Eli Lilly has agreed to acquire Centessa Pharmaceuticals in a transaction valued at $6.3 billion upfront, with a focus on expanding its neuroscience portfolio to include sleep disorder treatments. Announced on March 31, the deal sets a purchase price of $38 per share, reflecting a 27% premium compared to Centessa’s previous closing price of $27.58.
In addition to the upfront payment, the agreement includes a non-transferable contingent value right (CVR). This provision entitles Centessa shareholders to receive up to an additional $9 per share, contingent on achieving approval milestones for cleminorexton and ORX142 within a specified timeframe. If these milestones are reached, the total value of the deal could increase by as much as $1.5 billion over the next five years. The boards of directors of both companies have approved the transaction, and the companies expect it to close during the third quarter of 2026.
At the center of the acquisition is Centessa’s portfolio of orexin receptor 2 (OX2R) agonists, which are being developed to address conditions associated with the sleep-wake cycle. The lead candidate, cleminorexton, formerly known as ORX750, is currently undergoing a phase 2 clinical study evaluating its effects in narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia.
Previously reported phase 2 data for cleminorexton showed statistically significant, clinically meaningful, and dose-dependent improvements across several measures, including wakefulness, sleepiness, and cataplexy. Additional phase 1 data released in April 2025 indicated that a 5-mg oral dose of the drug delayed sleep by an average of 37.9 minutes, compared with 15.3 minutes for those receiving a placebo, resulting in a measured treatment difference of 22.6 minutes.
Beyond its lead program, Centessa is also advancing another clinical-stage candidate, ORX142. In a phase 1 study involving healthy adults, this compound demonstrated statistically significant and dose-dependent improvements in mean sleep latency. The company is also developing a third asset, ORX489, which remains in preclinical development for neuropsychiatric disorders.
“Orexin receptor biology represents one of the most compelling mechanistic opportunities in neuroscience as a direct intervention on the master switch of the sleep-wake cycle,” said Carole Ho in the announcement.
Centessa has increasingly concentrated its efforts on its OX2R franchise, particularly since late 2024, when it began to narrow its pipeline by discontinuing programs in hemophilia B, alpha-1 antitrypsin deficiency, and autosomal dominant polycystic kidney disease. This shift in focus coincided with leadership changes, as Mario Alberto Accardi assumed the role of chief executive officer at the end of last year after previously founding the company’s orexin program.
Through this acquisition, Lilly adds a group of sleep disorder drug candidates to its broader neuroscience portfolio. This portfolio already includes the Alzheimer’s disease treatment Kisunla, along with clinical-stage programs such as mevidalen and a GBA1 gene therapy for Parkinson’s disease, as outlined in the announcement.
The agreement also positions Lilly alongside competitors active in the same therapeutic area. Takeda is developing its own OX2R agonist, oveporexton, which is currently under review by the U.S. Food and Drug Administration, with a regulatory decision expected in the third quarter. At the same time, Alkermes is advancing alixorexton, a candidate that has moved into late-stage development following results from a phase 2 study.
With the completion of the acquisition, Lilly will take ownership of Centessa’s OX2R pipeline, encompassing both clinical-stage and preclinical assets intended for neurological, neurodegenerative, and neuropsychiatric conditions.
Why Centessa Is a Strategic Target
Centessa has gained attention for its advanced pipeline focused on neuroscience and rare diseases. By acquiring Centessa, Eli Lilly gains access to promising sleep disorder treatments that could address significant unmet patient needs. Centessa continues to demonstrate strong scientific capabilities, making it an attractive acquisition target.
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