Novo Nordisk's $5.2bn Acquisition of Akero
- amansp2006
- 7 hours ago
- 5 min read
By Kush Mahawar, Lexi Xiao, Joe Colton, Sean Yeow (University of Oxford); Diana Usova, Dylan Stiassny, Oli Cedar, Obianuju Okafor (University of Bristol)
Photo: Simone van der Koelen
Deal Overview
Acquirer: Novo Nordisk
Target: Akero Therapeutics
Total Transaction Size: $5.2bn (including CVR)
Closed Date: Expected Q4 2025
Target Advisors: Morgan Stanley and J.P. Morgan (Financial); Kirkland & Ellis (Legal)
Acquirer Advisors: Bank of America (Financial); Ropes & Grey (Legal)
On the 9th of October 2025, it was announced that Akero Therapeutics, a clinical-stage company focused on treatments for metabolic diseases, would be acquired by Novo Nordisk for an upfront cash payment of $4.7 billion and a contingent value right (CVR) of $0.5 billion, subject to customary closing conditions. The transaction is expected to close by the end of 2025, pending regulatory and shareholder approval.
Novo Nordisk has announced that the acquisition will be financed primarily through debt, supported by the company’s robust free cash flow. For Novo Nordisk, a global leader in obesity and type 2 diabetes therapies, the transaction aligns with the company’s long-term strategy to develop innovative medicines beyond the company’s core product focus and represents an expansion into metabolic liver diseases. For Akero, the determining factor is the company’s lead asset, Efruxifermin (EFX) which was developed for Metabolic Dysfunction-Associated Steatohepatitis (MASH). This has been identified by Novo Nordisk as a strategic addition to its pipeline.
Upon completion of the deal, Akero shareholders will receive the agreed cash consideration of $54 per share, a 17% premium to its closing price the day prior to the announcement of the deal, and an additional CVR of $6 per share. Akero will become a wholly owned subsidiary of Novo Nordisk. Novo Nordisk will gain full control of Akero’s assets and pipeline programmes.
“This acquisition embodies Novo Nordisk’s relentless ambition to move faster, go further, and ultimately deliver on our commitment to pursue leadership in diabetes, obesity and their associated comorbidities.” - Maziar Mike Doustdar, President and Chief Executive Officer of Novo Nordisk
Company Details (Acquirer - Novo Nordisk)
Novo Nordisk, together with its subsidiaries, engages in the research and development, manufacture, and distribution of pharmaceutical products internationally. Founded in 1923 and headquartered in Bagsværd, Denmark, the company is known for its GLP-1–based medicines (Ozempic, Wegovy and Rybelsus), a broad insulin portfolio, and treatments in rare blood and growth disorders.
Employing over 77,000 people in 80 countries, Novo Nordisk operates in two main segments: Diabetes and Obesity Care, and Rare Disease. The Diabetes and Obesity Care segment provides treatments for diabetes, obesity, cardiovascular, and other emerging therapy areas. The Rare Disease segment offers products in the areas of rare blood disorders, rare endocrine disorders, and hormone replacement therapy. Through continued investment in R&D, Novo Nordisk strives to bring novel and innovative products to the market and thereby sustain strong patent protection in the future.
Founded in 1923, headquartered in Bagsværd, Denmark
CEO: Maziar Mike Doustdar
Number of Employees: 77,000+
Market Cap: $200.8bn as of 07/11/2025
Enterprise Value (EV): $211.4bn
LTM Revenue: $46.8bn
LTM EBITDA: $23.8bn
LTM EV/Revenue: 5.2x
LTM EV/EBITDA: 10.1x
Recent Transactions: $1.1bn acquisition of Cardior Pharmaceuticals (March 2024), $1.1bn acquisition of Inversago Pharma (August 2023)
Company Details (Target - Akero Therapeutics)
Akero Therapeutics is a clinical-stage biopharmaceutical company specialised in developing transformational therapies for metabolic diseases, in particular MASH. Akero was founded in 2017, and is headquartered in South San Francisco.
As Akero’s products are still in the development stage, the company does not have any commercial revenue. EFX is currently in Phase 3 of its trial under the SYNCHRONY programme, after it was announced that the product has successfully completed Phase 2b. Despite substantial operating expenses, Akero had roughly $1.1bn in cash, cash equivalents and marketable securities on its balance sheet. Management expects this is sufficient to fund the current operating plan into 2028. By focusing on MASH, Akero is well positioned to emerge as a leading player in the field.
Founded in 2017, headquartered in South San Francisco, USA
CEO: Andrew Cheng
Number of Employees: ~70
Market Cap: $4.3bn as of 07/11/2025
Enterprise Value: $3.3bn
LTM Revenue: 0
LTM Operating Costs: $321.5m
LTM EPS: ($3.8)
Projections and Assumptions
Short-term Consequences
For 2025, Novo Nordisk does not expect the acquisition to have a material impact on its current profit guidance. However, overlapping R&D expenditures in 2026 will lead to a projected three percentage point drop in operating profit growth, especially with Akero’s Phase 3 trials of EFX extending into 2026. In the medium term, Novo Nordisk expects that its “world-leading capabilities in cardio-metabolic disease will enhance and accelerate evaluation of EFX in the Phase 3 SYNCHRONY program”. The acquirer aims to leverage its global regulatory and manufacturing operations to scale EFX quickly with its potential to become both a first-in-class and best-in-class treatment for MASH.
The market reaction was somewhat mixed for this deal. Whilst Akero shares jumped 16% in post-close trading, reflecting the offer price premium and high market confidence in the deal's successful completion, Novo Nordisk’s share price ticked down approximately 1%. This was principally driven by the pricing in of a significant Novo acquisition of a metabolic biotech company in light of both significant shareholder pressure from institutional investors such as ATG Healthcare to seal a major deal and new CEO Mike Doustdar’s commitment to expansion into the high growth cardiometabolic sector.
Long-term Upsides
This deal gives Novo Nordisk another long-term growth engine beyond its GLP-1 hits in diabetes and obesity. MASH is a large, under-served market, and Akero’s lead drug EFX is already in Phase 3 studies after encouraging Phase 2b data on improving liver fibrosis, even in patients with early cirrhosis. If those results are maintained, Novo can tap into a market early that looks poised to increase in its scope.
EFX is also a natural fit with Novo’s existing portfolio. Many MASH patients are already treated for obesity or type 2 diabetes, so there is significant potential for combinations and treatment sequencing. The deal terms align payout with de-risking milestones whilst giving Novo the option to scale a differentiated asset that peers are also chasing, demonstrated by Roche`s $3.5bn (including CVRs) buy of 89bio’s FGF21 program. If Phase 3 confirms the optimism engendered by the Phase 2b findings, Novo will successfully diversify its pipeline, reducing its reliance on GLP-1-based drugs, whilst also establishing its foothold in the cardiometabolic sector.
Risks and Uncertainties
Whilst the deal appears to be a strong strategic fit, significant questions remain. A fundamental driver of value for the deal is the success of Akero`s drug candidate EFX. CEO Mike Doustdar believes the drug can be a “cornerstone therapy” for MASH, but this hinges on the treatment receiving FDA approval, which should not be taken for granted. Several drugs with similar early-stage promise have failed to secure approval. If Akero`s EFX falls at the hurdle of Phase 3 trialling, a core asset of the merger would lose, undermining the strategic rationale the deal is predicated on.
Even if EFX does make it to market, the competition it will face from alternative drugs may be fierce. Currently, only Rezdiffra occupies the market, but there are other notable candidates in testing. Roche, which paid $2.4 billion for 89bio in September this year, has acquired Pegozafermin, another treatment in late-stage testing which is awaiting FDA approval. British company GSK paid $1.2 billion, and a potential further $800 million to Boston Pharmaceuticals, to acquire rights to Efimosfermin, which has demonstrated strong potential in the second phase of clinical trialling. Despite the deal`s strategic logic, it remains to be seen whether the acquisition of Akero`s lead asset EFX will generate the future revenue Novo Nordisk is making a big bet on.
“We look forward to joining the Novo Nordisk family and accelerating the momentum of EFX to deliver a transformational impact on patients’ lives.” - Andrew Cheng, M.D., Ph.D, President and CEO of Akero Therapeutics