Genmab acquires Merus for $8B, FDA approves Alzheimer’s blood test, and Trump Administration secures drug pricing deals. Complete biotech industry analysis.

1. Genmab’s $8 Billion Oncology Bet: The EGFR×LGR5 Bispecific Gamble

Danish biotechnology giant Genmab announced it will acquire Netherlands-based Merus for approximately $8 billion in cash, marking one of 2025’s most significant biotech transactions. The deal centers on petosemtamab, an EGFR×LGR5 bispecific antibody currently in phase III trials for head and neck cancer.

This acquisition represents a vote of confidence in next-generation cancer therapeutics. Bispecific antibodies—engineered to bind two distinct targets simultaneously—have emerged as a transformative class in oncology, offering the potential to overcome resistance mechanisms and improve patient outcomes. By securing Merus, Genmab gains not only petosemtamab but access to the entire bispecific platform and related pipeline assets.

The commercial potential appears substantial. Industry analysts project peak sales exceeding $2 billion for a successful first-line head and neck cancer therapy, though petosemtamab’s actual market penetration will depend on clinical efficacy, safety profile, and competitive landscape at launch. For Genmab, this deal accelerates its transformation into a global oncology powerhouse while filling a critical gap in its late-stage pipeline.

The transaction signals that despite earlier concerns about biotech valuations, investors and strategic buyers remain willing to deploy substantial capital for late-stage assets with compelling clinical data and clear regulatory pathways.

2. Novo Nordisk’s $5.2 Billion Metabolic Disease Expansion: The NASH Opportunity

Novo Nordisk announced it will acquire U.S.-based Akero Therapeutics for up to $5.2 billion, with the deal marking the first major acquisition under Novo’s new CEO leadership. The centerpiece is efruxifermin, an FGF21 analog in late-stage development for non-alcoholic fatty liver disease (NASH) and other metabolic conditions.

This acquisition represents a strategic pivot for Novo Nordisk, extending its reach beyond diabetes and obesity into the adjacent metabolic disease space. The global NASH treatment market represents a significant opportunity, with an estimated addressable population exceeding 30 million patients worldwide. Current therapeutic options remain limited, creating an opening for first-in-class or best-in-class therapies like efruxifermin.

FGF21 (fibroblast growth factor 21) is an emerging target in metabolic disease, with the mechanism showing promise in reducing liver fat, improving insulin sensitivity, and potentially reversing fibrosis. Efruxifermin’s clinical data has demonstrated meaningful improvements in liver histology and metabolic markers in NASH patients, positioning it as a potential standard-of-care therapy if approved.

For Novo Nordisk, this deal achieves multiple strategic objectives. It diversifies revenue streams beyond GLP-1 receptor agonists, addresses the growing epidemic of fatty liver disease, and leverages Novo’s existing infrastructure in cardiometabolic care. The acquisition signals confidence that obesity and metabolic disease represent interconnected opportunities, with the same patient populations often requiring multi-target therapeutic approaches.

3. Trump Administration Secures “Most-Favored-Nation” Drug Pricing with AstraZeneca

The Trump Administration announced a landmark drug pricing agreement with AstraZeneca, the second such deal following a similar pact with Pfizer. Under the framework, AstraZeneca will offer certain medications at up to 80% off list price through a federal TrumpRx website launching in 2026, in exchange for a three-year exemption from new drug import tariffs.

This represents a significant shift in U.S. pharmaceutical pricing policy. The “most-favored-nation” model ties American drug prices to the lowest prices charged in developed nations—including Canada, Germany, and Australia—effectively anchoring U.S. pricing to international references rather than allowing manufacturers to price independently.

For patients, the potential benefits are substantial. An 80% price reduction would dramatically improve accessibility to expensive medications, particularly cancer drugs, biologics, and specialty therapeutics. The TrumpRx platform aims to distribute medications directly to consumers, potentially bypassing pharmacy benefit managers and insurance intermediaries who have historically added markups.

For pharmaceutical companies, the trade-off is notable but calculated. While accepting steep price discounts, companies gain tariff exemptions and potential regulatory flexibility. For AstraZeneca, the deal aligns with its $50 billion U.S. expansion plans, including manufacturing investments that depend on favorable trade policies.

The broader significance lies in precedent-setting. If more companies agree to similar terms, the framework could fundamentally reshape U.S. drug pricing dynamics and accelerate a shift toward direct-to-consumer pharmaceutical sales. Industry analysts note this could pressure other manufacturers to negotiate similar deals to avoid falling behind competitors and facing harsher regulatory measures.

4. FDA Approves Roche-Lilly Alzheimer’s Blood Test: Democratizing Diagnosis

The FDA approved the Elecsys pTau181 blood test, co-developed by Roche and Eli Lilly, as an aid for diagnosing Alzheimer’s disease. This represents only the second blood-based diagnostic approved for Alzheimer’s and marks a significant milestone in making cognitive decline screening more accessible.

The test detects phosphorylated tau protein (pTau181), a biomarker associated with Alzheimer’s pathology. Previously, definitive diagnosis required expensive and invasive procedures including positron emission tomography (PET) scans, cerebrospinal fluid collection via lumbar puncture, or amyloid and tau PET imaging. Blood-based biomarkers promise to democratize Alzheimer’s diagnosis, enabling primary care physicians to identify at-risk patients without referring them to specialized centers.

The clinical implications are profound. Early detection allows earlier intervention with disease-modifying therapies, including lecanemab (Leqembi) and donanemab (Kisunla)—recently approved monoclonal antibodies that slow cognitive decline in early-stage disease. Widespread screening could identify thousands of asymptomatic individuals with amyloid and tau pathology who could benefit from preventive treatment before symptomatic dementia emerges.

For healthcare systems, blood-based diagnostics promise to reduce diagnostic bottlenecks and lower the cost of Alzheimer’s identification. A simple blood draw is far less burdensome than PET imaging or lumbar puncture, potentially enabling widespread screening in primary care settings.

For diagnostic manufacturers and pharmaceutical companies, this approval validates the blood biomarker space. Expect accelerated development of additional blood tests for other neurodegenerative diseases, including Parkinson’s disease and Lewy body dementia, as companies recognize the commercial and medical value of accessible, early-stage diagnostics.