Novo Nordisk and a separate prospective buyer walked away from a potential acquisition of MASH drug developer Akero Therapeutics, before Novo came back to the table to finish the deal a few months later.
The extensive back-and-forth is detailed in an
SEC filing
that shows how the
$4.7 billion upfront cash sale to Novo
eventually got done, and how it almost didn’t happen.
On May 14, after months of meetings, Novo proposed $58 per share. Then, nine days later, Akero was able to get a competing bidder described as “Party A” to put $62.50 per share on the table.
A few weeks later, on June 9, Novo and Party A told Akero they were no longer interested in a deal. It’s not clear from the filing what happened, though just days after making the $58-a-share offer, Novo said that its
CEO was stepping down
in a surprise announcement.
By September, and with a new CEO, Novo was back. It reengaged with Akero on Sept. 12 and, by October, made a new offer — but for a lower upfront price. It was now willing to give Akero $51 a share in cash, plus a contingent value right of $8 per share if Akero’s MASH drug got FDA approval by 2031. (CVRs have become
a regular feature in deals
in 2025 as a way to bridge value gaps.)
There’s been surging interest in MASH this year, after Madrigal Pharmaceuticals’ approved medicine showed market momentum.
And the Akero deal documents hint at wide interest from other drugmakers in the liver disease: 10 companies besides Novo signed confidentiality agreements with Akero over the last several years, according to the filing. Some of them may have even done deals already: GSK disclosed its plans to
buy Boston Pharmaceuticals
‘ MASH treatment candidate in May, and Roche scooped up
89bio
in mid-September.
To try and close the deal with Novo, Akero CEO Andrew Cheng made a counterproposal of $57 per share, plus a CVR of $10 per share if efruxifermin got FDA approval by 2032. The next day, Novo came back with $53 per share upfront and a $6 per share CVR.
Cheng went back with a request for $56 apiece upfront and a $6-per-share CVR.
Eventually, the two companies would come to terms on a $54-per-share buyout and a $6-per-share milestone payment. They announced the deal on Oct. 9.
Under new CEO Maziar Mike Doustdar, Novo says it would focus on its core areas of obesity and diabetes, but the company continues to expand its pipeline in broader cardiometabolic areas. The Akero deal was followed shortly by an
up to $2.1 billion acquisition
of Omeros’ Phase 2 kidney and blood disorder drug zaltenibart.