Lilly & Lox(o)

While New Yorkers have their famed duo of bagels and lox, Eli Lilly is making its own combo with its $8B purchase of Loxo Oncology. The cancer-focused biopharma just recently had its first US approval in Vitrakvi, which can target multiple cancers by focusing on tumor biomarkers instead of the affected tissue area. The deal cements Eli Lilly’s presence in the oncology space, but follows the trend noted in a recent report by EY that says drugmakers have been spending too much on stock buybacks and bolt-on acquisitions instead of megamergers like Takeda/Shire and BMS/Celgene. Loxo stockholders should be pretty happy with the deal—when Loxo shares went public in 2014 they cost $13, and Eli Lilly will be purchasing them for $235 a pop.

The making of a cancer-killing giant

Bristol-Myers Squibb has started off the 2019 season of M&A with a huge proposal: buying the biotech Celgene in a $74B deal. If completed, it would be the largest pharma acquisition to date, blowing the previous-record holder—Takeda’s pending Shire acquisition for $62B—out of the water. Both companies are oncology giants, specifically in immunology and blood cancers, but BMS will be acquiring a decent amount of risk with the purchase. Celgene’s market cap has gone down $70B in the past 14 months partly due to poor financial forecasts for when the company’s top drug Revlimid loses patent protection. BMS likely hopes to make that up with six possible product launches in the next few years. Okay, enough numbers. To round out this New Jersey-focused blurb, here’s some New Jersey would-you-rathers.

Konnichiwa, Dublin

Japan and Ireland have a history of mutual investment and medicine exchange, and an upcoming merger could be the latest and greatest chapter. Osaka-based Takeda announced in May that it would acquire the Dublin-based Shire for $62B, and it looks like its last regulatory hurdle with the EU will be cleared. Unlike these hurdles. Officials are slightly concerned about an IND in Shire’s pipeline that could treat Crohn’s Disease, which would overlap with Takeda’s biggest selling drug Entyvio. But Takeda’s happy to lose that investigational drug if it means closing the deal. After all, the new company would instantly become a global top 10 drugmaker. Keep your head on a swivel though, a few Takeda investors are still against the deal, citing the considerable debt Takeda will have to take on to make the purchase.

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…