Lilly has been active on the M&A front with a series of biotech acquisitions totaling up to more than $20 billion in 2026 to date  What moves are the company making?

By Patricia Van Arnum, Editorial Director, DCAT, pvanarnum@dcat.org

Riding high and positioning for more
With the blockbuster success of its Type 2 diabetes/obesity drugs, Mounjaro/ Zepbound (tirzepatide), and more blockbuster potential in its Type 2 diabetes/obesity drug franchise with Foundayo (orforglipron) and retatrutide, Eli Lilly and Company is riding high, but the company is not stopping there as it makes a push to diversify its portfolio with a series of biotech acquisitions in 2026.

Lilly’s solid financial footing, driven by its Type 2 diabetes/obesity franchise, is clear as it reaches new revenue heights. Lilly reported first-quarter 2026 revenues of $19.8 billion, a 56% increase year-over-year. Mounjaro’s revenues surged 125% to $8.7 billion, and Zepbound revenues grew 80% to $4.2 billion. For the full-year 2026, the company projects revenues in the range of $82 billion to $85 billion, which would be a 23% gain  compared to its 2025 full-year revenues of $65.2 billion. More success is projected in the near term for Lilly’s Type 2 diabetes/obesity drug franchise with Foundayo (orforglipron), an oral obesity drug approved by FDA in April (April 2026) and in late-stage development for treating Type 2 diabetes, and retatrutide, in late-stage development for treating obesity and Type 2 diabetes. In a recent analysis, Clarivate projects sales of orforglipron of $11.1 billion for obesity in G7 markets (Canada, France, Germany, Italy, Japan, the UK, and the US) in 2031, and $5.2 billion in expected sales for Type 2 diabetes in the G7 markets in 2031. Retatrutide, now in Phase III development to manage overweight and obesity and treat Type 2 diabetes, has projected revenues of $10 billion for obesity in the G7 markets in 2031, and $20.1 billion in expected sales for Type 2 diabetes in the G7 markets in 2031.

Coming under the radar: biotech acquisitions
With all the attention and strong financial showing in its Type 2 diabetes/obesity franchise, coming under the radar are other moves Lilly has made to diversify and build its pipeline. Among the bio/pharmaceutical majors, the company has been particularly active on the mergers and acquisitions (M&A) front with a series of announced/closed biotech acquisitions totaling more than $20 billion since January (January 2026). Lilly’s M&A include:

• Three vaccine companies, Curevo (Bothell, Washington), LimmaTech Biologics (Schlieren, Switzerland), and Vaccine Company (Bethesda, Maryland) for a combined $3.8 billion;
• Ajax Therapeutics (Cambridge, Massachusetts) developing JAK inhibitors for treating myeloproliferative neoplasms, a group of rare, chronic blood cancers, for $2.3 billion;
• Kelonia Therapeutics (Boston, Massachusetts) specializing in in vivo gene delivery, in a $7-billion deal ($3.25 billion upfront and $3.75 billion in milestone payments);
• CrossBridge Bio (Houston, Texas) developing dual-payload antibody-drug conjugates (ADCs), in a deal worth up to $300 million;
• Engage Biologics (San Carlos, California) specializing in non-viral DNA delivery for $203 million;
• Centessa Pharmaceuticals (Boston, Massachusetts and London) developing treatments for excessive daytime sleepiness and other neurological conditions, in a deal worth up to $7.8 billion ($6.3 billion upfront and $1.5 billion in milestone payments);
• Orna Therapeutics (Watertown, Massachusetts) developing  circular RNA therapeutics, for $2.4 billion; and
• Ventyx Biosciences (San Diego, California) developing a pipeline of small-molecule therapeutics, including NLRP3 inhibitors, for treating inflammation for $1.2 billion.

Taking a look at the moves
The two larger acquisitions by Lilly are of Centessa Pharmaceuticals ($7.8 billion, $6.3 billion upfront and $1.5 billion in milestone payments) and Kelonia Therapeutics ($7 billion, $3.25 billion upfront and $3.75 billion in milestone payments).

Centessa is advancing a pipeline of orexin receptor 2 (OX2R) agonists designed to address the neurobiological system critical to the sleep-wake cycle to treat excessive daytime sleepiness and disorders of impaired wakefulness. Its lead investigational candidate, cleminorexton, is in Phase IIa clinical studies across type 1, narcolepsy type 2, and idiopathic hypersomnia. Centessa’s OX2R agonist portfolio includes additional clinical and preclinical-stage assets with potential utility across a broader range of neurological, neurodegenerative, and neuropsychiatric conditions. 

Lilly’s pending acquisition of Kelonia Therapeutics is Lilly’s latest move in genetic medicines. Kelonia has developed a proprietary in vivo gene-placement system, iGPS, which uses specially engineered lentiviral-based particles designed to enter T-cells inside the body to allow the patient to generate chimeric antigen receptor T-cell (CAR-T) therapies. Kelonia’s lead program, KLN-1010, currently in Phase I development for relapsed/refractory multiple myeloma, is an investigational, one-time intravenous gene therapy that generates anti-B-cell maturation antigen (BCMA) CAR-T cells, targeting the BCMA protein expressed on the surface of multiple myeloma cells. 

Another move in genetic medicines is Lilly’s $2.4-billion acquisition of Orna Therapeutics. Orna is advancing a class of therapeutics using engineered circular RNA paired with lipid nanoparticles to allow the patient’s own body to generate cell therapies that can treat underlying disease. Orna’s lead program is ORN-252, a clinical-trial-ready, CD19 targeting in vivo chimeric antigen receptor T-cell (CAR-T) therapy designed to treat B cell-driven autoimmune diseases. 

A smaller deal in genetic medicines is Lilly’s $202-million acquisition of Engage Biologics, which has a proprietary non-viral DNA delivery platform designed to overcome limitations in DNA delivery, including potency, tolerability, and redosability. The platform combines engineered DNA payloads with lipid nanoparticle delivery and an mRNA-encoded proprietary technology designed to enhance localization and increase expression.

To build its position in infectious diseases, Lilly announced agreements this week (May 26, 2026) to acquire three early-stage vaccines companies for a combined $3.8 billion: Curevo ($1.5 billion), LimmaTech Biologics ($780 million), and Vaccine Company ($1.55 billion). Curevo’s lead product candidate is amezosvatein, an adjuvanted subunit vaccine for the prevention of shingles in adults. LimmaTech Biologics is developing vaccines against bacterial pathogens subject to potential antimicrobial resistance, including Staphylococcus aureus, Neisseria gonorrhoeae, and Chlamydia trachomatis. Vaccine Company is advancing a broad preclinical pipeline spanning multiple viral pathogens using its proprietary in vivo nanoparticle technology platform addresses manufacturing of virus-like particle vaccines. Its lead program applies this technology to Epstein-Barr Virus (EBV) with a five-antigen Phase 1-ready candidate.

In other deals, Lilly’s $2.3-billion acquisition of Ajax Therapeutics provides Lilly with JAK inhibitors for treating myeloproliferative neoplasms, a group of rare, chronic blood cancers. JAK inhibitors are a class of targeted immunomodulatory medications that block specific enzymes (JAK1, JAK2, JAK3, TYK2) to reduce inflammation and manage autoimmune disorders. Ajax’s lead asset, AJ1-11095, is an investigational, once-daily oral Type II JAK2 inhibitor currently being evaluated in a Phase I clinical trial with first proof-of-concept clinical data to be presented later in 2026. I

Lilly’s $1.2-billion acquisition of Ventyx Biosciences provides the company with a pipeline of small-molecule therapeutics, including NLRP3 inhibitors, designed to treat inflammation across a broad range of disease states, including cardiometabolic disorders, neurodegenerative diseases, and inflammatory disorders.

To boost its position in antibody drug conjugates (ADCs), Lilly’s $300-million acquisition of CrossBridge Bio provides it with new dual-payload ADC technology originally created by Kyoji Tsuchikama, PhD and Associate Professor at the University of Texas Health Science Center in Houston. CrossBridge Bio’s lead candidate, CBB-120, is a TROP2-targeting TOP1i/ATRi dual-payload ADC for treating certain cancers.