The largest pharmas have a collective $188 billion in firepower to spend on M&A transactions, with all but one signaling a desire to execute, according to a new analysis from Leerink Partners.
Big Pharmas are reaching into their wallets as M&A returns to the sector, with four major companies having the deepest pockets for transactions, according to a recent analysis from Leerink Partners.
Johnson & Johnson leads the pack with $21 billion in cash on hand and is the most likely to buy when market cap and executive commentary are also factored in, according to Leerink’s October 18 report on the biopharma industry’s M&A activity. Behind the healthcare behemoth are BioNTech, Amgen and Roche in terms of gross cash balance, the firm determined.
All together, large-cap pharmas included in the analysis have about $188 billion on hand to spend, Leerink reported.
“Over the next year, we expect robust activity to continue, because many large-cap biopharma companies are hungry for M&A,” Leerink said. Indeed, the only company in the analysis to definitively say no to M&A is Genmab, which has said the near-term focus is on deleveraging.
Pharma’s total firepower is down slightly from the $199 billion that was recorded at the end of June 2025 due to a flurry of deals that have spread across the sector. So far this year pharma companies have spent $97 billion across 28 deals, according to Leerink. This is well above the annual mean from 2009 through 2025, when pharmas averaged 19 total deals and $69 billion spent.
“We have also seen more mid-size biopharma companies step up and pursue substantial acquisitions for the first time,” Leerink wrote. Inflammation and immunology (I&I), oncology, rare disease and central nervous system (CNS) have all seen major deals, while business development in cardiovascular or metabolic disease has declined.
Many major pharmas have significant debt levels, which can constrain deal activity. But Leerink doesn’t think this will greatly limit acquisitions in the sector. Bristol Myers Squibb, Novartis and GSK also have high debt but maintain flexibility.
AbbVie has the highest net debt balance at around $60 billion, but Leerink still believes the company has plenty of leverage to execute. And AbbVie’s leadership is among those executives signaling that a major transaction is possible, Leerink wrote.
“We always said we’re not unwilling to pursue a late stage, even an on-market opportunity if it fits,” CEO Rob Michael said at the Morgan Stanley Annual Global Healthcare Conference in September. He pointed to differentiated assets in immunology, oncology, neuroscience, aesthetics or obesity as possibilities.
“The lens, again, is on those key growth drivers, and we have the financial wherewithal,” Michael continued. “We have plenty of capacity to be able to continue to execute deals, whether that is an early-stage opportunity that’s going to drive long-term growth, a late-stage asset or even on market.”
Also signaling a potential transaction over $10 billion are the leaders of Eli Lilly, Amgen, AstraZeneca and Merck.
Lilly has been the busiest pharma of the year, with 11 total deals conducted as of the end of the third quarter, for $31.7 billion spent so far. The company’s executives have been unabashed in expressing their desire for more deals, even after onboarding dozens of new programs already this year.
“As highlighted by all the new molecules we added to our pipeline through acquisitions, business development is an important component of our R&D strategy,” Dan Skovronsky, chief scientific and product officer, said in August during the company’s second quarter earnings call.
For future deals, Leerink expects Lilly to look for diversification beyond metabolic to areas such as I&I, CNS or oncology.
Over at J&J, CEO Joaquin Duato has said he wants to find more early-stage deals to bulk up the company’s position later in the decade. “We can achieve double-digit growth this decade without M&A,” he said in September at the Morgan Stanley meeting. “So our goal with M&A is to fortify our position to provide you the confidence that our growth is durable into the next decade.”
Leerink highlighted Amgen, too, nothing that “CEO Bob Bradway has suggested tremendous firepower.”
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