In a deal that could reach nearly $2 billion, Jiangsu Hengrui Pharmaceuticals Co. Ltd. has licensed a small molecule for treating cardiovascular disease to Merck & Co. Inc., dropping the China-based company into a space with lots of competitors in varying stages of development.

The obesity market is driving pharma’s return on investment (ROI) upward, with the projected return rising to 5.9% overall in 2024, but only reaching 3.8% if GLP-1 assets are excluded. At the same time, the average cost of developing a drug continues to rise and now stands at $2.23 billion, compared to $2.12 billion in 2023, according to Deloitte’s 15th annual analysis of the ROI from pharmaceutical innovation.

Astrazeneca plc is investing heavily in China, signing two R&D deals, worth up to about $8 billion in up-front payments and milestones combined, with Chinese companies Harbour Biomed Ltd. and Syneron Bio, establishing a joint venture with Shenzhen Kangtai Biological Products Co. (Biokangtai) for vaccines, and creating a new R&D center in Beijing through another $2.5 billion investment.

Building upon its already impressive obesity drug portfolio, Novo Nordisk A/S has licensed a triple agonist of the receptors for GLP-1, GIP and glucagon from United Biotechnology Co. Ltd. China-based United is getting $200 million up front and the chance to earn up to $1.8 billion in milestone payments. United Biotechnology retains the rights to subcutaneously administered UBT-251, which is in the early stages of development for treating obesity, type 2 diabetes and other diseases, in China, Hong Kong, Macau and Taiwan while Bagsværd, Denmark-headquartered Novo get exclusive rights to develop, manufacture and commercialize the triple agonist receptor across the rest of the world.

Alcon AG plans to acquire Lensar Inc. for up to $430 million in a transaction expected to close in the latter half of the year. The acquisition will add Lensar’s Ally robotic cataract laser treatment system, Streamline software technology and Lensar legacy laser system to Alcon’s cataract surgery portfolio and expand global access to Lensar’s femtosecond laser technology.

Sanofi SA is getting deeper into oncology and immunology therapy development through buying Dren Bio Inc.’s myeloid cell engager for deep B-cell depletion, DR-0201. The deal could reach as high as $1.9 billion for privately held Dren. Sanofi is paying a hefty $600 million up front, and milestone payments to come could add up to $1.3 billion.

Oxford Biotherapeutics Ltd. is partnering with Roche AG to expand the current field of tumor antigens that can be drugged with antibodies, as part of a potential $1 billion-plus agreement. The agreement will see Oxford Biotherapeutics apply its membrane protein discovery platform to search for novel cancer cell antigens, which will be validated through the research collaboration, with Roche then taking the lead in advancing any resulting antibody programs.

The antibody-drug conjugate (ADC) juggernaut powers on, with Japan’s Taiho Pharmaceutical Co. set to acquire Araris Biotech AG for up to $1.14 billion. Of that, $400 million will be up front, with the remainder tied to milestones with a maximum value of $740 million, around the progress of three ADCs for treating solid and hematological cancers.