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June 2026
Biopharma M&A Market Update and 2024 Outlook
Healthcare M&A activity declined in 2023 due, in part, to rising interest rates and persistent economic uncertainty. Biopharma was the most active healthcare subsector for M&A, while Services experienced the largest year-over-year decline due largely to a drop in financial sponsor activity. Looking forward to 2024, we expect Biopharma M&A activity to remain resilient as large pharmaceutical companies attempt to fill revenue and pipeline gaps via acquisitions of late- or commercial-stage companies. Furthermore, we expect to see more pre-commercial biopharma companies pursue strategic alternatives, including mergers, reverse mergers and cash-out transactions as a result of the challenging capital markets environment.
Healthcare | M&A Themes
- Healthcare M&A deal value was $181B YTD 2023, down 10% on an annualized basis, from $235B in 2022, while deal volume was 94 transactions YTD 2023, down 34% on an annualized basis, from 166 transactions in 2022
- Biopharmaceuticals remained the most active sub-sector of Healthcare and represented 58% of deal value and 33% of the number of Healthcare transactions in 2023 (vs. 36% of deal value and 27% of the number of Healthcare transactions in 2022)
- Oncology was the most active therapeutic area for M&A, with 11 deals totaling $49B in deal value (~$6B excluding Pfizer’s ~$43B announced acquisition of Seagen)
- Rare Disease was the second most active therapeutic area for M&A, with 9 deals totaling $13B in total deal value (~$6B excluding Biogen’s ~$7B acquisition of Reata)
- Immunology was the third most active therapeutic area for M&A, with 7 deals totaling $25B in total deal value (~$15B excluding Merck’s ~$10B acquisition of Prometheus)
- Healthcare services transaction activity is down significantly from 2022, with 27 deals totaling $44B in deal value vs. 71 deals totaling $89B in 2022
- HCIT activity is also depressed from 2022, with 6 deals totaling $5B in deal value vs. 21 deals totaling $25B in deal value in 2022
Healthcare | M&A Activity
$ in billions
4Q 2023 Healthcare | M&A Activity
$ in millions
Biopharma | M&A Themes
Biopharma M&A deal activity declined modestly in 2023 with the announcement of 44 deals YTD, down 11% on an annualized basis from 58 in 2022
- Both large cap and mid-cap biopharmas have taken advantage of the challenging capital markets environment to acquire commercial or late-stage assets to fill revenue gaps
- Pfizer – Seagen (~$44B transaction value at 45% unaffected premium)
- Biogen – Reata (~$7.1B transaction value at 59% unaffected premium)
- Astellas – Iveric (~$5.1B transaction value at 64% unaffected premium)
- Acquirers have moved early to protect / expand key franchises
- Novo Nordisk – Inversago (Metabolic – ~$1B transaction value for private target)
- Eli Lilly – Versanis (Obesity – Up to ~$1.95B transaction value for private target)
- Eli Lilly – DICE (Immunology – ~$2.4B transaction value at 42% unaffected premium)
- Acquirers seeking to establish new growth pillars have acted boldly or bid aggressively for targets
- Merck – Prometheus (Immunology – ~$10B transaction value at 75% unaffected premium)
- Sanofi – Provention (Immunology – ~$2.5B transaction value at 273% unaffected premium)
- GSK – Bellus Health (Respiratory – ~$1.6B transaction value at 103% unaffected premium)
- New equity issuance in biopharma has seen a slight uptick from 2022 in terms of pace, however remains down from elevated pandemic levels
- 135 IPOs and FOs priced through November 10, 2023, raising ~$22.8B in total issuance (compared to 118 through November 10, 2022, raising ~$18.4B in total issuance)
- Of the IPOs priced in 2023, 8% priced below the launch range and 83% are trading below issue
We expect biopharma M&A activity to remain elevated in 2024. On the supply side, given challenging capital markets environment, we anticipate more biopharma companies to consider strategic transactions as a means to continue developing their assets and technologies. We also expect distressed publicly traded companies will continue to pursue reverse mergers or mergers of equals transactions. In addition, financial buyers will continue to step into provide cash-out transactions for companies trading significantly below cash. On the demand side, large biopharma continues to face impending revenue gaps due to anticipated patent expiries and will continue to acquire commercial stage of clinically de-risked companies in billion-dollar-plus deals. Larger transactions are possible, but we believe they are less likely considering recent FTC challenges to Horizon/Amgen and Seagen/Pfizer. We expect to see significant activity away from the mega deals.
4Q 2023 Biopharma | M&A Activity
$ in millions
Biopharma | Q4 Selected Key Upcoming Events
Written By:
Dan Lepanto
Senior Managing Director, Healthcare Mergers & Acquisitions
Dan Berenson
Director, Biopharma Mergers & Acquisitions
Aniket Kaloti
Director, Biopharma Mergers & Acquisitions
Disclosures
The Center for Pharmacoeconomics (“CPE”) is a division of MEDACorp LLC (“MEDACorp”). CPE is committed to advancing the understanding and evaluating the economic and societal benefits of healthcare treatments in the United States. Through its thought leadership, evaluations, and advisory services, CPE supports decisions intended to improve societal outcomes. MEDACorp, an affiliate of Leerink Partners LLC (“Leerink Partners”), maintains a global network of independent healthcare professionals providing industry and market insights to Leerink Partners and its clients. The information provided by the Center for Pharmacoeconomics is intended for the sole use of the recipient, is for informational purposes only, and does not constitute investment or other advice or a recommendation or offer to buy or sell any security, product, or service. The information has been obtained from sources that we believe reliable, but we do not represent that it is accurate or complete and it should not be relied upon as such. All information is subject to change without notice, and any opinions and information contained herein are as of the date of this material, and MEDACorp does not undertake any obligation to update them. This document may not be reproduced, edited, or circulated without the express written consent of MEDACorp.
© 2026 MEDACorp LLC. All Rights Reserved.
MEDACorp has received funding to examine the potential impact of federal policies and activities on the market incentives for generic and biosimilar entry.
Disclosures
The Center for Pharmacoeconomics (“CPE”) is a division of MEDACorp LLC (“MEDACorp”). CPE is committed to advancing the understanding and evaluating the economic and societal benefits of healthcare treatments in the United States. Through its thought leadership, evaluations, and advisory services, CPE supports decisions intended to improve societal outcomes. MEDACorp, an affiliate of Leerink Partners LLC (“Leerink Partners”), maintains a global network of independent healthcare professionals providing industry and market insights to Leerink Partners and its clients. The information provided by the Center for Pharmacoeconomics is intended for the sole use of the recipient, is for informational purposes only, and does not constitute investment or other advice or a recommendation or offer to buy or sell any security, product, or service. The information has been obtained from sources that we believe reliable, but we do not represent that it is accurate or complete and it should not be relied upon as such. All information is subject to change without notice, and any opinions and information contained herein are as of the date of this material, and MEDACorp does not undertake any obligation to update them. This document may not be reproduced, edited, or circulated without the express written consent of MEDACorp.
© 2026 MEDACorp LLC. All Rights Reserved.
MEDACorp has received funding to examine the potential impact of federal policies and activities on the market incentives for generic and biosimilar entry.
Disclosures
The Center for Pharmacoeconomics (“CPE”) is a division of MEDACorp LLC (“MEDACorp”). CPE is committed to advancing the understanding and evaluating the economic and societal benefits of healthcare treatments in the United States. Through its thought leadership, evaluations, and advisory services, CPE supports decisions intended to improve societal outcomes. MEDACorp, an affiliate of Leerink Partners LLC (“Leerink Partners”), maintains a global network of independent healthcare professionals providing industry and market insights to Leerink Partners and its clients. The information provided by the Center for Pharmacoeconomics is intended for the sole use of the recipient, is for informational purposes only, and does not constitute investment or other advice or a recommendation or offer to buy or sell any security, product, or service. The information has been obtained from sources that we believe reliable, but we do not represent that it is accurate or complete and it should not be relied upon as such. All information is subject to change without notice, and any opinions and information contained herein are as of the date of this material, and MEDACorp does not undertake any obligation to update them. This document may not be reproduced, edited, or circulated without the express written consent of MEDACorp.
© 2026 MEDACorp LLC. All Rights Reserved.
MEDACorp has received funding to examine the potential impact of federal policies and activities on the market incentives for generic and biosimilar entry.
