Novo Nordisk buys Akero for $5.2B to lead the MASH drug race

Novo Nordisk is acquiring Akero Therapeutics for up to $5.2 billion, targeting a late-phase drug for MASH (metabolic dysfunction-associated steatohepatitis).

Why it matters: The deal positions Novo as a frontrunner in the fast-growing MASH market, a space with blockbuster potential and intense pharma competition.

Backstory: Akero’s Phase 2 data of efruxifermin (EFX), published in February, was described as “transformational” and doubled the company's stock price. Roche responded by acquiring rival 89bio for up to $3.5 billion last month. Novo is now paying $4.7B upfront for Akero, a 19% premium, and a $500M milestone based on US approval of EFX for cirrhosis caused by MASH.

Big picture: Novo aims to pair EFX with its obesity drug Wegovy, recently approved for MASH, to broaden its metabolic disease portfolio. The MASH market is heating up, with approved drugs like Madrigal’s Rezdiffra and new players like Roche entering the fray.

What’s next: EFX is in phase 3 trials, with data expected in early 2026. The full $5.2B deal hinges on FDA approval by mid-2031 and Novo’s new CEO, Mike Doustdar, sees EFX as a future “cornerstone therapy.” A lot is at stake in this race, as Madrigal’s Rezdiffra, the first FDA-approved MASH drug, earned $350M in its first six months.