The Agreement
Novo Nordisk has agreed to acquire Akero Therapeutics in a deal valued at $5.2 billion, marking another major move in the intensifying competition around liver disease treatments – a field that’s recently drawn multiple high-profile buyouts.
As part of the agreement, Novo Nordisk will pay $54 per share in cash at closing and offer an additional $6 per share in a contingent value right, payable if Akero’s MASH drug candidate efruxifermin gets the FDA green light by June 30, 2031. The initial payout comes to $4.7 billion, representing a 19% increase over Akero’s average stock price.
Akero’s board has approved the deal, and both companies anticipate finalizing the acquisition by the end of 2025.
Market Reaction and Competitive Landscape
Akero drew major attention earlier this year after reporting that efruxifermin reduced liver fibrosis by nearly 25% over placebo. At the time, analysts at Jefferies called the outcome a “home run” and said it significantly lowered the program’s risk profile. The market reacted immediately, sending Akero’s stock up 115%.
The strength of those findings also made waves elsewhere. Roche began pursuing a comparable approach and recently acquired 89bio for $3.5 billion. Regulatory filings tied to that sale noted Akero as a point of comparison, since 89bio is advancing a similar FGF21-based drug called pegozafermin. The documents also indicated that up to six other companies had shown interest in buying 89bio.
Strategic Fit for Novo Nordisk
With the acquisition, Novo Nordisk will now assume responsibility for advancing efruxifermin, including overseeing the Phase III SYNCHRONY study. The candidate will sit alongside Wegovy, which secured approval for the same indication earlier this year.
BMO Capital Markets described the acquisition as a strong strategic match for Novo, pointing out the recent green light for Wegovy and the fact that the company previously shelved its own FGF21 effort.
Akero also aligns with Novo’s broader push in metabolic disease, an area anchored by its hugely successful semaglutide portfolio. Wegovy turned the company into a global heavyweight, but momentum has slowed and several pipeline bets have fallen through. Newly appointed CEO Maziar Mike Doustdar has launched a sweeping overhaul in response, a move that has already resulted in 9,000 job cuts.
In a note issued Thursday morning, analysts at BMO said they see the agreement favorably – especially in light of Novo’s recent internal reorganization – as they believe Doustdar is steering the company back in the right direction.
A Hot Market for MASH Treatments
The Danish drugmaker hasn’t been shy about striking deals recently. It has recently inked multiple licensing agreements, and some industry watchers believe Novo may have been among the bidders for Metsera, the high-profile obesity startup that Pfizer scooped up for $4.9 billion.
Jefferies analysts estimate that Novo has roughly $63 billion in available capital for acquisitions.
The MASH field in particular has become a magnet for large pharmaceutical companies. The landscape shifted after Madrigal’s Rezdiffra won approval in 2024, opening the first commercial path in the space. Since then, Roche has snapped up 89bio, and in May, GSK paid $1.2 billion to acquire efimosfermin alfa, an FGF21 candidate from Boston Pharmaceuticals.
Additional Considerations
While efruxifermin’s data are promising, the transition to Phase III (and eventual regulatory approval) is never without hurdles. Novo must navigate regulatory scrutiny, demonstrate long-term benefits and safety, and prove cost-effectiveness in a high-stakes metabolic disease field. Acquisitions of this size carry integration risk — merging Akero’s culture, R&D programme and pipeline into Novo’s broader operations may take time. With MASH linked to obesity and type 2 diabetes — two core areas for Novo — the acquisition has the potential to unlock large commercial opportunity if efruxifermin becomes approved and adopted.
