Big Pharma Went on a $20 Billion Shopping Spree in March
Three mega-deals worth over $20 billion landed in March alone, with Lilly, Merck, and Biogen all making billion-dollar bets. Big pharma's $1.2 trillion cash pile and looming patent cliffs are fueling what Goldman Sachs calls a potentially record-breaking year for biotech dealmaking.
Three mega-deals landed in a single month. That hasn't happened in years.
In March 2026, three of the world's biggest drugmakers collectively dropped over $20 billion on acquisitions. Eli Lilly scooped up Centessa Pharmaceuticals for up to $7.8 billion. Merck grabbed Terns Pharmaceuticals for $6.7 billion. And Biogen closed out the month by agreeing to buy Apellis Pharmaceuticals for $5.6 billion. Each deal closed (or was announced) within a span of six days. If biotech M&A were a sport, March was the trade deadline, and every general manager was on the phone.
The Biggest Check: Lilly Goes All-In on Sleep
Eli Lilly's $7.8 billion deal for Centessa, announced March 31, is the marquee transaction of the bunch. Lilly is paying $38 per share upfront (a 40.5% premium to Centessa's recent trading average) plus up to $9 per share in contingent payments tied to FDA approvals. The total potential payout: $47 per share.
So what's Lilly buying? A pipeline built around orexin receptor agonists, which are drugs designed to treat sleep-wake disorders like narcolepsy and idiopathic hypersomnia. Think of orexin as the brain's "stay awake" signal. Centessa's lead candidate, cleminorexton, posted positive Phase IIa results across three different sleep conditions. If Lilly can push it across the finish line, it would enter a market with massive unmet need and very few competitors.
The CVR milestones (contingent value rights, basically bonus payments if certain goals are hit) are worth watching. Centessa shareholders get $2 per share if cleminorexton wins any FDA approval before January 1, 2030, another $2 for narcolepsy type 2 approval within five years of closing, and $5 more for idiopathic hypersomnia approval within five years of closing.
Merck's $6.7 Billion Bet on Blood Cancer
A week earlier, on March 25, Merck announced its acquisition of Terns Pharmaceuticals for $53 per share in cash. The headline number is $6.7 billion, though Terns was sitting on roughly $1 billion in cash, making the net price closer to $5.7 billion.
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The prize here is TERN-701, an oral drug in Phase 1/2 trials for chronic myeloid leukemia (CML), a type of blood and bone marrow cancer caused by a specific genetic mutation. TERN-701 belongs to a class of drugs called tyrosine kinase inhibitors, which work by blocking the faulty protein that drives the cancer. Early trial data showed promising signs of efficacy and safety, positioning it as a potential best-in-class treatment.
The strategic logic is clear: Merck needs to fill the hole that Keytruda will leave. Its blockbuster cancer immunotherapy faces looming patent expiration, and CEO Rob Davis has been vocal about the company's willingness to pursue "multi-tens of billions" in deals. Terns won't single-handedly replace Keytruda's revenue, but it strengthens Merck's hematology-oncology bench at a time when every pipeline addition counts.
Merck expects to take a $5.8 billion charge (about $2.35 per share) when the deal closes, likely in Q2 2026. The acquisition is being treated as an asset purchase for accounting purposes, which tells you how early-stage the pipeline still is.
Biogen Buys Revenue, Not Just Potential
Biogen's deal for Apellis stands out from the other two for one reason: it comes with real, existing revenue. Apellis generated $689 million in sales in 2025 from two FDA-approved drugs, Syfovre and Empaveli. Both are formulations of pegcetacoplan, a complement C3 inhibitor (a drug that tamps down part of the immune system that can go haywire and damage healthy tissue).
Syfovre treats geographic atrophy, a progressive form of age-related macular degeneration that leads to vision loss. Empaveli is approved for paroxysmal nocturnal hemoglobinuria. Combined revenue is projected to grow at a mid- to high-teens rate through at least 2028.
Biogen is paying $41 per share in cash, which represents an 86% premium to Apellis' 90-day average trading price and 35% above the 52-week high. Shareholders also get a contingent value right worth up to $4 per share, tied to Syfovre hitting global sales milestones of $1.5 billion and $2 billion between 2027 and 2031.
Beyond the immediate revenue boost, the deal gives Biogen something it didn't have before: a commercial footprint in nephrology. That infrastructure will be critical when Biogen's own kidney disease drug, felzartamab, potentially reaches the market. Phase 3 data is expected in 2027.
Why Everyone's Buying Right Now
Three mega-deals in one month doesn't happen by accident. Several forces are converging to create what Goldman Sachs has called a potentially record-breaking year for biotech M&A.
First, big pharma is sitting on enormous cash reserves. That's a staggering war chest, and it's earning nothing sitting in treasury accounts while patents on drugs generating an estimated $230 billion in annual North American branded revenue march toward expiration by 2030. The patent cliff isn't a future problem; it's a present emergency that demands action.
Second, biotech valuations spent much of 2024 and early 2025 in the basement. An IPO drought and depressed share prices made acquisition targets unusually affordable. That window is closing as deal activity and rising stock prices inflate valuations, which actually creates more urgency to buy now before prices climb further.
Third, the regulatory environment has stabilized enough that dealmakers feel comfortable writing big checks. William Blair analyst Andy Hsieh has pointed to M&A prospects as a key driver of biotech stock performance, while Janus Henderson has highlighted improved policy visibility as a tailwind.
Not everyone is celebrating, though. Some analysts warn that valuations are getting bloated and that buyers risk overpaying for clinical-stage assets with uncertain futures. BioPharma Dive has noted tension between deal enthusiasm and the reality that many targets are still years away from generating meaningful revenue.
The Scoreboard So Far
Q1 2026 has been relentless. Beyond the big three March deals, the quarter also featured AbbVie striking an exclusive licensing deal with RemeGen for a bispecific antibody worth up to $5.6 billion including milestones, Sanofi entering a collaboration with Earendil on autoimmune assets worth up to $2.56 billion including milestones, and Lilly's separate $2.4 billion deal for Orna Therapeutics' CAR-T platform in February.
For context, total biopharma M&A in 2023 was approximately $158 billion. If Q1 2026's pace holds, this year could rival or surpass that.
The message from boardrooms across the industry is unmistakable: buy now, or watch someone else buy your target. When pharma execs start acting like buyers at a real estate bidding war, you know the market has shifted. And based on what we've seen so far, the second quarter could be even wilder.
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