AstraZeneca's $39 billion acquisition of Alexion strengthens several assumptions: firstly, rare-disease segment is more and more becoming a key issue for big and small pharmaceutical companies; secondly mega-deals are not over (it is the largest deal in AstraZeneca's history). And thirdly, there is still future for the pharmaceutical industry outside Covid-19 R&D.

Rare diseases definetely are a high-growth therapy area with unmet medical need.
Over 7 000 rare diseases are known today, but only.5% have US Food and Drug Administration-approved treatments.

With Alexion, AstraZeneca will add treatments for uncommon blood and immunological disorders in its portfolio. It will build on a pipeline of 11 molecules across more than 20 clinical-development programmes. Alexion's deal will also consolidate the UK giant's position among the world's 10 biggest drugmakers. "This deal is even more extraordinary given that it is a cross-border transaction", the Evaluate Pharma research noted (actually the fith biggest in biopharma).

Soliris, Alexion's biggest product, with about $4 billion in 2019 sales, is a monoclonal antibody. The medicine is approved in many countries for the treatment of patients with paroxysmal nocturnal haemoglobinuria (PNH), atypical haemolytic uremic syndrome, generalized myasthenia gravis and neuromyelitis optica spectrum disorder. More recently, Alexion launched Ultomiris (ravulizumab), a second-generation C5 monoclonal antibody with a more convenient dosing regimen.

In June, analysts were betting on a mega-deal with Gilead. But the UK Big Pharma focused on other fields. For years, AstraZeneca has built a growing scientific presence in oncology, cardiovascular, renal and metabolism, or respiratory diseases. In 2014, it fought off a $117 billion takeover offer from Pfizer, saying it could create more shareholder value following its own pursuits. At that time, Pascal Soriot's big promise to the market was that AstraZeneca could deliver $45billion of revenue by 2023. In 2020, group sales are just $26 billion and could reach $37 billion in 2023.

Alexion deal is announced as AstraZeneca and Oxford University's vaccine candidate against Covid-19 will require more analysis. The data AstraZeneca and Oxford released last month showed that the shot works, but left doubts over how much protection it would provide. They said their vaccine was 90% effective when a half-dose was given before a full-dose booster, and that two full doses showed an efficacy of 62%. A manufacturing mistake led to two different results from two dosing regimens, creating confusion over the best quantity to use and the vaccine's overall efficacy. The US trial has recruited 17,000 of the 40,000 participants it's seeking, and won't read out until late January or early February. As a result, an emergency-use authorization in the U.S. probably wouldn't be forthcoming before late February or early March. Working with more than 20 partners in over 15 countries, including Brazil and India, the company intends to produce as many as 3 billion doses next year.

With this surprising deal, the 2020 end looks like the beginning of 2018. At that time, several acquisitions lead the first months of the year, with Sanofi in pole position. The French company entered the 2018 takeover scene with two announcements in January focusing small biotechs for a combined total of about $16.5 billion (Ablynx for $4.8 billion in cash and Bioverativ for $11.6 billion in rare blood disease). Still in 2018, the shopping spree hit American drugmakers too with Celgene acquiring Juno Therapeutics, another leader in cell therapy for cancer, for $9 billion.