Viewed simply by numbers of merger and acquisition (M&A) deals, 2023 was a down year: 1,078 biotech companies found buyers last year, down from 1,088 in 2022, while the number of pharma companies carrying out buyouts fell more significantly, from 778 two years ago to 679.

These numbers come from LSEG, the global financial markets infrastructure and data provider that owns the London Stock Exchange. LSEG’s data also reveals marked increases in the dollar values assigned to the biotech companies and pharma companies that are being acquired. The total value of biotech M&A in 2023 stood at $122.2 billion, up 45% from $84.2 billion a year earlier. The total value of pharma M&A jumped 38% year over year, from $98.5 billion in 2022 to $135.5 billion in 2023.

The final quarter of 2023 saw M&A activity heat up, with no fewer than nine announced acquisition deals of $1 billion or more. The largest of these (and the second largest transaction announced in 2023) saw Bristol Myers Squibb (BMS) agree to acquire neuro drug developer Karuna Therapeutics for $14 billion, a deal set to close in the first half of 2024. BMS was very busy in Q4 2023, as it also announced plans to buy out radiopharmaceutical drug developer RayzeBio and oncology drug developer Mirati Therapeutics. The former proposal is set at $4.1 billion; the latter, up to $5.8 billion ($4.8 billion plus another $1 billion in milestone-based contingent value rights).

The M&A revival reflects buyers’ need to generate new revenue and replenish pipelines as longtime blockbusters lose patent exclusivity—as well as buyers’ ability to fund deals as capital set aside for that purpose is at near-record levels.

Another possible reason for the M&A uptick: A jump in FDA approvals of new therapies last year. Indeed, approvals rose 50% last year—from 37 in 2022, to 55 in 2023. The number of Biologics License Applications approved by the agency has risen from 10 in 2018, to 17 in 2023 (same number as in 2018, a year that saw 59 drug approvals).

“If you look at some of the some of the biotech companies that are getting these approvals, then that is really good news for the M&A market, because that really drives interest from the larger buyers either to acquire them or partner with them,” said Subin Baral, global life sciences deals leader, EY. “So, it does play a role in M&A.”

What companies will be among those whose M&A potential is tracked in coming months? Leading candidates are in the following A-List. It includes 10 biopharma companies that analysts and other market watchers have seen as buyout targets in recent months. This list is based on notes to investors and comments in news outlets. For each company mentioned, the list explains where talk of acquisitions has surfaced, and why.

This A-List marks the first compilation of takeover targets by GEN since our September 2019 A-List of top M&A prospects. Investors would have been very wise to follow that list since it included two big targets that were bought out for tens of billions of dollars in the intervening five years: Seattle Genetics (later renamed Seagen and acquired by Pfizer for $43 billion despite antitrust concerns, in a deal completed December 14); and Alexion Pharmaceuticals (acquired by AstraZeneca for $39 billion in a deal completed in 2021).

GEN has also enjoyed earlier success predicting some companies on the cusp of being bought out. GEN’s February 26, 2018, A-List included three companies that later found buyers: AveXis (acquired by Novartis for $8.7 billion in 2018) and two companies that changed hands in 2019: Spark Therapeutics (bought by Roche for $4.8 billion), and Tesaro (snapped up by GlaxoSmithKline, now GSK, for $5.1 billion).

Only 1 of the 10 companies on our 2017 list found a buyer. Juno Therapeutics was purchased for $9 billion by Celgene, which a year later got bought out by BMS for $74 billion.

Argenx (ARGX)

Argenx saw a pair of clinical setbacks in late 2023—disappointing data from Phase III trials of subcutaneous Vyvgart Hytrulo (efgartigimod alfa and hyaluronidase-qvfc) in primary immune thrombocytopenia and pemphigus. But in July 2023, Vyvgart Hytrulo aced a late-stage trial in chronic inflammatory demyelinating polyneuropathy, which Thomas J. Smith (Leerink Partners) suggested will drive a label expansion this year, helping place the company on the firm’s list of immunology companies with “greater strategic optionality,” including M&A. Smith noted that Argenx has built a strong generalized myasthenia gravis franchise based on the original intravenous efgartigimod alfa (Vyvgart, approved in 2021), plus Vyvgart Hytrulo (approved June 2023).

Arrowhead Pharmaceuticals (ARWR)

After Alnylam Pharmaceuticals, “we think ARWR is the leading RNAi [RNA interference] play with late-stage, wholly owned [cardiovascular] medicines and earlier extrahepatic Targeted RNAi Molecules (TRiMs),” Edward A. Tenthoff (Piper Sandler) wrote in October, including Arrowhead among 12 M&A candidate “names we think make the most sense.” The developer of treatments based on its TRiMs platform is expected to release data from the Phase III PALISADE trial assessing ARO-APOC3 in familial chylomicronemia syndrome in mid-2024, to be followed (if positive) with Arrowhead’s first New Drug Application in Q4 2024. Tenthoff noted that Novo Nordisk bought RNAi developer Dicerna in 2021 for $3.3 billion—while Arrowhead’s market cap had ballooned from $2.7 billion to $3.4 billion at the start of 2024.

Aurinia Pharmaceuticals (AUPH))

Speculation about Aurinia Pharmaceuticals getting acquired by Gilead Sciences sparked a 7% jump in Aurinia’s stock November 20, 2023. A day later, Aurinia shares dived 5% as the talk proved to be just that. Market watchers have long opined that Aurinia’s FDA-approved lupus nephritis treatment Lupkynis (voclosporin) has yet to fulfill blockbuster expectations ($1 billion-plus in annual sales). After top shareholder MKT Capital urged management to consider a possible sale of the company in April 2023, Aurinia launched a review in June, and later appointed founder/ex-CEO Robert Foster, PharmD, PhD, to the board. Douglas Miehm (RBC Capital Markets) has estimated that Aurinia’s value could be in the high $20s or low $30s per share, but that the company will more likely fetch $18 to $20 per share.

Biohaven (BHVN)

When Pfizer acquired Biohaven Pharmaceuticals for $11.6 billion in 2022, the buyer agreed that development-stage compounds that were not in Biohaven’s calcitonin gene-related peptide (CGRP) program would be spun out into a new public company, Biohaven, Ltd. That “new” Biohaven has been a subject of takeover talk ever since. On December 22, Douglas Tsao (H.C. Wainwright) observed that Biohaven was “emerging as an attractive M&A target” as the firm initiated coverage of the stock with a buy rating and $50 price target (17% above its December 29, 2023, closing price). In December, Biohaven was among pharma and biotech companies cited by Cantor Fitzgerald as potentially attracting strategic interest.

BioMarin Pharmaceutical (BMRN)

BioMarin Pharmaceutical appeared on every GEN takeover target A-List issued between 2013 and 2019. Buyout speculation was rekindled in November 2023, when Elliott Investment Management reportedly took a $1 billion-plus stake in the company. Akash Tewari (Jefferies) projected BioMarin could find a buyer at $130–$150/share—rising to $170–$185/share should pediatric achondroplasia therapy Voxzogo (vosoritide) generate around $2 billion in sales, and hemophilia A treatment Roctavian (valoctocogene-roxaparvovec-rvox or “val rox”), around $1 billion in sales. Tim Lugo (William Blair) projects $123–$148/share. More cautious is Luca Issi (RBC Capital Markets): “We continue to see a relatively limited buyer’s universe and await further clarity on the potential new vision for the company.”

Exelixis (EXEL)

Exelixis resurfaced as a buyout candidate last spring following public criticism of its R&D spending by Farallon Capital Management. Exelixis has funded efforts to expand its label for approved cancer drug cabozantinib, sold as Cabometyx and Cometriq. Other expenditures at Exelixis concern legal wrangles. In July, Exelixis settled patent litigation with Teva Pharmaceutical Industries. In October, a legal dispute with MSN Laboratories went to a second trial. Exelixis “is a good mid-cap pick up for a larger name that wants to expand its footprint into oncology,” Bret Jensen (TheStreet’s Real Money Pro) commented in December. But a buyout, he added, is likelier after Exelixis resolves MSN’s lawsuits, something he expects will occur this spring.


At a challenging time for many larger contract research organizations, London-based hVIVO has grown by specializing in human-challenge clinical trials of infectious and respiratory disease vaccines and antivirals. hVIVO won six major contracts in 2023 totaling £41.9 million (about $53 million) and kicked off 2024 with a £6.3 million (about $8 million) agreement to conduct a Phase IIa human challenge trial of a human rhinovirus candidate being developed by an undisclosed biotechnology client. HVO stock soared 162% during 2023, making the company a potentially attractive target: “hVIVO’s valuation is, in our mind, undemanding, for the highly visible near-term growth we expect and consistent delivery of targets by management,” Cavendish Global observed.

Intra-Cellular Therapies (ITCI)

Intra-Cellular Therapies’ sole marketed drug, Caplyta (lumateperone), is approved for adult schizophrenia and bipolar I and II depression. But when it aced a Phase III trial in patients with major depressive disorder and bipolar depression (both with mixed features) in March, Intra-Cellular found itself a topic of M&A buzz. Brian Abrahams (RBC Capital Markets) referred to the company as a top takeover target, while Cantor Fitzgerald predicted Intra-Cellular could attract strategic interest from would-be buyers. “A potential approval of the drug for additional indications will boost the growth prospects,” Ekta Bagri (Zacks Equity Research) wrote in December 2023.

Madrigal Pharmaceuticals (MDGL)

Madrigal Pharmaceuticals has sparked acquisition talk over the past year following positive Phase III data for its resmetirom for NASH (nonalcoholic steatohepatitis, more recently called metabolic dysfunction-associated steatohepatitis) with liver fibrosis. The thyroid hormone receptor-b selective agonist is under FDA review, with a target decision date of March 14. If approved, resmetirom would become the first FDA-authorized therapy for NASH. Thomas J. Smith (Leerink Partners) included Madrigal on his firm’s list of immunology companies with “greater strategic optionality,” including M&A. “Madrigal could prove to be a bargain for big pharma on the hunt for a top-shelf NASH asset,” George Budwell (The Motley Fool) commented, based on Madrigal’s then-market cap of $6 billion, which fell to $4.5 billion by January 2024.

Sarepta Therapeutics (SRPT)

Sarepta Therapeutics made GEN’s last takeover targets A-List in September 2019. The developer best known for Duchenne muscular dystrophy (DMD) therapies returned to the radar of M&A watchers in May 2023 after an FDA advisory committee recommended accelerated approval of Elevidys (delandistrogene moxeparvovec), approved in June as the first-ever DMD gene therapy. “I think that would help not only the gene therapy sector, but also put Sarepta probably in, again, the target for an acquisition from a larger pharma,” David Nierengarten (Wedbush) told CNBC. “As a smaller bolt-on acquisition, larger firms may be willing to take the gamble on a slow, but steady, growth opportunity at a fair price,” investor “Another Mountain’s Rock” wrote in SeekingAlpha.

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