Following AstraZeneca’s success in vaccine development during the Covid-19 pandemic, the pharmaceutical giant is now looking to expand its scope through acquisitions across a range of indications, says CEO Pascal Soriot. “We want to be a sustainably growing company. Until 2025, we have strong growth ahead of us, but we also believe we can continue to grow very strongly post-2025 and it’s all about innovation in the pipeline.”

On 23 August, at a Reuters Newsmakers online forum, Soriot announced his interest in increasing AstraZeneca’s portfolio of bolt-on acquisitions leading up to 2025. Soriot said AstraZeneca is particularly interested in oncology, cardiovascular disease, and rare diseases, and taking part in more ‘small to mid-size’ bolt-on acquisitions in the upcoming years.

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“We focus on our internal research and development efforts, but we always look for external opportunities. The world of science is a big ocean, and we have to look for ideas and projects where they are.”

Recently, AstraZeneca has had a run of successful acquisitions, including the 2021 acquisitions of Alexion Pharmaceuticals and more recently TeneoTwo in a deal that’s worth potentially $1.27 billion. TeneoTwo is developing T cell engagers for the treatment of haematological cancers. About the British company’s interest in oncology, Soriot said, “Cancer continues to kill people, so a lot more has to be done in terms of early diagnosis and new treatments.”

Additionally, cardiovascular disease-related acquisitions are not out of the question for AstraZeneca. “There is a huge unmet need still in cardiovascular disease. People forget this, but cardiovascular disease continues to be the biggest killer in the world ahead of cancer,” said Soriot.

AstraZeneca’s deal history

Over the last four years, AstraZeneca has spent approximately $40 billion on cardiovascular disease acquisitions over six deals. In this period, AstraZeneca has also taken part in five oncology and respiratory disease deals, respectively. These have been major steps in the company’s plan to expand its portfolio.

An example of AstraZeneca’s deals in the cardiovascular disease clinical landscape is its agreement with US-based Dogma Therapeutics. In 2020, AstraZeneca acquired Dogma Therapeutics’ preclinical oral PCSK9 inhibitor program. PCSK9 inhibitors modulate low-density lipoprotein (LDL) levels to lower LDL cholesterol. Increased LDL cholesterol levels are a major risk factor for cardiovascular disease.

AstraZeneca’s cardiovascular, renal, and metabolism (CVRM) portfolio includes 18 marketed drugs and an investigational cardiovascular disease drug, eplontersen. In 2021, AstraZeneca entered a global development and commercialization agreement with Ionis Pharmaceuticals to investigate eplontersen to treat familial amyloid neuropathies (FAN) and familial amyloid cardiomyopathies (FAC). The FDA has granted the drug an orphan drug designation, and Phase III trials with eplontersen were completed In June.

In 2019, AstraZeneca entered a $6.9 billion global development and commercialization agreement with Japan’s Daiichi-Sankyo for Enhertu. In August 2022, the FDA approved Enhertu to treat non-small cell lung cancer (NSCLC) patients whose tumours have activating HER2 (ERBB2) mutations and previously received systemic therapy, making it the first approval for a HER2-targeting therapy in NSCLC, a major development in the field. Prior to this, the FDA had granted Enhertu regulatory approval for breast cancer treatment. In addition to this deal, and AstraZeneca’s previous collaborations with Accent Therapeutics and French biotechnology company Innate Pharma, the company has an extensive merger and acquisition (M&A) history within the oncology landscape.

Another area where AstraZeneca has had significant deals has been respiratory disorders. In 2014, AstraZeneca acquired Spain’s Almirall, along with the latter’s respiratory franchise, for an initial consideration of $875 million on completion and up to $1.22 billion in development. This acquisition, amongst others, strengthened AstraZeneca’s respiratory disease portfolio with drugs such as Duaklir Genuair, Pulmicort Turbuhaler, and Oxis Turbuhaler. In 2021, AstraZeneca sold $270 million worth of assets to Covis Pharma, which then transferred AstraZeneca’s chronic obstructive pulmonary disease (COPD) inhalers Tudorza and Duaklir to Covis.

The company currently has five Phase III clinical trials in progress for respiratory diseases that aim to target conditions such as asthma and COPD. “Many people think that asthma is just a minor disease that you treat with a few inhaler products, but in fact severe asthma can kill people, so there’s a lot more improvement we can bring to treating those conditions as well,” said Soriot. According to GlobalData, asthma and COPD feature most commonly amongst the 88 investigational respiratory drugs that are currently in Phase III clinical trials.

GlobalData is the parent company of Pharmaceutical Technology.

At the same event, Soriot highlighted key considerations that contribute to the decision to integrate a company into the fold. AstraZeneca is interested in incorporating a new pipeline to its portfolio, “provided it really fits our strategy, we can add value, we think we can integrate the product, the team and the company that we acquire, they fit culturally within our company and geographically we can execute on the integration. But essentially [this is] driven by our strategy and focusing on what we want to achieve as a company,” explained Soriot.

Despite a Covid-19-related decrease in the overall number of M&As in 2021, the pharmaceutical industry saw steady growth in acquisitions for oncology and respiratory diseases. The industry has seen a rising trend in M&A for oncology and cardiovascular disease over the last few years. Between 1 May 2016 and 31 May 2021, the FDA approved 207 drugs for cancer and malignant haematology. According to Nature biopharma dealmakers, cancer-focused deals accounted for 29% of the 1,968 deals signed in 2021.