Validating Fusion Pharmaceuticals Inc.’s radiopharmaceutical technology and manufacturing capabilities, Astrazeneca plc offered to buy the firm for $2 billion up front in cash, plus a contingent value right that could raise the total deal value by another $400 million.

Advanced Medical Solutions Group plc (AMS) signed an agreement to buy Peters Surgical SAS for up to €141.4 million (US$154.6 million). The move by AMS for the tissue repair and skin closure manufacturer is part of its strategy to buy assets which will strengthen its product portfolio and broaden its global reach.

Another med-tech acquisition was wiped off the charts after Japan’s Olympus Corp. rescinded the acquisition of South Korean medical device firm Taewoong Medical Co. Ltd. on March 7, after finding “data integrity issues” related to Taewoong’s products.

In a move to build up its dominance in the radiopharma market, Telix Pharmaceuticals Ltd. said it plans to acquire radioisotope production technology firm Artms Inc. and its advanced cyclotron-based isotope production platform, manufacturing plant and stockpile of ultra-pure rare metals.

Despite a slowdown in the fourth quarter (Q4), med-tech deals concluded the year with the highest deal-value total in BioWorld MedTech’s records. In 2023, a total of $10.63 billion was raised from deals, a 33% increase over the $7.99 billion deal total in 2022. Meanwhile, annual M&A value dropped 58%, from $153.09 billion in 2022 to $64.8 billion in 2023.

The slow pace of financing in med-tech appears to have stimulated cardiac arrhythmia technology developer Adagio Medical Inc. to turn to a special purpose acquisition company (SPAC) in a type of deal that has all but vanished in the last year. The company signed an agreement with Arya Sciences Acquisition Corp. IV to combine in a reverse merger deal that will result in Adagio’s listing on Nasdaq under “ADGM.”

Boston Scientific Corp. agreed to acquire neurostimulation company Axonics Inc. for $71 per share or $3.7 billion in total. Axonics focuses on stimulation of the sacral neve to treat overactive bladder and bowel dysfunction. It also offers a bulking agent to address stress urinary incontinence in women. The deal is expected to close in the first half of 2024, pending approval of stockholders and regulators.

Two big pharma firms placed high offers on Dec. 26 to acquire companies focused on radiopharmaceuticals and cell therapies in what Evercore ISI analysts are calling a “good sign for the end of the year.”

Echoing trends seen last year, the med-tech industry concluded 2023 with a continued surge in deal value juxtaposed against a more substantial decline in M&A value. Deal value for the year, including licensings, collaborations and joint ventures, reached $10.63 billion from 1,656 deals, the highest annual value in BioWorld’s records.