Eli Lilly, striving to outpace Novo Nordisk, dominated the dealmaking scene in 2023 by executing six acquisitions. Although Pfizer, BMS and AbbVie sealed the largest M&A deals of the year, they did not lead in terms of volume.

Private Company Edition: Publicly held Ascendis outsourced its preclinical AMD program to private Eyconis. Also, Innovation Endeavors revealed a new $630m VC fund and Mirae raised $50m for its first life science fund, while Accent, Comanche and Tr1X each brought in $75m rounds.

Vertex and CRISPR look beyond beta thalassemia and sickle cell disease. Also, Bicycle gets $50m up front in Novartis deal, Regeneron commits $75m initially under a Treg collaboration with Sonoma, and Jounce gets a better deal from Concentra to wave off Redx merger.

Biotech stock indices have seen a recent recovery but remain well below their 2021 peaks raising questions about the likelihood of raising money for R&D. The number of companies announcing leadership changes, shifting pipeline priorities and job cuts is rising as a result.