outlook | PwC: https://www.pwc.com/gx/en/services/deals/trends/health-industries.html

[7] [8] [9] [10] [11] [12] [14] [17] [18] [19] [20] [21] [22] [23] Bio/Pharma’s Top Mergers & Acquisitions Thus Far in 2024 – DCAT Value Chain Insights: https://www.dcatvci.org/features/bio-pharmas-top-10-top-mergers-acquisitions-thus-far-in-2024/

[16]  Navigating Key Challenges in M&A Deals in the Rare Disease Sector – As Prescribed: https://www.morganlewis.com/blogs/asprescribed/2025/02/navigating-key-challenges-in-m-a-deals-in-the-rare-disease-sector

[24] Eli Lilly to buy Scorpion Therapeutics’ cancer therapy for up to $2.5 billion | Reuters: https://www.reuters.com/business/healthcare-pharmaceuticals/eli-lilly-buy-cancer-drug-developer-scorpion-therapeutics-25-bln-2025-01-13