A merger “O.K.” with a slight delay

Not to be outdone by the Cigna-Express Scripts merger, CVS Health and Aetna’s proposed merger has been approved by the US Justice Department. The $69B (nice) deal combines Aetna’s insurance skills with CVS’s drug benefits management and nearly 10,000 pharmacy locations to create a healthcare behemoth. The deal will allow Aetna customers to seek less expensive medical services at those pharmacy locations, including CVS’s 1,000+ walk-in clinics which have served 25M patients since 2000.  To get the deal approved, Aetna had to sell all its standalone Medicare Part D plans. Otherwise, the merged company would have owned 30 percent of those drug plans—an unacceptable share to the DOJ. We’ll be interested to see how the new company competes with the similarly structured Cigna-Express Scripts in the coming years.

A merger “O.K.” with little delay

Cigna and Express Scripts have received their parents’ the Justice Department’s blessing to go ahead with their wedding merger. The health insurer and pharmacy benefit manager say they’re a good fit for each other since they’ll be able to share information about their customers’ medical expenses that will help them manage patient health better. But the announcement has got to sting a bit for CVS Health and Aetna, who have been waiting on DOJ approval for their merger since before the Cigna-Express Scripts deal was announced. Visual/meme representation of that here. You’ve gotta think that Amazon’s ever-threatening encroachment into the healthcare industry is driving some of these vertical mergers between health insurers and PBMs.

Baysanto? Monsantayer?

Whatever they end up calling themselves, Bayer and Monsanto have finally crossed the last big regulatory hurdle in the way of their proposed merger. The US Department of Justice gave Bayer permission to go through with the $62.5B deal on Tuesday. It’s one of the largest mergers on record (list of those here), and the new company will have control of over 25% of the world’s seeds and pesticides. Get ready for a future where Mbayto branded trees litter the landscape. The companies claim that the merger will allow them to increase spending on R&D, but Business Insider reports that they’ll only really be spending about $500M more than when they were separate. With that much of the market cornered there’s probably a better reason the deal will benefit the companies…

Adding CAR-T to the shopping cart

How about some exciting, multi-billion dollar deals to spice up the first quarter? First, Sanofi acquired Bioverativ, a hemophilia-focused biopharmaceutical company that spun out of Biogen last February. Since losing patent protection, Sanofi has seen flagging revenue from their flagship Lantus products—which occupy the #4 and #15 spots on IQVIA’s list of Top Medicines by Invoice Spending—and they’re hoping Bioverativ can give their treatment portfolio a boost. Similarly, Celgene boosted their pipeline prospects by acquiring Juno Therapeutics, who have a promising CAR-T candidate expected to be FDA-approved in 2019. Celgene also recently bought Impact Biomedicines, all part of a strategy to preemptively address profit losses when their blood cancer drug Revlimid goes off-patent in a few years.

5. Who’s up for a good fat freezing? Anyone? Anyone?

Allergan. That’s who. Last week, Allergan announced its acquisition of Zeltiq and its flagship CoolSculpting system. CoolSculpting is the system you’ve see in ads. It cools fat cells underneath the skin, which then freeze and die, resulting in a whole new you! It’s almost like Allergan thinks we live in a society of increasing vanity. Add fat freezing to Allergan’s portfolio that already includes Botox, Kybella (injection to treat double chin), and other aesthetics and plastic surgery offerings and what do you get? A one-stop-shop for pulling off that sweet, sweet Joan Rivers look you’ve always wanted. Just kidding… Kind of…

3. That time when avoiding antitrust created distrust

Insurance: taking the safe path that might cost you now, but will benefit you in the long run. Insurance company Aetna apparently tried the safe path to accomplish a “megamerger” with Humana by pulling out of ACA exchanges where the two were competing. According to Judge John D. Bates, who officially blocked the merger on Monday, Aetna pulled out of these markets not simply due to profit concerns, but to “improve its litigation position.” Turns out, as anyone with insurance could tell you, the safe path doesn’t always benefit you as much as you think it will. The blocked deal doesn’t bode well for the Anthem-Cigna merger, which has a larger price tag than the Aetna-Humana deal and is similarly stalled by the US Justice Department.

3. The not-so-exciting side of M&A

Mergers & Acquisitions – the making of a new company, new products, and the seemingly endless new opportunity. But it’s not all sunshine and rainbows; just ask some Mylan employees. Mylan announced in a December 5 SEC filing that they are “currently developing the details of the cost reduction initiatives, including workforce actions,” and that “less than 10 percent of its global workforce may be impacted.” That’s a significant number considering Mylan reported 35,000 employees in 2015. In October, Mylan terminated 94 employees after acquiring Meda Pharmaceuticals in New Jersey. According to FiercePharma, Mylan provided “severance, benefits and outplacement services during [the] transition.” But that’s not the news this 10% wants to hear. To them, M&A feels more like MMA [spoiler alert: it’s a broken nose].

4. It’s going to be YUGE

Election season has passed and Donald Trump is set to take office in 2017, accompanied by a newly Republican-filled Congress. This means we could be poised to witness even more of the mega-mergers that have taken place across the pharma landscape. These mergers have been popular for US companies partly because it has allowed them to achieve huge (…yuge) tax savings due to US tax rates. President-elect Trump has stated multiple times that corporate tax rates are too high and that he will be working to drop them drastically to promote competition within the US. If this comes to fruition, be prepared to see more companies bring in off-shore dollars to take advantage of these changes.