Eli Lilly's Top Dealmaker: "Don't Be Surprised" to See More M&A That Pushes Lilly Into New Areas
Lilly just spent over $20 billion on acquisitions in 2026. And its top dealmaker says they're just getting started.
Here's what's happening, and why you should care.
The Big Statement
"Don't be surprised to see more M&A that pushes Lilly into new areas."
That's not a rumor. It's not a leak from an anonymous "person familiar with the matter."
It came straight from Jacob Van Naarden, Eli Lilly's head of corporate development and oncology, speaking at the American Society of Clinical Oncology's annual meeting.
And here's why that matters beyond the headline:
Lilly is no longer just the GLP-1 company that makes Mounjaro and Zepbound. It's turning into something much bigger, a diversified pharmaceutical powerhouse that's aggressively expanding into oncology, neuroscience, immunology, and even vaccines.
Think of it like a tech giant reinvesting profits from a hit product into building an entire ecosystem. Amazon used e-commerce profits to build AWS. Apple used iPhone profits to build services and wearables.
Eli Lilly is doing the pharmaceutical version of that right now.
Who Is Jacob Van Naarden?
You'll probably see his name a lot in the coming months.
Van Naarden runs Lilly's oncology business and recently became head of corporate development, a dual role that puts him at the center of Lilly's most ambitious expansion in decades.
He's not just a dealmaker. He's the guy who helped integrate Loxo Oncology after Lilly's $8 billion acquisition in 2019. He knows what makes a good deal work, not just on paper, but in the lab and at the bedside.
His boss, CEO Dave Ricks, approached him last fall about sharpening Lilly's dealmaking skills and widening its "aperture" beyond the small, early-stage bets where Lilly traditionally focused.
Van Naarden started executing the strategy almost immediately.
Here's what he said at a recent conference, and this line tells you everything about his mindset:
"We are making more offers than you can possibly imagine. What's interesting is how many of the multibillion dollar deals we are attempting to do and getting rebuffed with some frequency."
Translation: They're hungry. And they're swinging for the fences. ⚾
By The Numbers: Lilly's 2026 Deal Spree
Let's look at the raw numbers, because they're genuinely staggering.
Not even halfway through 2026, Lilly has already announced it will spend:
- More than $10 billion upfront
- Potentially up to $25 billion including milestone payments
- Eight acquisitions in total
Compare that to all of last year: Lilly spent about $4 billion on roughly 40 deals.
The difference isn't just in dollars, it's in strategy.
Previously, Lilly liked to place small bets on early-stage assets. Cheap because they were risky. Now, armed with GLP-1 cash, they're pursuing experimental drugs that are more likely to work — and carrying bigger price tags because of it.
"These things are medicines," Van Naarden said in a separate interview at his Stamford, Connecticut office. "You can see enough to say OK, this is real, and we can underwrite paying a bigger price than we pay for some preclinical thing."
That's a fundamental shift in how Lilly thinks about capital allocation.
Where Is All The Cash Coming From?
Simple answer: Mounjaro and Zepbound.
In Q1 2026 alone, these two drugs combined for $12.8 billion in global revenue. Lilly's total Q1 revenue hit $19.8 billion, up 56% year over year. Adjusted EPS came in at $8.55 against a $6.79 estimate.
That's not growth. That's a launch pad.
Lilly's market capitalization now stands at about $1 trillion, up from $190 billion in 2021. It's the first healthcare company to join the trillion-dollar club, which is otherwise dominated by tech giants like Apple, Microsoft, and Nvidia.
Van Naarden called it a "generational opportunity" to redeploy that capital across all of Lilly's disease areas, not just to fuel company growth, but to help patients with all different kinds of diseases.
(And yes, that's a genuine sentiment, not just corporate-speak. I'll show you why in a minute.)
Breaking Down The Big Deals
Let's walk through the most significant acquisitions Lilly has announced in 2026. This is where strategy meets reality.
Kelonia Therapeutics, Up to $7B
Lilly agreed to acquire Kelonia in April for $3.25 billion upfront, with the remaining payments contingent upon clinical and regulatory milestones.
Kelonia is developing in vivo CAR-T cell therapy — a next-generation cancer treatment that works inside a patient's body. Traditional CAR-T requires extracting a patient's cells, genetically modifying them in a lab, and reinfusing them. In vivo CAR-T skips all that.
This is Lilly's second in vivo CAR-T acquisition after purchasing Orna Therapeutics for up to $2.4 billion in February. They're doubling down on this technology.
Centessa Pharmaceuticals, Up to $6.1B
Centessa focuses on neuroscience, specifically narcolepsy and other sleep disorders. Lilly is clearly signaling that neuroscience is a major priority, alongside oncology.
Three Vaccine Developers, $3.8B
In a surprise move, Lilly agreed to acquire Curevo, LimmaTech Biologics, and Vaccine Company, marking a renewed push into infectious disease prevention.
Lilly had largely sidelined infectious disease in recent years. These deals signal that's changing.
Citi analyst Geoffrey Meacham noted that each vaccine target highlights viral pathogens linked to long-term neurological and oncology risks, which are in-line with Lilly's existing interests.
Side note: This move is happening while Robert F. Kennedy Jr., a longtime vaccine critic, leads the US Department of Health and Human Services. That's a fascinating backdrop that adds political complexity, but Lilly seems undeterred.
Orna Therapeutics, $2.4B
Orna uses engineered circular RNA to develop in vivo CAR-T therapies targeting autoimmune diseases and cancers. This is another bet on the same technological frontier as Kelonia, just from a different angle.
Ventyx Biosciences, Up to $1.1B
Ventyx focuses on inflammatory diseases. Immunology is one of Lilly's three priority expansion areas, alongside oncology and neuroscience.
And more...
- Ajax Therapeutics — terms not fully disclosed, but announced in Q1 2026
- CrossBridge Bio — $300 million acquisition in April
- Scorpion Therapeutics' cancer program — up to $2.5 billion (announced January 2025)
- Seamless Therapeutics — $1.1 billion deal for gene therapies targeting hearing loss
Van Naarden's team evaluates "at least" 10 potential deals per week.
Let that sink in.
The Big Why: Avoiding The "One-Hit Wonder" Trap
Now let's talk about why Lilly is doing all this. Because it's not just "we have cash, let's spend it."
There's a deeper strategic rationale, and it starts with a painful lesson from Lilly's own history.
The Prozac Lesson
In the early 2000s, Lilly lost patent protection on Prozac, its blockbuster depression drug. The result? A decade-long tailspin as the company struggled to find its footing.
CEO Dave Ricks, a Lilly veteran who took the helm in 2017, lived through that. He knows what happens when a pharma company relies too heavily on one product.
Lilly still has about a decade of patent protection left on Mounjaro and Zepbound. But Ricks and his team are not resting on their laurels. They've seen this movie before. They know how it ends if you don't prepare.
The Industry-Wide Patent Cliff
It's not just Lilly. The entire pharmaceutical industry faces a $300 billion+ patent cliff by 2030, with an estimated $150 billion at risk by 2027 alone.
Merck's Keytruda, which makes up more than half of Merck's revenue, loses exclusivity soon. The pain is coming for almost everyone.
Lilly is fortunate. Its patent cliff is further out. But that's exactly why they're acting now, from a position of strength rather than desperation.
"We have this really like almost generational opportunity to redeploy that capital in all of our disease areas to not only fuel growth for the company in the decades to come, but to help a lot more patients." — Jacob Van Naarden
That's the difference between reactive M&A (Pfizer after the COVID cliff) and proactive M&A (Lilly right now).
Where Is Lilly Going Next?
Van Naarden made one thing crystal clear: "Nothing is off the table".
But three therapeutic areas are clearly prioritized:
1. Oncology
Lilly's second-largest therapeutic area, generating $9.4 billion in 2025 sales. The Kelonia, Orna, and Scorpion deals all feed into this. Oncology remains the top M&A target across pharma in 2026, with upfront payments totaling ~$25.4 billion so far.
2. Neuroscience
Alzheimer's (Kisunla), sleep disorders (Centessa), and new pipeline exploration. Lilly recently split its BioMedicines division into two units, Lilly Neuroscience and Lilly Immunology, signaling these are standalone priorities.
3. Immunology
Omvoh earned a new Crohn's disease indication in 2025. The Ventyx acquisition ($1.2B) adds inflammatory disease assets. Autoimmune diseases saw ~$12.7 billion in upfront M&A payments in 2026 so far, a fast-rising category.
Genetic Medicine
Here's a number that surprised me: About one-third of Lilly's pipeline is now genetic medicines.
Most are still early-stage. But Lilly is making aggressive bets here, including gene therapies for hearing loss, in areas that other drugmakers have abandoned due to high costs and uncertain sales prospects.
That's either visionary or reckless. Time will tell.
Industry Context: The 2026 M&A Boom
Lilly isn't alone in this buying spree.
Global pharma M&A upfront payments hit over $64 billion in the first four months of 2026, up from $24.5 billion in the same period of 2025.
The number of deals jumped from 14 to 24 year over year.
Gilead has been nearly as aggressive, with acquisitions focused on cancer and autoimmune diseases. Merck, Biogen, and others are also active.
EY's report found M&A spending increased by 81% in 2025, and dealmakers are positioned to go even further in 2026.
This isn't a Lilly story. It's an industry story. Lilly just happens to have the best seat at the table.
Risks To Watch
Let me be balanced here. This strategy isn't without risks.
Integration complexity
Eight major acquisitions in six months. Integrating that many companies, each with their own culture, systems, and people, is brutally hard. Pharma has a long history of failed integrations.
Valuation risk
Van Naarden himself admitted they're getting "rebuffed with some frequency" on multibillion-dollar deals. That suggests intense competition and potentially inflated valuations.
GLP-1 longevity
Mounjaro and Zepbound are the engine. If competition intensifies faster than expected (Novo Nordisk is not standing still), or if pricing pressure accelerates, the cash flow that funds this M&A could shrink.
Clinical failure
Many of these acquisitions are for experimental drugs that haven't completed large-scale clinical studies. Some will fail. That's just how biotech works. The question is whether Lilly's hit rate justifies the premium prices they're paying.
Investor Takeaway
If you own Lilly stock, or are considering it, here's what this M&A strategy means for you:
- Short term: Expect continued headline risk as more deals are announced. Investors may react to individual deal premiums, but the broader strategy is what matters.
- Medium term: Watch for clinical readouts from acquired assets. The Kelonia and Orna in vivo CAR-T programs are particularly important.
- Long term: This is a bet that Lilly can successfully transition from a GLP-1 company to a diversified pharma leader. The Prozac lesson suggests they're moving at exactly the right time.
Lilly's M&A strategy is offensive, not defensive. They're not scrambling to fill a patent hole. They're using their GLP-1 windfall to build for the next decade.
That's a very different, and arguably more attractive, position than most of their peers.
Jacob Van Naarden said "don't be surprised" to see more M&A that pushes Lilly into new areas.
He wasn't exaggerating.
Lilly has already announced over $20 billion in acquisitions in 2026, from in vivo CAR-T cancer therapies to Alzheimer's drugs to shingles vaccines.
The company has a generational opportunity to redeploy its GLP-1 cash into building a more diversified, more resilient, and ultimately more valuable pharmaceutical company.
Whether they succeed depends on execution. But the strategy is clear:
Lilly is no longer just the weight-loss drug company.
It's becoming something much bigger.
And according to its top dealmaker, we haven't seen anything yet.
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