Novo Nordisk said on Thursday it would acquire Akero Therapeutics for up to $5.2 billion in cash, marking a significant push into treatments for fatty liver disease as the Danish drugmaker seeks to broaden its pipeline beyond diabetes and obesity drugs.

The deal sent Akero shares up by more than 17% in premarket trading, while Novo Nordisk shares slipped 1.56% as investors questioned the cost of the acquisition.

Under the terms, Novo will pay $54 per share in cash at closing, valuing Akero at about $4.7 billion.

Akero shareholders will also receive a contingent value right of $6 per share, or an additional $500 million, if the US Food and Drug Administration approves Akero’s experimental drug efruxifermin by June 30, 2031.

Novo Nordisk said the acquisition aligns with its strategy to develop therapies for people living with diabetes, obesity, and related conditions such as metabolic dysfunction-associated steatohepatitis (MASH).

Focus on obesity-linked liver disease

South San Francisco-based Akero is developing efruxifermin, a potential treatment for MASH, a chronic liver disease closely tied to obesity and diabetes.

The company is conducting late-stage clinical trials on patients with advanced liver scarring, or cirrhosis, caused by the disease.

“Efruxifermin could become a cornerstone treatment either on its own or in combination with Wegovy,” Novo Nordisk Chief Executive Mike Doustdar said in a statement.

He called the acquisition a key step in expanding Novo’s treatment portfolio beyond traditional diabetes drugs.

Doustdar, who took charge in July, has moved quickly to reshape the company’s strategy.

Last month, he announced plans to cut about 9,000 jobs worldwide as part of an effort to boost efficiency and reinvest in drug development.

Analysts split over deal valuation

While the deal gives Novo Nordisk a promising foothold in the emerging market for liver disease therapies, some analysts said the $5.2 billion valuation appeared steep.

Nordnet analyst Per Hansen says the acquisition is costly and shows Novo is “still building on the breadth of its portfolio”

“The share price reaction may be a sign of something that is not mentioned in the announcement — the share buyback,” Hansen said.

Novo’s Danish peer Zealand Pharma, which is also active in fatty liver disease research, saw its shares fall about 2.4% following the news.

Competition with Eli Lilly intensifies

The acquisition comes as Novo Nordisk faces mounting competition from US rival Eli Lilly, whose weight-loss and diabetes treatments have surged in global demand.

Doustdar has emphasized that Novo’s strategy will focus on developing next-generation obesity and diabetes drugs that can also treat cardiometabolic conditions such as MASH, rather than branching into unrelated disease areas.

Some investors have urged Novo to increase spending on research and development to strengthen its long-term pipeline and diversify beyond weight management.

The acquisition of Akero is expected to help the company achieve that goal, while also positioning it to capture a share of the fast-growing liver disease treatment market.

The transaction is expected to close around the end of the year, pending regulatory approval.

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