Novo Nordisk buys Akero for US$5.2B to boost MASH drug pipeline with EFX

USA—Danish pharmaceutical firm Novo Nordisk has agreed to acquire Akero Therapeutics, a US-based clinical-stage company, in a deal that could reach up to US$5.2 billion.

This move aligns with Novo Nordisk’s recent expansion into the liver disease market as part of its broader restructuring efforts.

The Danish firm will pay Akero shareholders US$54 per share in cash, representing a 16% premium over Akero’s last closing price of US$46.49 on October 8.

Additionally, Novo Nordisk will pay US$6 per share upon U.S. approval of Akero’s lead product, efruxifermin (EFX), for treating compensated cirrhosis caused by metabolic dysfunction-associated steatohepatitis (MASH), expected by mid-2031.

This acquisition marks the first significant deal under Novo Nordisk’s new CEO, Mike Doustdar, who joined the company in August 2025.

Doustdar has been tasked with reviving Novo’s position after falling behind Eli Lilly in the weight loss and type 2 diabetes market. He has already reduced the workforce by 9,000 jobs to streamline operations.

Liver disease represents a promising growth area for Novo Nordisk, as evidenced by the company’s drug Wegovy (semaglutide) becoming the first glucagon-like peptide-1 receptor agonist approved in the U.S. for treating MASH earlier in August 2025.

GlobalData estimates that the MASH market across seven major markets, including the U.S., France, Germany, Italy, Spain, the U.K., and Japan, could reach US$25.7 billion by 2032.

Since over 40% of MASH patients also have type 2 diabetes and more than 80% are overweight or obese, Novo Nordisk sees a clear strategic fit given its expertise in obesity and diabetes treatments.

EFX, Akero’s drug, is a fibroblast growth factor 21 (FGF21) analog designed to reduce liver fat, inflammation, and fibrosis.

It is currently in Phase III clinical trials known as the SYNCHRONY program, involving 3,500 patients with pre-cirrhotic or compensated cirrhosis stages of MASH.

Earlier Phase IIb trials showed significant improvements, with fibrosis reductions of 49% and 29% in two studies, outperforming placebo groups.

This acquisition follows a trend in the pharmaceutical industry where major companies are investing heavily in FGF21 analog treatments for MASH.

Recently, Roche purchased 89bio, which develops pegozafermin, for US$3.5 billion, and GSK acquired efimosfermin from Boston Pharma for US$2 billion.

Novo’s deal is the largest, indicating strong confidence in the potential of FGF21-based therapies.

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