The acquisition of Mariana will complement Novartis’s lutetium-based radioligand therapies with candidates using actinium. Lilly, Bristol and AstraZeneca all have made recent high-priced buys in the space.

Mohit Manrao, head of AstraZeneca’s US oncology business unit, explained the company’s diverse approach in an interview, including investments in ADCs, cell therapy and radiopharmaceuticals.

The $16.5bn deal, intended to increase Novo Nordisk’s production of semaglutide-containing products, led a $36bn-plus quarter for M&A transactions, according to Evaluate.

Bristol Myers Squibb and Lilly have recently done billion-dollar radiopharmaceuticals deals, and now the UK group wants a piece of the market. But can it make its Fusion fusion work?