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.

Before hunting for acquisitions, the internal business owner (deal sponsor) must write a thesis answering "what problem are we solving?" This prevents reactive M&A driven by inbound opportunities and ensures strategic alignment from the start, separating the "why" from the "who."

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.

Combining strategy, M&A, and integration under a single leader provides a full lifecycle, enterprise-wide view. This structure breaks down silos and creates a "closed-loop system" where post-deal integration performance and lessons learned directly feed back into future strategy and deal theses, refining success metrics beyond financials.

Acquiring smaller companies at a 5-6x EBITDA multiple and integrating them to reach a larger scale allows you to sell the combined entity at a 10-12x multiple. This multiple expansion is a powerful, often overlooked financial driver of M&A strategies, creating value almost overnight.

Framing M&A like a marriage, rather than a transaction, fosters a long-term perspective. Sourcing is dating to find value alignment, the Letter of Intent is the engagement, and post-close integration is the marriage itself—the phase where the real, hard work of building a successful union begins.

The biotech ecosystem is a continuous conveyor belt from seed funding to IPO, culminating in acquisition by large biopharma. The recent industry-wide stall wasn't a failure of science, but a halt in M&A activity that backed up the entire system.

When acquiring a business, don't rely on a single outcome like achieving a growth target. Instead, seek assets that offer multiple ways to win. Even if the primary goal is missed, the acquired data, technology, or talent could create significant value for other business units, providing built-in insurance for the deal.

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.