BridgeBio's founder saw biotech VCs exclusively funding high-risk "home run" platforms. He built a company to acquire therapies for smaller rare genetic diseases—"singles and doubles"—that were ignored. Aggregating these de-risks the portfolio and creates a major market opportunity.

A third of small-to-mid-cap biotech firms are becoming profitable, with cash reserves projected to soar from $15B in 2025 to over $130B by 2030. This financial strength, combined with large-cap patent expirations, positions them not just as acquisition targets but as potential players in the M&A landscape themselves.

Large pharmaceutical companies face losing up to 50% of their revenues by 2030 due to the largest patent expiration wave in history. To survive, they will be forced to acquire innovation from the biotechnology sector, fueling a sustained M&A cycle for years to come.

After years of focusing on de-risked late-stage products, the M&A market is showing a renewed appetite for risk. Recent large deals for early-stage and platform companies signal a return to an era where buyers gamble on foundational science.

While known for late-stage acquisitions, Mirum strategically uses smaller deals for early-stage assets to expand its capabilities. The Anthoran Therapeutics deal serves as a model: a low upfront payment with a back-ended structure allows Mirum to enter early-phase development—a new area for the company—while managing financial risk.

Mirum's acquisition strategy targets late-stage assets like berlovitug that can leverage its established global commercial operations. This approach maximizes efficiency, as new products fit into the existing sales structure supporting its current portfolio, especially in the adult hepatology space, making the acquisition highly strategic.

In the rare disease space, success hinges on deep patient community engagement. Smaller, nimbler biotechs often excel at creating these essential personal ties, giving them a significant advantage over larger pharmaceutical companies.

The M&A landscape is evolving beyond Big Pharma's patent cliff-driven acquisitions. Mid-to-large biotechs like BioMarin, Insight, and Ionis are now positioned as buyers, creating a richer, more diverse deal-making ecosystem.

The current biotech M&A boom is less about frantically plugging near-term patent cliff gaps (e.g., 2026-2027) and more about building long-term, strategic franchises. This forward-looking approach allows big pharma to acquire earlier-stage platforms and assets, signaling a healthier, more sustainable M&A environment.