Novo Nordisk A/S ( NVO ) agreed on Thursday to acquire Akero Therapeutics, Inc. ( AKRO ) focused on metabolic diseases.

Transaction terms

Novo Nordisk ( NVO ) will pay $54 per share in cash (or an aggregated value of $4.7 billion) at closing.

In addition, Akero shareholders will receive a non-transferable CVR entitling holders to a potential additional payment of $6 per share in cash (or an aggregated value of $0.5 billion) upon U.S. regulatory approval of EFX for the treatment of compensated cirrhosis due to MASH.

Strategic And Portfolio Fit

The acquisition reflects Novo Nordisk's ( NVO ) long-term strategy to develop innovative and differentiated medicines for diabetes, obesity and associated comorbidities.

Akero's fibroblast growth factor 21 (FGF21) analog efruxifermin (EFX) is a potentially best-in-class treatment for metabolic dysfunction-associated steatohepatitis (MASH).

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EFX is being evaluated as a once-weekly subcutaneous injection in the phase 3 SYNCHRONY program, which consists of three clinical trials designed to support regulatory approval for the treatment of pre-cirrhotic (F2-F3) MASH and compensated cirrhosis (F4) due to MASH.

The phase 3 program builds on two 96-week phase 2b trials, in which EFX has been observed to significantly improve liver fibrosis and reverse compensated cirrhosis due to MASH.

Over 96 weeks, the HARMONY (F2-F3) and SYMMETRY (F4) trial demonstrated 49% and 29% reduction in fibrosis without worsening of MASH, respectively, compared to 19% and 11% in the respective placebo groups.

Financial implications

The transaction is not expected to impact Novo Nordisk's ( NVO ) previously communicated operating profit outlook for 2025.

The free cash flow outlook for 2025 is expected to be negatively impacted by approximately $4 billion, reflecting the expected enterprise value. The implied 2025 free cash flow outlook is therefore 9-19 billion Danish kroner, depending on the timing of closing.

For 2026, the acquisition is expected to lead to increased research and development costs, with an estimated negative impact on full-year operating profit growth in 2026 of around three percentage points. The transaction will be mainly debt-financed.

Price Action: AKRO stock is up 17.64% at $54.69 during the premarket session at the last check on Thursday.

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