Improvements in generating, purifying, and delivering RNA material, as well as addressing challenges with degradation by enzymes, have made the RNA class more attractive to drug developers.

With only weeks to go in 2022, the three major pharmas each had inked between 16 and 20 deals. Meanwhile, Pfizer has been less busy with 12 deals, but those include M&A totaling $18.2bn.

Lilly’s donanemab showed faster, deeper amyloid clearance versus Biogen/Eisai’s Aduhelm and Roche’s failed Phase III gantenerumab studies showed the importance of deep, rapid removal.

Centers for Medicare and Medicaid Services’ standard for determining whether drugs produce a clinically meaningful improvement in cognition that would allow for broader Medicare coverage is unclear. But Eisai/Biogen’s lecanemab is likely to serve as a first test.