The year started strong for pharma M&A with Johnson & Johnson inking the largest deal of 2025 in the first two weeks of January. After that, no other matchup reached those heights again.
But despite an M&A environment that hasn’t fired on all cylinders in recent years, drugmakers have employed a “string of pearls” strategy more focused on smaller early- to mid-stage buys than game-changing megadeals. And the impetus for these deals has shined a light on the therapeutic areas where the industry sees the most potential.
The fact that the two biggest deals of the year were rooted in neuroscience is no accident. Although Big Pharma began dropping out of the space years ago due to mixed clinical results, drugmaking giants are diving back into the pool as scientific know-how and market prospects improve.
And just because pharma leaders have been more reluctant to pull the M&A trigger amid economic uncertainty, the business case for dealmaking is still there. Many of the largest companies are grappling with recent or upcoming patent cliffs threatening a revenue foundation they’ve built for years, and need to fill those gaps for continued growth.
Here’s a look at the top three deals of the year so far and what they reveal about where pharma is looking to leverage external innovation.
Johnson & Johnson and Intra-Cellular Therapies
Value: $14.6 billion
Announced at this year’s J.P. Morgan Healthcare Conference in January, J&J’s $14.6 billion purchase of Intra-Cellular Therapies marked an effort to build on the company’s growing presence in mental health. The ketamine-based depression drug Spravato has raked in sizable revenue for J&J, becoming a blockbuster in 2024 with $1.1 billion in sales.
Now the drugmaking giant is having another go at the space, this time in clinical depression and schizophrenia with Intra-Cellular’s Caplyta, which is already on the market and generating solid sales growth forecasts from analysts.
For J&J, the acquisition was part of a bigger facelift as the company sells off its orthopedics unit just a few years after shedding its consumer arm. By slimming down to the fundamentals, J&J is placing more emphasis on its clinical pipeline to bolster its future drug sales.
The deal was not only the biggest this year, but eclipsed most M&A in 2024 when no announced acquisitions between pharma and biotech rose above $5 billion.
Novartis and Avidity Biosciences
Value: $12 billion
Novartis deepened its neuroscience presence this year with the $12 billion purchase of Avidity Biosciences, which boasts a pipeline of RNA treatments for neuromuscular conditions.
Avidity’s late-stage candidates target rare diseases like Duchenne muscular dystrophy, and fit into Novartis’ M&A strategy of using its expertise to usher drugs over the regulatory finish line, chief strategy and growth officer Ronny Gal told PharmaVoice in June.
Like J&J, Novartis is one of the few large pharmas that’s still chugging away in neuroscience. Its most notable win — the spinal muscular atrophy gene therapy Zolgensma — has seen steady sales despite difficulties in the gene therapy space overall.
Pfizer and Metsera
Value: $10 billion
The third-largest deal of the year was in the hot, hot weight loss arena, and the deliberations to buy Metsera couldn’t have been more contentious. A bidding war broke out between pharma giants Pfizer and Novo Nordisk, ratcheting up the price over the course of a week before Pfizer came away the victor.
Pfizer has been itching to get into the next wave of weight loss treatments for a while, and what started as a $4.9 billion acquisition more than doubled in size by the end.
For its trouble, Pfizer gets an elevator ride to the upper echelon of clinical weight loss potential with a pipeline of candidates that could deliver long-term dosing and next-generation effectiveness by leveraging different approaches that work alone and in combination with one another. Metsera’s lead candidate is a long-acting GLP-1 that achieved a level of weight loss similar to Eli Lilly’s blockbuster Zepbound in a mid-stage trial.
Pfizer has had a rough go since the end of the COVID-19 pandemic when vaccine revenue nosedived. But with a good deal of cash on hand, the company is building back up with pharma’s future in mind where weight loss has proven to be a worthwhile investment.
