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Pharma’s $1 billion-plus deals favored late-stage assets, leaving too many biotechs for too few buyers
By 2023, heavy capital inflows had created far more biotechs than pharma could ever buy, and pharma’s $1 billion-plus acquisitions went mostly to late-stage assets. Of 86 such deals from 2019 through September 22, 2023 in Sleuth’s analysis, about 63% were for companies with approved or pivotal-stage assets, and those deals took about 87% of the value. Many biotechs would reach late-stage or commercial status and still find no buyer.
Pharma buys late-stage assets to replace revenue at risk from loss of exclusivity (LOE), a need especially pressing heading into the late 2020s.
Deal count fell in 2023, but value held at about $73 billion
Deals worth more than $1 billion fell to nine in 2023 through September 22, from 22 in 2021 and 17 in 2022, while their value held at about $73 billion, in line with $64 billion in 2021 and $74 billion in 2022. Value peaked at $255 billion across 20 deals in 2019, an outlier driven by Bristol Myers Squibb’s purchase of Celgene and AbbVie’s of Allergan, which totaled $178 billion. At least one deal topped $20 billion in every year except 2021, with Seagen the 2023 mega-deal.
Pharma was writing fewer, larger checks in 2023, not spending less.
Commercial-stage assets took 76% of deal value
By count, 40.7% of the 86 deals were for commercial-stage assets, 22.1% for pivotal or registrational assets, 14.0% for Phase 2 and 23.3% for earlier stages. By value, commercial assets alone took 76.1%, while Phase 2 and earlier deals together took 13.4%. Immunology (23.3% of deals) and oncology (20.9%) were the most common therapeutic areas, followed by rare disease (15.1%) and CNS (10.5%), areas where assets can span several indications and reimbursement is favorable.
Biologics and small molecules split the deals almost evenly, at 50.0% and 46.5% of the count. Sleuth expected the mix to tilt toward biologics, because recent approvals had favored them and the Inflation Reduction Act added an incentive to develop them.
For biotechs, the lesson was not to expect a large takeout on platform value or early-stage assets. Stellar pivotal data and, increasingly, strong launches are what get deals done.
Many biotechs with late-stage assets will find no buyer
Sleuth’s 2023 view was that M&A, long the industry’s lifeblood, cannot absorb the number of biotechs created in recent years. Pharma tends to favor assets with more than $1 billion in peak sales potential, a hurdle Sleuth works through in its biotech math on the blockbuster model, so companies in a “no man’s land” of $500 million to $1 billion can be passed over unless they fit an acquirer’s existing commercial infrastructure.
That is a problem for any company whose assets can’t generate enough cash to stay independent, and Sleuth expected some to merge, combining smaller assets into a company big enough to sustain itself commercially.
At least 12 of the 27 flagged targets have since agreed to be acquired
The analysis flagged 27 companies in priority therapeutic areas with late-stage or commercial assets that could draw M&A interest, across CNS, immunology, oncology, rare disease and two others. Their median market cap was about $3 billion at the September 22, 2023 close, in line with pharma’s stated preference for bolt-ons over mega-mergers.
After the list was published, at least 12 of the 27 agreed to be acquired. In 2023 and 2024, Bristol Myers Squibb bought Mirati ($4.8 billion) and Karuna ($14 billion), Roche bought Roivant’s RVT-3101 through Telavant ($7.1 billion), AbbVie bought ImmunoGen ($10.1 billion) and Lilly bought Morphic ($3.2 billion). From 2025 to March 2026, Johnson & Johnson bought Intra-Cellular ($14.6 billion), Sanofi bought Blueprint, Supernus bought Sage, Merck bought Verona ($10 billion), BioMarin bought Amicus ($4.8 billion), while Servier agreed to buy Day One ($2.5 billion) and Biogen agreed to buy Apellis ($5.6 billion).
Ten of the 12 had commercial or registration-stage assets when flagged, the profile the deal data said pharma pays for; the exceptions were the list’s two Phase 2b immunology assets, RVT-3101 and MORF-057. Sleuth tracks 2026 buyers and their remaining capacity in its T15 pharma buyout map.
Deal counts and values cover biopharma M&A deals worth more than $1 billion from 2019 through September 22, 2023; market caps are as of the September 22, 2023 close. This page is a dated snapshot; acquisitions of flagged companies are current as of September 2026.
Frequently asked questions about biotech consolidation
How many $1 billion-plus biopharma M&A deals were there from 2019 to 2023?
Sleuth counted 86 from 2019 through September 22, 2023, with a high of 22 in 2021 and nine in 2023 to that date, worth about $73 billion.
What stage of assets does pharma pay the most for?
In Sleuth’s September 2023 analysis, about 63% of $1 billion-plus deals since 2019 were for approved or pivotal-stage assets, and they took about 87% of deal value.
Why will many biotechs not find a buyer?
In Sleuth’s 2023 view, capital inflows created far more biotechs than pharma can consolidate, and pharma favors assets with more than $1 billion in peak sales potential, leaving $500 million to $1 billion assets at risk of being passed over.
Which companies on Sleuth’s 2023 target list were acquired?
As of September 2026, at least 12 of the 27 had agreed to be acquired after the list was published: Karuna, Mirati, Roivant’s RVT-3101 (through Telavant), ImmunoGen, Morphic, Intra-Cellular, Blueprint, Sage, Verona, Amicus, Day One and Apellis.
