Copenhagen, Oct. 10, 2025 — Novo Nordisk announced on Thursday that it will acquire Akero Therapeutics for up to $5.2 billion in a deal aimed at strengthening its pipeline of metabolic and liver disease treatments. The acquisition marks the first major strategic move by Chief Executive Officer Mike Doustdar, who assumed leadership in July.
Under the terms of the agreement, Akero shareholders will receive $54 per share in cash at closing, with an additional $6 per share as a contingent value right (CVR). The CVR payment depends on U.S. regulatory approval of Akero’s lead candidate, efruxifermin (EFX), by June 30, 2031.
If all milestones are met, the transaction would value Akero at $5.2 billion, representing a 57% premium to its stock price before reports of the deal surfaced. Shares of Akero Therapeutics rose nearly 18% in premarket trading following the announcement.
Focus on a promising liver drug
Akero Therapeutics, based in South San Francisco, has developed EFX, a once-weekly injectable therapy in late-stage clinical trials for treating metabolic dysfunction-associated steatohepatitis (MASH). Formerly known as nonalcoholic steatohepatitis (NASH), MASH is a severe liver condition characterized by inflammation and fibrosis and can lead to cirrhosis and other serious complications.
EFX mimics the natural protein FGF21, which helps regulate metabolism. In clinical studies, EFX has shown promise in reversing liver fibrosis, resolving MASH, and improving metabolic markers linked to cardiovascular health. The drug is being tested under Akero’s SYNCHRONY program, which includes multiple Phase 3 trials involving more than 3,000 patients.
“MASH is one of the fastest-growing liver diseases worldwide, and EFX has shown meaningful potential to change how it’s treated,” Doustdar said in a statement. “This acquisition reinforces our commitment to addressing interconnected metabolic conditions such as obesity, diabetes, and liver disease.”
Strategic shift for Novo Nordisk
Novo Nordisk, headquartered in Denmark, has built its global dominance through diabetes and obesity drugs, including its best-selling product Wegovy. However, as competition intensifies—particularly from Eli Lilly—the company has been seeking new avenues for growth. The Akero deal signals an expansion into adjacent therapeutic areas with strong metabolic links.
Industry analysts said the move aligns with Novo Nordisk’s strategy to extend its leadership in chronic disease management. “This is a logical step for Novo,” said Per Hansen, an analyst with Nordnet. “The company is staying within its core metabolic expertise rather than diversifying too broadly.”
Still, some investors expressed concern about the price tag. Novo’s shares fell about 2% in early trading on the Copenhagen exchange after the announcement. Analysts said the acquisition, though expensive, could pay off if EFX becomes the first widely approved treatment for MASH.
Deal structure and financial advisors
According to the companies, Akero Therapeutics shareholders will receive approximately $4.7 billion upfront, with the potential for another $500 million contingent on regulatory success. The boards of both firms have unanimously approved the agreement.
The acquisition is expected to close by the end of 2025, pending shareholder and regulatory approvals. Akero is being advised by Morgan Stanley and J.P. Morgan, with legal counsel from Kirkland & Ellis LLP. Novo Nordisk’s advisors were not disclosed.
Broader implications for the market
The deal represents Novo Nordisk’s largest acquisition to date and underscores the growing race among pharmaceutical firms to dominate the emerging market for metabolic and liver diseases. It follows smaller transactions earlier this year, including Novo’s $1.1 billion acquisition of Cardior Pharmaceuticals.
If successful, EFX could complement Novo’s existing obesity drugs and create combination therapies that address multiple aspects of metabolic dysfunction. This integrated approach may help Novo retain its lead in an increasingly competitive global market.
Akero’s integration is expected to accelerate the late-stage development and potential commercialization of EFX. “We are proud of the progress our team has made,” Akero CEO Andrew Cheng said. “Joining Novo Nordisk provides the resources and scale needed to bring EFX to patients faster.”
As regulatory review proceeds, investors and patients alike will be watching whether EFX can deliver on its promise. The acquisition highlights both the high cost and high potential of the next wave of chronic disease treatments.
If approved, EFX could become one of the first breakthrough therapies for MASH—a condition affecting millions worldwide—and a cornerstone of Novo Nordisk’s future growth strategy.
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