By Doug Brown and Ivan Lim
After several years of subdued activity, biopharma M&A has returned with significant momentum. According to IQVIA, deal value more than doubled in 2025 to $133 billion, after a 2024 in which no single deal topped $5 billion. By mid-2026, first-half deals of roughly $130 billion had nearly matched that full-year total, and IQVIA now projects 2026 to be the strongest year since the pandemic. So far this year, there have been more than 40 biopharma acquisitions worth $1 billion or more, already well above the total for all of 2025. Patent cliffs, attractive biotech valuations, strong pharmaceutical balance sheets and intense competition for innovation are once again driving deal activity.
Amid the focus on valuation, assets and strategic fit, boards should be asking a more fundamental question: Do we have the leaders who will make this acquisition successful?
Deals Don’t Create Value. Integration Does.
Across industries, the track record is sobering. Baruch Lev and Feng Gu analyzed 40,000 acquisitions over 40 years and found that 70-75% failed to meet their stated objectives. Biopharma is no exception: EY-Parthenon found that about 70% of acquired early-stage biopharma assets did not meet deal expectations.
Some of that is science; drugs fail. But much of it is execution, and execution is the part that is actually under an acquirer’s control.
In biopharma, where acquisitions frequently involve specialized science, entrepreneurial cultures and dispersed teams, leadership quality is often what separates the deals that pay off from those that don’t.
Companies Are Acquiring Capabilities, Not Just Assets
Today’s acquirers are pursuing far more than revenue or scale. They are acquiring:
- Novel antibody platforms, including bispecifics and antibody-drug conjugates (ADCs)
- In vivo cell therapy and gene editing
- RNA technologies
- Precision medicine expertise
- Specialist commercial teams and niche market connectivity
Those capabilities are inseparable from the people who created them. The scientific assets matter. The leadership, talent and culture behind them can matter just as much.
Not every deal is a bet on people. AbbVie’s $10.9 billion acquisition of Apogee Therapeutics in 2026 bought a Phase 3 antibody, a molecule that can largely move into AbbVie’s own development machine. Its $2.1 billion purchase of Capstan Therapeutics in 2025 bought a Phase 1 in vivo CAR-T program and, above all, the platform and the scientists who built it. Boards need to know which kind of deal they are approving.
M&A Experience Is Not Integration Experience
Boards often overestimate the value of generic M&A experience, prioritizing leaders who have led deals while failing to recognize that there is a significant difference between participating in a transaction and leading a successful integration. The capabilities required to negotiate a deal are not the same as those required to retain talent, align cultures, redesign operating models and deliver a multi-year value creation plan.
McKinsey’s research on more than two decades of deal data found that companies pursuing a steady stream of acquisitions earned about 2% more in annual shareholder returns than their peers. What separated them wasn’t deal volume; it was integration capability. They were 1.9 times more likely to say they had the right tools and talent for M&A, and 1.6 times more likely to have a clear playbook for designing the combined organization. Closing a deal is a transaction. Integration is a strategic leadership challenge.
The Greatest Risk Often Sits on the Talent Chart
In biotech, much of an acquisition’s value resides in a relatively small number of scientists, founders and senior leaders. When key individuals leave, knowledge, relationships and innovation capability often leave with them. This is why leading acquirers must conduct talent diligence with the same rigor as financial, legal and operational diligence, identifying critical leaders before close and deciding, deliberately, who will lead what.
Retention Is Not the Strategy. The Right Leaders Are.
Talent diligence is too often reduced to a retention list: identify the key people, write the checks, hope they stay. That misses the point. The goal is not to keep everyone who built the company. It is to put the right leaders in charge of the combined organization, and to make that decision before close rather than after.
Sanofi offers a useful contrast, because it has faced this test before.
In 2018, Sanofi acquired Bioverativ, the hemophilia business spun out of Biogen, for $11.6 billion, and Ablynx, the Belgian nanobody company, for $4.8 billion, bringing both into a combined rare blood disorders business. Both CEOs moved on, and Sanofi brought in outside leaders to run the combined business unit and its medical organization. But the integration was deliberate. Before the Ablynx deal closed, Sanofi committed to an integration plan: Ablynx would remain a separate legal entity for at least two years, its R&D would stay in Ghent, there would be no organizational changes in the first year, and employees received pay protection and three-year retention awards. Sanofi’s first significant job cuts in Ghent came six years later, as part of a company-wide pipeline reprioritization.
The results speak for themselves. The Bioverativ pipeline produced ALTUVIIIO, which passed $1.3 billion in sales in 2025, and Ghent remains Sanofi’s nanobody research center, with nanobody programs still in its clinical pipeline.
Seven years later, Sanofi faces the same test with Blueprint Medicines. In June 2025 it agreed to pay $9.1 billion, with more tied to the success of an early-stage immunology drug, and pitched the deal as more than Ayvakit: a pipeline and a precision-medicine discovery engine. “We are excited to welcome Blueprint’s talented people,” then-CEO Paul Hudson said. About a year later, Blueprint’s CEO, chief scientific officer and chief commercial officer have moved on. In August 2026, Sanofi filed notices to cut 229 Blueprint roles, roughly a third of the pre-deal workforce, and to close Blueprint’s former Cambridge headquarters. At Ablynx, the first significant cuts came six years after close, as part of a broader Sanofi restructuring. At Blueprint, they came in about one, and they targeted Blueprint’s own sites.
The departures alone aren’t the problem; Ablynx lost its CEO too. The question is whether Sanofi has put the same deliberate leadership and integration plan in place this time.
Some consolidation after any acquisition is rational. A new CEO is reshaping Sanofi, and Blueprint’s elenestinib is still advancing in Phase 3. Ayvakit may keep the deal looking defensible for years. But it raises the question every acquirer should answer before signing: if you pay a platform premium, what is your plan for the people who make it a platform? Whether Sanofi bought the engine or just the car will not be clear until the results of the early pipeline are known.
Same company, two very different starting points. If the outcomes diverge, the difference will not be culture or science. It will be whether leadership was treated as a deliberate decision or a downstream consequence.
Five Questions Every Board Should Ask
As deal activity accelerates, boards should hold integration and talent to the same discipline they apply to strategic and financial diligence:
- Is the current leadership team built for transformation, and who will lead the integration and the combined organization?
- What capabilities will the combined organization require, and where do we need to bring in outside talent to drive the integration and lead the combined team?
- Which individuals are essential to retaining value?
- Can leaders operate effectively across cultures and geographies?
- What does success look like in 12, 24 and 36 months, not just the first 100 days?
The Next Competitive Advantage
The companies that create the greatest shareholder value in the coming M&A cycle may not be those that complete the largest transactions. They will be the ones that treat every acquisition as what it ultimately is: a leadership event.
The science may justify the deal.
The financial model may support it.
The strategic rationale may convince investors.
Leadership decides whether any of it is realized.